American Academy of Pediatrics will review treatment guidelines for transgender minors


NeuroTypical
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Back in 2018, the American Academy of Pediatrics issued it's first policy statement, it urged clinicians use a nonjudgmental approach where the clinician supported the child's professed gender identity.  Youth should, the policy recommended, have "access to comprehensive gender-affirming and developmentally appropriate health care".    

Now, according to the Wall Street Journal, they're going to conduct a systematic evidence review and might amend it's policy based on the results.

The exact scope of the review has yet to be determined, but is expected to include an evaluation of medical interventions such as puberty blockers and hormones, which are in some cases used to delay puberty or boost physical features associated with a gender different from the patient’s sex at birth. 
 
The process, known as a systematic evidence review, typically looks at all relevant evidence behind any given treatment, adjusting for bias and other potential flaws. It will be conducted by an external organization, the AAP said. 
 
Its goal will seek to confirm best practices for treatments of transgender youth, adolescents and young adults, the AAP said. The association’s board, voting in its headquarters in the Chicago area, approved the external review on Thursday afternoon.

When systematic evidence reviews were conducted in the U.K., Sweden, Finland, Norway, and France, the result in all those countries was to urge more caution with medical interventions, noting there simply wasn't enough evidence to support the notion that benefits outweigh the risks.  The US became an outlier with it's policy to "provide medical, even surgical, support to whatever the minor says about themselves".

I'm cautiously optimistic that a systematic review of available evidence will result in better, more soundly evidence-based, guidelines.  

And as I wander around the internet, I'm offering to bet ten bucks that they end up revising their policies in a "use more caution before supporting medically or surgically" direction.   Because helping a 16 yr old girl chop off her own breasts, without any preconditions like psychotherapy or an awful lot of diagnostic rigor, just because she feels like a boy, is one of the most idiotic things the human race has ever run with since they awarded the Nobel Peace prize to the guy who invented the frontal lobotomy

 

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1 hour ago, NeuroTypical said:

I'm cautiously optimistic that a systematic review of available evidence will result in better, more soundly evidence-based, guidelines.  

It would be wonderful to be so optimistic.  But the pattern in the past several years has been that every time some European country discovers "Hey, maybe we went too far with this,"  the US keeps plowing ahead and ignoring other countries' findings.  When has the US (government or governing medical bodies) ever done anything different?

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2 hours ago, Carborendum said:

It would be wonderful to be so optimistic.  But the pattern in the past several years has been that every time some European country discovers "Hey, maybe we went too far with this,"  the US keeps plowing ahead and ignoring other countries' findings.  When has the US (government or governing medical bodies) ever done anything different?

If memory serves, the same week that the US government said that the Covid vaccines were perfectly safe for minors, five European countries ordered that the Moderna vaccine *not* be given to minors until they were able to fully investigate claims that the vaccine was causing cardiovascular complications in teenage boys. 

Cue people wondering which set of experts to trust on this one. 

Making matters worse is that when all of this was going on, a rather controversial TV show was airing in Japan that was premised on the aftermath of man-hating female scientists unleashing a disease that was genetically engineered to wipe out men as a gender. Given that this was on peoples' radar at the time, you had a few folks noting how it was only teenage boys who were suffering complications and not teenage girls and thus going into "conspiracy theory" mode. 

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4 hours ago, NeuroTypical said:

 

Back in 2018, the American Academy of Pediatrics issued it's first policy statement, it urged clinicians use a nonjudgmental approach where the clinician supported the child's professed gender identity.  Youth should, the policy recommended, have "access to comprehensive gender-affirming and developmentally appropriate health care".    

Now, according to the Wall Street Journal, they're going to conduct a systematic evidence review and might amend it's policy based on the results.

The exact scope of the review has yet to be determined, but is expected to include an evaluation of medical interventions such as puberty blockers and hormones, which are in some cases used to delay puberty or boost physical features associated with a gender different from the patient’s sex at birth. 
 
The process, known as a systematic evidence review, typically looks at all relevant evidence behind any given treatment, adjusting for bias and other potential flaws. It will be conducted by an external organization, the AAP said. 
 
Its goal will seek to confirm best practices for treatments of transgender youth, adolescents and young adults, the AAP said. The association’s board, voting in its headquarters in the Chicago area, approved the external review on Thursday afternoon.

When systematic evidence reviews were conducted in the U.K., Sweden, Finland, Norway, and France, the result in all those countries was to urge more caution with medical interventions, noting there simply wasn't enough evidence to support the notion that benefits outweigh the risks.  The US became an outlier with it's policy to "provide medical, even surgical, support to whatever the minor says about themselves".

I'm cautiously optimistic that a systematic review of available evidence will result in better, more soundly evidence-based, guidelines.  

And as I wander around the internet, I'm offering to bet ten bucks that they end up revising their policies in a "use more caution before supporting medically or surgically" direction.   Because helping a 16 yr old girl chop off her own breasts, without any preconditions like psychotherapy or an awful lot of diagnostic rigor, just because she feels like a boy, is one of the most idiotic things the human race has ever run with since they awarded the Nobel Peace prize to the guy who invented the frontal lobotomy

 

A big part of what's going on is that people are noticing the overlap between "autism spectrum" and "gender dysphoria". 

It's now suspected, especially after some controversial studies coming out of places like Canada, that a considerable number of individuals who are being steered towards gender reassignment are in fact individuals who actually need counseling to either deal with autism-related issues causing them to not feel comfortable in their own skin, an inability to process same-sex attraction, or both. 

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11 hours ago, mikbone said:

Guess how many level one studies there are for performing surgery or giving hormone therapy to transgender patients.

In the US or in other countries?  Hint: I have no idea on either count.

11 hours ago, mikbone said:

I think it is a positive indicator that they are considering the review.  

Well, it would help if you answered your own question since most of us are not in tune enough with the medical industry to be able to answer the question.

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1 hour ago, Carborendum said:

In the US or in other countries?  Hint: I have no idea on either count.

Well, it would help if you answered your own question since most of us are not in tune enough with the medical industry to be able to answer the question.

It is extremely difficult to get patients or approval for level one studies on children or pregnant women concerning controversial procedures or medications.  I suspect zero.  Not willing to do the research though.

 

At least one person on the committee is weary and voice full about the current policy and  they don’t want to be seen as late comers to the game when other countries have started changing policy.

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2 hours ago, mikbone said:

It is extremely difficult to get patients or approval for level one studies on children or pregnant women concerning controversial procedures or medications.  I suspect zero.  Not willing to do the research though.

 

At least one person on the committee is weary and voice full about the current policy and  they don’t want to be seen as late comers to the game when other countries have started changing policy.

This is the freaking smoking gun on all transgender medical practices.  Yet no one in the public eye has even mentioned this?  I would think that at the very least Rand Paul would have asked about this.  But at least we have this:

 

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