United Kingdom’s ban on puberty blockers for children is not a culture war but a safety matter

Yet again, Australia’s health ministers and officials have been warned about puberty blockers, the drugs given to minors who reject their birth sex and want the “wrong puberty” to be chemically suppressed.

The typical response from our gender medicine lobby, and their social justice backers in politics, is that any scepticism about standards of evidence and safety is somehow right-wing bigotry.

But the latest wake-up call is the decision to impose an indefinite ban on puberty blockers announced by the UK’s Labour government under Health Secretary Wes Streeting, who happens to be gay. And of course, Streeting – like those in Australia critical of puberty blockers – is concerned about the welfare of vulnerable young people.

This is not a culture war. The endocrine systems of minors know no politics.

“The Cass review [into paediatric gender medicine] made clear that there is not enough evidence about the long-term effects of using puberty blockers to treat gender incongruence [also called gender dysphoria] to know whether they are safe or beneficial,” Streeting said in the UK House of Commons.

“That evidence should have been established before they were ever prescribed for this purpose.

“It is a scandal that medicine was given to vulnerable young children without the proof that it is safe or effective or through the rigorous safeguards of a clinical trial.”

Adolescence, normally, is a time of rapid gains in bone density, setting the body up for a healthy adult life, and important change and development in the brain that continues at least until age 25.

Britain's Secretary of State for Health and Social Care, Wes Streeting. Picture: Getty Images
Britain’s Secretary of State for Health and Social Care, Wes Streeting. Picture: Getty Images

Puberty blockers suppress the natural sex hormones that play a part in this crucial development.

Talk of blockers being “fully reversible” strains credulity. There is no such thing as the wrong puberty, or a person born in the wrong body.

Hence Streeting’s statement, “We do not yet know the risks of stopping pubertal hormones at this critical life stage. That is the basis upon which I am making decisions. I am treading cautiously in this area, because the safety of children must come first.”

Puberty blockers have been the drivers of the unprecedented international surge in young people, predominantly teenage females, identifying out of their birth sex and seeking medicalised “affirmation” of a transgender or non-binary identity.

Their distress is real, but there are often pre-existing issues other than gender that may better explain what they are going through. These underlying difficulties include mental health disorders, autism, ADHD, abuse, trauma and awkward same-sex attraction.

After April’s final report from the UK Cass review – the world’s most comprehensive inquiry into the care of young people with gender distress – it should be beyond argument that the gender medicalisation of minors has no solid evidence base to justify such life-altering interventions.

Systematic evidence reviews – the gold standard for evaluating healthcare – have reached the same sobering conclusion in very different health jurisdictions from Sweden to Florida and the UK.

The evidence is very weak and uncertain. There is no way of knowing with confidence that puberty blockers and cross-sex hormones will be safe and beneficial for minors with gender distress.

Gender clinics in public children’s hospitals in Melbourne, Brisbane, Perth, Sydney and other Australian cities introduced experimental medicine as routine treatment without any high-quality data.

We have listened as health ministers and bureaucrats dismiss the relevance of the Cass review with talking points from the local gender medicine lobby. We were told that unlike the London-based Tavistock clinic, whose shortcomings led to Baroness Hilary Cass’s appointment, our gender clinics are “multidisciplinary”.

In fact, the Tavistock also claimed to be multidisciplinary. And in any case, we haven’t been told how multiplying the number and type of clinicians magically compensates for everybody’s near total ignorance about the safety and effects of the medical interventions.

You will also hear the vague claim that Australia’s gender clinics are more “careful”. Yet the per capita use of puberty blockers in our country appears to be higher than it was in the UK. British people express disbelief when told that in Australia girls as young as 15 have been referred by children’s hospital gender clinics for double mastectomies.

Women’s Forum Australia head of advocacy Stephanie Bastiaan warns Australia is “behind” the rest of the world in gender reforms. There is increasing pressure on Queensland Premier David Crisafulli to reform the state’s gender care laws. “Even America now is making moves in the right direction and New Zealand just a couple of weeks ago announced one of their health regulatory bodies has urged caution on using puberty blockers to treat children,” Mr Bastiaan told Sky News host Rita Panahi. “A review is certainly a first step, but I would be calling for a halt on these medical treatments.”

Baroness Cass commissioned an evaluation of gender medicine treatment guidelines internationally, noted their reassuring talk of “multidisciplinary teams” at work in the gender clinic, but also found in those guidelines a lack of agreement about the very purpose of assessing patients.

Part of the problem is that the dominant “gender-affirming” treatment model is influenced by identity politics. Fear of “pathologising” a trans identity may make clinicians hesitate to use the perfectly ethical psychotherapy needed to seriously consider the role of non-gender factors in a minor’s distress.

Australia’s Health Minister, Mark Butler, should know all this. His officials have briefed him on the fact that the Cass-commissioned guideline evaluation judged Australia’s de facto national treatment guideline to be of low quality, lacking in rigorous development, and not recommended for use. Yet this document, issued by the Royal Children’s Hospital Melbourne, is used across Australia. It has been judged “untrustworthy” by a pioneer of the evidence-based medicine movement, Canada’s Professor Gordon Guyatt.

Butler’s officials have also encouraged him to resurrect an unreliable 2019-20 review by the Royal Australasian College of Physicians (RACP) to fend off persistent calls for a proper Cass-style review in this country. The RACP review was affected by serious conflicts of interest and had nothing to say about the safety of the specific medical interventions. In this tradition of reviews that fail to ask the right questions, we have had recent pseudo-inquiries ordered by the Queensland and NSW governments. In South Australia, independent MP Frank Pangallo almost managed to broker a promising parliamentary inquiry in his state. In the Senate, motions for a gender clinic review put by the One Nation party, have been defeated amid pious but hollow statements about avoiding “culture wars”.

The original culture war was the conversion of former gay rights organisations into LGBTQ lobbies focused on trans-rights activism and the promotion of paediatric gender medicine. This is why, in the UK, the only peak gay group that campaigned against puberty blockers was the LGB Alliance, founded in 2019. Its concern is that potentially same-sex attracted young people are being converted by gender medicine into trans “heterosexuals”.

There is a basis for this fear in historic data from pioneering gender clinics in Amsterdam and London. Older LGB people will often say they recall a period of bodily discomfort growing up and sometimes had thoughts of opposite-sex identification. Today’s young detransitioners, who regret gender medicalisation, include young people who say they have come to accept their same-sex orientation.

Detransitioners, disaffected Democrats, troubled parents of no particular politics and members of LGB Alliance USA were among those who went to Washington, DC, last week to bear witness as the US Supreme Court heard a constitutional challenge to a Republican state ban on paediatric gender medicine. The breadth of the social movement opposed to gender medicalisation of minors is not well understood.

Supreme Court hearing of US v Skrmetti case.
Supreme Court hearing of US v Skrmetti case.

What almost everybody has heard is the “transition or suicide” lever deployed to persuade reluctant parents to agree to medical interventions despite the risks for their children including sterilisation, impaired sexual function, a severely restricted relationships pool and lifelong status as a medical patient. In no other area of healthcare do clinicians talk about suicide risk in such a reckless manner, carrying a real risk of becoming a self-fulfilling prophecy. The studies cited for these alarming claims are low-quality anonymous online surveys of self-selected respondents who are well versed in the suicide narrative. The one robust and specific study, published early this year by Finnish researchers and based on comprehensive health registry data, found that suicide risk is driven by the psychiatric co-morbidities of gender clinic patients, not by their gender distress, and there was no evidence that medical transition reduced suicide risk.

The suicide trope has been used in Australia to frustrate transparency and accountability in paediatric gender medicine. This dates back to 2020, when the RACP advised the then federal health minister Greg Hunt that a national inquiry into gender clinics “would further harm vulnerable patients and their families through increased media and public attention”. This unsupported claim, coming from a medical college conflicted by its history of promoting paediatric gender medicine, has been revived by health officials briefing Mr Butler.

In the UK, members of Mr Streeting’s own Labour Party continue to be among those making irresponsible threats of suicide – on behalf of distressed young people. To his credit, Mr Streeting did not give in to emotional blackmail but commissioned a review by an expert on suicide prevention Professor Louis Appleby, whose report is highly relevant to political and media commentary in Australia.

“The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide,” he said.

“One risk is that young people and their families will be terrified by predictions of suicide as inevitable without puberty blockers – some of the responses on social media show this.

“Another is identification, already-distressed adolescents hearing the message that ‘people like you, facing similar problems, are killing themselves’, leading to imitative suicide or self-harm, to which young people are particularly susceptible.”

Can Australia’s political system rise to the challenge of this medical scandal in the making?

How many of our politicians have stayed silent so far, but would quietly agree with National Party MP David Gillespie, who spent 33 years in medicine before politics, and recently declared paediatric gender medicine to be lacking in evidence, a breach of the rule “First, do no harm,” and “a blot on the medical profession”.

Referring to the Cass review, he asked “why NSW Health and other state health departments haven’t responded like the grown-ups in the UK … and in Scandinavia.”

Why, indeed?

Source: The Australian

https://www.theaustralian.com.au/health/united-kingdoms-ban-on-puberty-blockers-for-children-is-not-a-culture-war-but-a-safety-matter/news-story/48c2e8d123c4ed426f7adaa3a3af5857?amp&nk=be923e2ef5a5f3a3e471173b7caaaa23-1734141931