Hannah Is a Girl. Doctors Finally Treat Her Like One.

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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Doctor X » Wed Apr 12, 2017 5:06 am

Anaxagoras wrote:I think that Abdul's position is that giving the hormones is equivalent to chemical castration.
What you quoted appears intended to equal an actual surgical castration to remove the penis as well as the testicles. Nevertheless, let us pretend, since I am Humble--Yet MagNIfIcent--that the intended reference was "chemical castration." Is that what is happening?

Back in 2011, the American College of Pediatrics came down very strongly against the practice:
The American College of Pediatricians (The College) is alarmed by the increasingly prevalent and unscientific trend to treat Gender Identity Disorder (GID) in children as an inborn trait rather than as the treatable psychological condition it is. GID in children is manifest as a strong desire to be the opposite sex, and/or the belief that he or she actually is the opposite sex.
. . . .
Puberty is not a disorder. Psychologically dissociating from your biological gender is. Hormone blocking agents induce a disease state (the absence of puberty) at a critical time in a child’s physical, emotional and mental development. Sex hormones not only trigger the development of secondary sex characteristics, but also influence the development of the adolescent brain. This likely explains why most GID children come to accept their biological gender during adolescence.
There is a lot of "claims without evidences"--thanks--in that statement. I then searched to see if there is any update. There is in a way a VERY long article from 2016 along with evidences references for the statements well worth reading before commenting upon it further:
ABSTRACT: Gender dysphoria (GD) of childhood describes a psychological condition in which children experience a marked incongruence between their experienced gender and the gender associated with their biological sex. When this occurs in the pre-pubertal child, GD resolves in the vast majority of patients by late adolescence. Currently there is a vigorous, albeit suppressed, debate among physicians, therapists, and academics regarding what is fast becoming the new treatment standard for GD in children. This new paradigm is rooted in the assumption that GD is innate, and involves pubertal suppression with gonadotropin releasing hormone (GnRH) agonists followed by the use of cross-sex hormones—a combination that results in the sterility of minors. A review of the current literature suggests that this protocol is founded upon an unscientific gender ideology, lacks an evidence base, and violates the long-standing ethical principle of “First do no harm.” At least the author did not claim that comes from the Oath of Hippocrates. . . .

Same People
I personally don't know enough to say. Does it lead to impotence and/or sterility perhaps? Actual gender reassignment surgery is not being suggested though, until they are an adult.
As you can see from the very long article and my Humble--Yet MagNIfIcent--commentary above, there is no certainty here. The ACPeds comes down firmly on the argument that this is a psychological rather than a developmental disorder. Their use of "gender" and "sex" may rankle the Rankleble who make declarations on what they are the same way you and I try to declare what a completed catch is in the NFL. Be that as it may, they are not discussing the condition I highlighted.

Who is correct?

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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Anaxagoras » Wed Apr 12, 2017 8:21 am

Well, after reading the article from ACP (about halfway through it; I've also had work and a meeting intervene) I think I have to admit that the New York Times opinion piece almost had me fooled.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Doctor X » Wed Apr 12, 2017 8:37 am

To be honest, I do not know who is right, but I do know that the first cardinal sign of Voodoo Science is:
Discoverers make their claims directly to the popular media, rather than to fellow scientists.
and I default more to the ACPeds rather than this other guy. Show me the hard evidences--thanks--either way.

--J.D.
Mob of the Mean: Free beanie, cattle-prod and Charley Fan Club!
"Doctor X is just treating you the way he treats everyone--as subhuman crap too dumb to breathe in after you breathe out."--Don
DocX: FTW.--sparks
"Doctor X wins again."--Pyrrho
"Never sorry to make a racist Fucktard cry."--His Humble MagNIfIcence
"It was the criticisms of Doc X, actually, that let me see more clearly how far the hypocrisy had gone."--clarsct
"I'd leave it up to Doctor X who has been a benevolent tyrant so far."--Grammatron
"Indeed you are a river to your people.
Shit. That's going to end up in your sig."--Pyrrho
"Try a twelve step program and accept Doctor X as your High Power."--asthmatic camel
"just like Doc X said." --gnome

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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Abdul Alhazred » Wed Apr 12, 2017 8:54 am

Anaxagoras wrote:Abdul, you are reacting to this emotionally instead of dispassionately weighing the pros and cons.
There are no "pros and cons".

The hormones are chemical castration and are described as such by adults who do it voluntarily.

As for the doctor -- ideology follows interest.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Abdul Alhazred » Wed Apr 12, 2017 8:57 am

Anaxagoras wrote:Well, after reading the article from ACP (about halfway through it; I've also had work and a meeting intervene) I think I have to admit that the New York Times opinion piece almost had me fooled.
You should have know it is a lie, because it is a New York Times opinion piece. :)
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Anaxagoras » Wed Apr 12, 2017 11:18 am

Possibly relevant: Snopes calls the American College of Pediatricians "a small and politically-motivated group" and notes that they should not be confused with the American Academy of Pediatrics (AAP).

Here is their "About Us" page from their own website:

https://www.acpeds.org/about-us
Core Values of the College

The American College of Pediatricians:

Recognizes that there are absolutes and scientific truths that transcend relative social considerations of the day.
Recognizes that good medical science cannot exist in a moral vacuum and pledges to promote such science.
Recognizes the fundamental mother-father family unit, within the context of marriage, to be the optimal setting for the development and nurturing of children and pledges to promote this unit.
Recognizes the unique value of every human life from the time of conception to natural death and pledges to promote research and clinical practice that provides for the healthiest outcome of the child from conception to adulthood.
Recognizes the essential role parents play in encouraging and correcting the child and pledges to protect and promote this role.
Recognizes the physical and emotional benefits of sexual abstinence until marriage and pledges to promote this behavior as the ideal for adolescence.
Recognizes that health professionals caring for children must maintain high ethical and scientific standards and pledges to promote such practice.
Recognizes the vital role the College has in promoting quality education for parents, physicians, and other health professionals.

Objectives of the College

The Objectives of the College are:

To foster and stimulate improvements in all aspects of healthcare of infants, children, and adolescents;
To promote the basic father-mother family unit as the optimal setting for childhood development, while pledging to support all children, regardless of their circumstances;
To affirm that parents have the inalienable right and responsibility to educate and rear their children;
To advocate for children at all stages of development, from conception to young adulthood;
To cultivate and encourage parental responsibility for and involvement in the child’s life;
To engender the honest interpretation of scientific pediatric research, without deference to current political persuasions;
To promote the highest standards of medical practice among its Members and within the field of pediatrics;
To encourage and support sound, ethical scientific research in all aspects of healthcare for infants, children, and adolescents; and
To cooperate with other organizations having similar purposes and standards.
I guess you could say that they are socially conservative, and don't approve of same-sex couples raising kids. Also pro-life if I'm reading that correctly. Also opposed to out-of-wedlock sex.

That's not to say they are wrong, just to point out that their opinion isn't necessarily representative of a general consensus of pediatricians.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Rob Lister » Wed Apr 12, 2017 11:34 am

Anaxagoras wrote:Possibly relevant: Snopes calls the American College of Pediatricians "a small and politically-motivated group" and notes that they should not be confused with the American Academy of Pediatrics (AAP).
It is worth looking at what the AAP has to say on the matter of GID

https://www.google.com/search?q=America ... te:aap.org

Specifically nutshelled in this power point
https://www.aap.org/en-us/Documents/sol ... rofalo.pdf

snip
Peri-pubertal Children
•For gender non-conforming adolescents, these physical changes can be unbearable
•Gender dysphoria often intensifies or emerges around puberty
•Early intervention with GnRH analogs may alleviate psychological harm
•GnRH agonists (leuprolide, histrelin) effectively suppress the production of sex hormones at the pituitary level

GnRH Agonists
•POTENTIAL BENEFITS
Completely reversible
–“Buys time”
–Allows exploration while distress is alleviated
–Prevents the physical changes of an undesired puberty, some which are irreversible
–May prevent future medical interventions/surgeries
–Considered safe – although long-term f/u studies meager
emphasis mine. At first glance it looks like a contradiction but they're saying the undesired puberty is irreversible. Are they saying the puberty can happen later?


I have no opinion other than that stated previously; potential future lawsuit.

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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Anaxagoras » Wed Apr 12, 2017 12:53 pm

Rob, also see the next slide after that one on potential risks. That's slide 33, btw.

Bone density, height and brain development are listed. Again, these are potential risks and they don't really go into detail. But I do wonder especially about those second two issues. Delay puberty and do you only delay the usual growth spurt, or do you end up with a shorter adult in the end? Also what about brain development. Nobody seems to know for sure.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Abdul Alhazred » Wed Apr 12, 2017 1:34 pm

Snopes.

Google's prospective official truth detector. :lmao:
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by gnome » Wed Apr 12, 2017 2:42 pm

I wonder if questions of modification will become less of a problem if we evolve culturally to where fewer people care if someone who appears (and is) biologically male acts and dresses in ways more often associated with females, and vice versa (arguably we may be closer to achieving that with females adopting male dress and behavior). In shorter terms, can we make our society more welcome to people with complex or inverted gender identity to the point where there's no need to change the biology?

Maybe someone can help me out on this one--is the need for chemical and surgical solutions addressing a physiological need or a cultural need?
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by gnome » Wed Apr 12, 2017 3:00 pm

ed wrote:Or is it that upon observing another vhuman you have no right to make an assumption about that persons gender? Is using a masculine or feminine pronoun a microagression? Is it evidence of hate if you use such pronouns without permission? It it like a gendered variation of vous and tu?

Remember that feelings only get more hurt, not less.
I think you're anticipating being held to the standards of the most unreasonable representatives. Just because someone somewhere raises a stink about something does not mean that is the new rule. Getting outraged over little things is kind of an American pastime, including getting outraged about outrage.

Let me turn it around a little. What do you think is reasonable in certain situations, being aware that someone's gender identity may be different than they appear? I would guess it depends on the situation.
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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Doctor X » Thu Apr 13, 2017 12:22 am

Anaxagoras wrote:Possibly relevant: Snopes calls the American College of Pediatricians "a small and politically-motivated group" and notes that they should not be confused with the American Academy of Pediatrics (AAP).
Thank you, it seemed really, really odd the since the "article" seemed all rhetoric without actual references. A lot of ipse dixit, but I did not have time to wade through it. Given I searched for the "American Academy of Pedicatrics" I am going to block that page from my search.

So what do the real evidence-based pediatrons say? Unfortunately I am going to have to do some research since I have hit a busy period.

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Re: Hannah Is a Girl. Doctors Finally Treat Her Like One.

Post by Doctor X » Thu Apr 13, 2017 7:46 pm

So what does SCIENCE [!--Ed.] say:

From a the abstract of an article linked on the actual AAP:
Stage were too advanced for pubertal suppressive therapy to be an affordable option for most patients. Two-thirds of patients were started on cross-sex hormone therapy. Greater awareness of the benefit of early medical intervention is needed. Psychological and physical effects of pubertal suppression and/or cross-sex hormones in our patients require further investigation.
In other words, "we have no fucking clue" what this does. The same page provides an "info box":
What’s Known on This Subject:

Studies in the Netherlands show that pubertal blockade at Tanner 2/3 prevents unwanted sex characteristics and improves psychological functioning. Endocrine Society guidelines (2009) recommend pubertal suppression for adolescents with gender identity disorder until approximately age 16.
then provides the paper:
The diagnosis of gender identity disorder (GID), including both childhood and adolescent/young adult subtypes, is listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. This was redefined as "gender dysphoria" in the DSM-5 Adolescents with GID must display strong and persistent cross-gender identifications, discomfort with his or her sex, and exhibit significant distress from gender dysphoria. ["Snip!"--Ed.]

Many of these gender-variant children will ultimately develop a nonheterosexual orientation in adolescence; however, gender dysphoria in children that intensifies with onset of puberty rarely subsides. Individuals with GID have no proven genetic, anatomic, or hormonal abnormalities, but present with psychological symptoms, including anxiety, depression, or suicidal ideation; a significant number engage in self-harm behaviors.

In 1979, the World Professional Association for Transgender Health established standards of care for the treatment of GID, which included partially irreversible cross-sex hormone therapy treatments (androgens for genotypic female individuals and estrogens for male individuals) for patients who had completed or nearly completed puberty, and fully irreversible gender reassignment surgery thereafter. Here is the argument for the irreversible effects of hormone therapy: Although cross-sex hormones and genital reconstructive surgery promote cross-gender physical features, they often fail to achieve the appearance of the affirmed gender. Cross-sex hormones cannot undo breasts, body contour, and limited height in genotypic females or male-pattern facial/scalp hair distribution, skeletal changes, voice pitch, and “Adam’s apple” in genotypic male individuals. These cause emotional distress and can be altered only with expensive out-of-pocket treatments, often with unrewarding results.

In September 2009, the Endocrine Society published guidelines for the treatment of adolescents with GID that recommended suppression of puberty by using reversible gonadotropin-releasing hormone (GnRH) analogs at Tanner stage 2/3 for adolescents who fulfill strict readiness criteria. The World Professional Association for Transgender Health has just released its latest standards of care (7th edition), which echo the Endocrine Society in its recommendation to offer reversible pubertal suppression in young adolescents. All guidelines require close collaboration with mental health providers.

Pubertal suppression with gonadotropin-releasing analogs has been used since the 1980s for central precocious puberty. In 2000, the Amsterdam Clinic for Children and Adolescents initiated a protocol for the use of a GnRH analog with adolescents with GID who were at least age 12 and had reached Tanner stage 2 or 3, in doses comparable with treatment of central precocious puberty. Some teenagers were older and more developed. This fully reversible treatment allowed patients time until age 16 to decide, in consultation with health professionals and their families, whether to begin hormone treatment that would allow them to transition physically. The first 70 Dutch candidates treated with GnRH analogs between 2000 and 2008 showed improved psychological functioning. None opted to discontinue pubertal suppression and all eventually began cross-sex hormone treatment. More recently, the Amsterdam group found that adolescents with GID who underwent pubertal suppression had improved behavioral, emotional, and depressive symptoms with psychometric testing.
Moving on to the discussion:
One of the most striking characteristics of our population is the prevalence of psychiatric diagnoses and history of self-harming behaviors, which corroborates previous findings. Comorbid psychiatric conditions may hinder the diagnostic evaluation or treatment of gender dysphoria. ["Snip!"--Ed.]

Our observations reflect the Dutch finding that psychological functioning improves with medical intervention and suggests that the patients’ psychiatric symptoms might be secondary to a medical incongruence between mind and body, not primarily psychiatric. Here comes the speculation; which is not a criticism since they do not know. Future research is needed to understand how adolescent patients change psychologically when they attain a physical appearance similar to or indistinguishable from their affirmed gender peers after being treated with early pubertal suppression followed by cross-sex hormone therapy.

Children and Adolescents With Gender Identity Disorder Referred to a Pediatric Medical Center
--J.D.
Mob of the Mean: Free beanie, cattle-prod and Charley Fan Club!
"Doctor X is just treating you the way he treats everyone--as subhuman crap too dumb to breathe in after you breathe out."--Don
DocX: FTW.--sparks
"Doctor X wins again."--Pyrrho
"Never sorry to make a racist Fucktard cry."--His Humble MagNIfIcence
"It was the criticisms of Doc X, actually, that let me see more clearly how far the hypocrisy had gone."--clarsct
"I'd leave it up to Doctor X who has been a benevolent tyrant so far."--Grammatron
"Indeed you are a river to your people.
Shit. That's going to end up in your sig."--Pyrrho
"Try a twelve step program and accept Doctor X as your High Power."--asthmatic camel
"just like Doc X said." --gnome

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