Trans youth will no longer be prescribed puberty blockers at NHS England gender identity clinics in a new “blow” to gender-affirming healthcare.

Puberty blockers are a type of medicine that prevent puberty from starting by blocking the hormones – like testosterone and oestrogen – that lead to puberty-related changes in the body. In the case of trans youth, this can delay unwanted physical changes like menstruation, breast growth, voice changes or facial hair growth.

On Tuesday (12 March), NHS England confirmed the medicine, which has been described as “life-saving” medical care for trans youth, will only be available to young people as part of clinical research trials.

The government described the move as a “landmark decision”, Sky News reported. It believed such a move is in the “best interests of the child”.

  • Th4tGuyII@kbin.social
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    God damn Tories. What do they know about “best interests of the child” that a doctor doesn’t already know? Less than nothing is the answer.

    If a young person is suffering from gender dysmorphia to the point of considering gender affirmation procedures, then I think it’d be in their best interest to not exacerbate that condition. Delaying the onset of puberty via puberty blockers until they’re at the age where that can legally consent to such procedures isn’t exactly novel.

    Even if they eventually decide not to undergo those procedures, all you habr to do is take them off the blockers and they’d undergo puberty as normal. There’s not all that much downside for an awful lot of upside for those in need.

    • frezik
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      What you fail to take into account is the pink haired lesbian man haters dragging kids into alleyways and stopping them from having puberty. This is a totally real thing. A child can’t even walk to school without being accosted by pink haired lesbian man haters armed with syringes and a copy of a Dworkin book.

    • Clbull@lemmy.world
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      Even if they eventually decide not to undergo those procedures, all you habr to do is take them off the blockers and they’d undergo puberty as normal. There’s not all that much downside for an awful lot of upside for those in need.

      Is that actually true? Do those medications actually permanently prevent puberty after a certain point?

      • NoIWontPickAName@kbin.earth
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        There are side effects last I looked, people like to pretend their aren’t, even fucking ibuprofen has side effects.

        So idk, it depends on how bad maybe?

        • frezik
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          They have side effects. Permanent puberty block isn’t one of them. We’ve had these drugs on the market since the '80s, and they treat more than just trans youth. We have a pretty good idea on how puberty progresses with them.

        • dana@lemmy.world
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          Yes, there are side effects. They vary depending on the length of treatment (generally patients are not allowed to stay on them indefinitely to mitigate this) and the medication used, but puberty blockers have been used for ~40 years now and we have a good understanding of the risks. GnRH agonists are the most common type of puberty blocker used today, and the typical side effects are:

          • Hot flashes
          • Gynecomastia
          • Fatigue
          • Weight gain
          • Decreased libido and erectile function

          These side effects generally end once treatment stops, whether switching to hormone replacement therapy or stopping all gender-affirming treatment. These side effects are typical of low sex hormone levels in general, and are generally annoyances that can be managed rather than major risks that are likely to harm the patient long term. It’s also worth noting that some of these are seen as neutral or even positive to some patients - e.g. patients who were assigned male at birth and are interested in feminizing treatment often consider gynecomastia and decreased erectile function as positive effects.

          When puberty blockers are continued for longer periods of time, there are additional risks which grow with the duration of the treatment:

          • Reduced bone density, which can increase risk of or worsen osteoporosis
          • Metabolic issues, which can worsen weight gain or diabetes in particular
          • Having puberty delayed by any means tends to result in a child growing taller than they would otherwise

          These risks are more serious, which is why puberty blockers are not prescribed indefinitely. For gender affirming treatment, puberty blockers are generally prescribed for up to two or three years, depending on local regulations and the patient’s tolerance of the treatment. After this period, patients have the option of either continuing gender affirming treatment with hormone replacement therapy (so that they can experience a different puberty than the one typically associated with their birth sex), or stopping treatment and allowing puberty to run its course as usual.

          It’s also worth noting that puberty blockers are not considered in a vacuum - the risks are considered against the risk of allowing puberty to continue as usual. For children with gender dysphoria, puberty is often a severely traumatic experience. This can cause or worsen depression and suicidality, and can leave a transgender person with sexual characteristics they do not want and will have to treat later with riskier and/or more intense forms of treatment like surgery. The risks of puberty blockers are comparatively mild, which is part of why the side effects are regarded as safe for transgender patients.

          Lastly, I’ll also note that all of this treatment involves mental health professionals as well. While adults in some regions can choose to start gender affirming treatment on their own without needing a formal diagnosis, treatment for children requires much more work and dedication. Typically, a minor who wants to begin gender affirming treatment for gender dysphoria will need:

          • Consent from at least one parent
          • A diagnosis or letter of support from a mental health practitioner who’s seen them as a patient
          • A doctor or endocrinologist who can prescribe the medications
          • Ongoing check-ups while they’re undergoing treatment, to assess both their physical health (physical exams, blood work to check hormone levels and organ function) and mental health (sessions with a mental health practitioner to make sure that the treatment is actually benefiting their mental health and consistent with their identity)
      • dana@lemmy.world
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        No, barring some other condition, puberty resumes once you stop using puberty blockers. There are increasing risks of side effects when staying on puberty blockers for more than a couple years, so it’s usually a temporary measure to give children with gender dysphoria more time to explore their identity without subjecting them to the irreversible effects of puberty yet. As a result, doctors won’t allow a patient to stay on puberty blockers permanently (barring outliers where it would actually be safer to do so, e.g. because of cancer risk associated with sex hormones). There are two typical outcomes:

        1. The patient determines that they would like to transition medically, and will transition from puberty blockers to hormone replacement therapy according to their goals. This essentially allows them to replace the pubertal effects typically associated with their birth sex with something else depending on the regimen.
        2. The patient determines that they don’t want to transition medically, and stops puberty blockers without starting hormone replacement therapy. At this point, puberty begins/resumes on its own as usual.
    • Jojo@lemm.ee
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      Even if they eventually decide not to undergo those procedures, all you habr to do is take them off the blockers and they’d undergo puberty as normal. There’s not all that much downside for an awful lot of upside for those in need.

      Oh, don’t worry. Statistically, people who start puberty blockers almost always go on to receive hormone therapy as adults, so you don’t really have to worry about people deciding not to continue. It’s definitely* because of the medicine that they go on to do HRT, and not because the kids that are getting through the bullshit to actually start blockers are the kids who are almost 100% guaranteed to be trans. Don’t think too hard and it’ll all just go away.

    • harderian729@lemmy.world
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      Doctors can be manipulated to support an agenda, too.

      They used to classify homosexuality as a mental disorder, for example.

      They also used to recommend lobotomies as treatment for unruly wives.

      Do you think there are no instances of doctors being manipulated or corrupt in the current day? They of course have a profit incentive to get as much business as possible. It’s why you seen cosmetic surgeons lie through their teeth to manipulate vulnerable people into giving them money.

      • floofloof@lemmy.ca
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        Doctors still have a lot more experience of what works than Conservative politicians do. And if you took “it must be impossible for any doctor ever to abuse this power for corrupt ends” as the standard for approving a treatment, no treatments would ever get approved.

      • frezik
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        Doctors can be thrown in jail for supporting unnecessary care. How do I throw politicians in jail for blocking necessary care?

        • Ziixe@lemmy.dbzer0.com
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          Why don’t we look across the Channel and oh? What’s that? A shiny sharp guillotine? Don’t mind if we do

      • Maggoty@lemmy.world
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        Ah yes and it was famously the politicians that showed them the light. Not other doctors conducting research and presenting evidence.

        Politicians certainly never had to be dragged kicking and screaming into the 21st century of medicine.

        • Kyrgizion@lemmy.world
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          I’ve seen this claim many, many times, but I have yet to see my very first news article (from an actual source!) confirming it.

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            Even if there was a cherrypicked case out there, the vast majority of suicides are by those who are denied medical treatment and/or suffer discrimination.

            By forcing puberty, politicians are forcing these teens to face a future where for example they have to live as a woman with a male sounding voice or beard. Needing more expensive and painful treatments to partially reverse such as facial feminization surgery. That is life full of discrimination and didn’t have to be.

            • harderian729@lemmy.world
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              the vast majority of suicides are by those who are denied medical treatment and/or suffer discrimination.

              Do you have sources comparing the suicide rates of those denied trans treatment and those granted it at an early age?

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            In absolute fairness, this is what happened to David Reimer. It’s how we know that you can’t just force a gender on someone, even if you start when they’re an infant. Conversion therapy never ever helps, it only ever hurts, and trying to force trans kids to be cis is as bad as trying to force cis kids to be trans. Let people pick their own goddamn paths in life, it’s not that hard to keep your nose out of other people’s business (not you, the busybodies who have to “save the children” from well researched medicine and medical professionals with their common sense >.<)

              • HopeOfTheGunblade@kbin.social
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                Yeah, it’s fucking awful. John Money was incredibly fucked up as a person, and even with all of the terrible that’s documented, there’s at least hints that it was even worse; that the surgeon who fucked up the circumcision did so, so that Money had a twin pair for his study. Using a cauterizing iron in that way and at those settings certainly wasn’t a standard procedure.

        • Neuromancer@lemm.ee
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          Reimer twins. It’s a well documented case. I suspect that is the case they are referencing.

          • maniclucky@lemmy.world
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            One case in the 60s/70s? That’s bad evidence. I assume you are clarifying and not supporting the person above.

            • Neuromancer@lemm.ee
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              Why don’t you calm down and not be hostile.

              You asked for a case. I gave you as well known case.

              If you had read the case, it was common practice and that is the study that ended it.

              • maniclucky@lemmy.world
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                Disinformation merits hostility. I’ll yield when I’m wrong.

                Because this case ended it, it is no longer true that doctors force transitioning, thus proving my assertion that the person above is full of shit. Show me a relevant case and I’ll be happy to change my mind. Some case in which a doctor forced transitioning and was not prosecuted or sued over it within the last decade. I’m flexible on the date.

                • Neuromancer@lemm.ee
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                  If you had read the case, which you haven’t. You would have learned this was a common practice.

                  You keep moving the goalpost. I was just responding to your inaccurate statement.

                  • maniclucky@lemmy.world
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                    Was. It was common practice. It is not relevant because the person above asserted that it is currently common practice. My goalposts are stationary and your evidence only provides historical context.

      • hydroptic@sopuli.xyz
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        seen doctors force sex change to children that lead to the child killing themselves in adulthood

        Why do transphobes lie all the fucking time? Like, is there something wrong with your brain preventing you from not lying?

        • OneLemmyMan@lemmy.world
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          it was a documentary on tv about a guy that tried to detransition but for whatever reason was not happy with it

        • harderian729@lemmy.world
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          Why do you people always argue in bad faith?

          Detransitioning is real and a lot of people end up regretting the decisions that you pressure them into making.

          • floofloof@lemmy.ca
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            Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence

            Results: A total of 27 studies, pooling 7928 transgender patients who underwent any type of GAS, were included. The pooled prevalence of regret after GAS was 1% (95% CI <1%–2%). Overall, 33% underwent transmasculine procedures and 67% transfemenine procedures. The prevalence of regret among patients undergoing transmasculine and transfemenine surgeries was <1% (IC <1%–<1%) and 1% (CI <1%–2%), respectively. A total of 77 patients regretted having had GAS. Twenty-eight had minor and 34 had major regret based on Pfäfflin’s regret classification. The majority had clear regret based on Kuiper and Cohen-Kettenis classification.

            Conclusions: Based on this review, there is an extremely low prevalence of regret in transgender patients after GAS.

            • frezik
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              For additional context, here’s a study on the regret rate of hip and knee surgery:

              On analysis a significantly greater proportion of TKA [total knee replacement] patients reported moderate or severe (Mod/Sev) DR [17.1% (56/328)] compared to THA [total hip replacement] patients [4.8% (18/376)]. Conversely, a significantly reduced proportion of TKA patients reported having No DR [42.1% (138/328)] compared to THA patients [66.7% (251/376)]. On multivariate logistic regression analysis joint replacement type (TKA/THA) and change in Oxford score were significant predictors of DR with gender, age, BMI and ASA grade not significantly associated. TKA patients were more than twice as likely to have Mod/Sev DR compared THA patients (Odds Ratio = 2.33 (95% CI 1.24-4.39)). Patients with poorer improvements in pain and function 1-year post-operatively (measured by Oxford scores) reported greater levels of DR.

              Regret rate of gender affirming surgery is basically rounding error.

              • feedum_sneedson@lemmy.world
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                Well now I’m confused, because I’ve met a lot of people with knee replacements who were very happy with the results. All surgeries can and do have complications, so I’m very surprised the numbers are that low for SRS. It implies it goes perfectly almost every time.

            • andros_rex@lemmy.world
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              Even people who regret their surgeries aren’t necessarily regretting that they had gender affirming care. Surgeries can go wrong and aren’t always predictable. They can change our relationships with our bodies. Regret isn’t always “I regret transitioning” - it can be “I don’t like the way my scars healed.”

              Team “no regrets” here. Right after I got out of surgery I woke up just enough to look down where them titties where and smiled.

          • Ĺįĺįţĥ ţĥę §ęŕpęŋţ🍏🐍@lemmy.world
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            You are so full of shit. Why do transphobes always insist transitioning is forced?

            What about when trans people are forced to not transition? Suicide rates go up.

            What happened to me when I was forced to conform to a cis gender role for 40 years? Denial, suicidal thoughts, drug addiction, and alcoholism. After I started hormone therapy, I completely lost all interest in drugs and alcohol, and I no longer consider suicide. I’m happy and I want to take care of myself. I became a productive member of society.

            There are about 1.5 million transgender people living in the US. 1% regret their decision and detransition. That is 15,000 people. And 0% of them were “pressured” into transitioning.

          • NOT_RICK@lemmy.world
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            It’s a good thing that medical best practice is to put adolescents on reversible puberty blockers until they are adults at which point the adult can make decisions about their medical care, then.

          • hydroptic@sopuli.xyz
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            Detransitioning is a different claim than doctors forcing children to transition you dumbass. Nobody’s saying detransitioning isn’t a thing

          • maniclucky@lemmy.world
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            They are not referring to detransitioning (which is real though a minority to my understanding). They are referring to the blatant lie that doctors force patients to transition.

            Edit: He -> They. Feels really inappropriate to assume gender given the context.

      • Solivine@sopuli.xyz
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        Transition surgeries have among the lowest regret rates for any kind of surgery. They are life saving.

          • Solivine@sopuli.xyz
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            Please read the other comment below that details the regret rate for transition related surgeries. Unfortunately my browser is unable to translate that article, but one bad case doesn’t not outweight the many, many good ones.

          • DesertCreosote@lemm.ee
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            On the off chance that you’re actually asking, there have been studies that have shown the regret rate for transitioning is less than 1%.

            Here’s an article about a recent study which tracked people up to 23 years post-transition, showing median regret as 0 out of 100.

            Now, you might be thinking to yourself “but that’s just one study, with around 200 participants, and the results were so uniform it caused issues with the statistics. Maybe it’s wrong.” Well, here is a meta-analysis of 27 additional studies, with almost 8,000 participants, which also shows regret rates are <1%.

            Hope that helps.

            • Solivine@sopuli.xyz
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              Thanks for responding to them and finding the sources, I find that exhausting with bad faith arguers.

            • feedum_sneedson@lemmy.world
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              Interesting, I can’t access the actual paper but on the face of it that’s quite strong evidence, isn’t it. But I’ve never had a problem with people undergoing elective SRS as adults.

      • NOT_RICK@lemmy.world
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        Good thing puberty blockers aren’t a fucking sex change. Even if your almost certainly bullshit comment was true, it still as relevant to puberty blockers as birth control pills are to abortion; related, but a completely different function.

        • harderian729@lemmy.world
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          Calm down. Why are you getting so mad because he made a rational comment?

          This fierce tribalism needs to stop.

          • NOT_RICK@lemmy.world
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            There’s nothing tribal about calling out bullshit and there’s nothing rational about making shit up. Telling that you tone police me rather than refuting what I said, though.

            • harderian729@lemmy.world
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              Yeah, but you’re only getting upset because he said something rational that you didn’t like.

              Now you’re trying to pretend it doesn’t make sense because again, it’s something you don’t like.

              Why can’t you people argue in good faith? Is it because you’re tribalist?

              • NOT_RICK@lemmy.world
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                Why can’t you people argue in good faith?

                First off, Hitchens’ razor.

                Besides that, physician heal thyself. Every interaction I’ve had with you has consisted of you asking me leading questions. You keep asking people that disagree with what seems to be your position to provide evidence to back their claims yet you’re perfectly happy to accept a false claim because it aligns with your views. If you were actually the paragon of objectivity you pretend to be you’d ask the guy above to backup his claim too. So, can you remind me who is tribal?

      • Mouselemming@sh.itjust.works
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        Puberty is a sex change forced on all children by their own hormones. Just because it matches the sex they were assigned at birth doesn’t mean it doesn’t force radical physical changes. It’s stressful even for cis kids, and can lead trans kids towards suicide.

        Blocking it postpones the permanent physical changes until the person is old enough to make a rational decision whether to have (less extreme needed) medical intervention to achieve a physical appearance that matches the sex they weren’t assigned at birth, or to stop taking the blockers and allow their assigned sexual characteristics to develop.

        Anyone who thinks doctors are pushing trans surgeries should be in favor of puberty blockers.

        • feedum_sneedson@lemmy.world
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          That’s a bit like saying life is forced on you by your conception and birth, though. It’s getting a bit metaphysical at that point.

      • Diotima@kbin.social
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        I’ve seen space vampires enslave circus clowns in a plot to corner the world’s market on instant ramen, too.

        Source: Trust me bro.

      • MxM111@kbin.social
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        Even assuming it is true,

        1. would that person kill themselves regardless or even earlier?
        2. doctors are people sure, but at least they have medical training, and supposed to focus on the interest of the patient, as opposed to politicians, who are focused on satisfying their constituents.
        • OneLemmyMan@lemmy.world
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          did i say we should allow politicians to choose? i swear most people here try to push their agenta one way or another. People replying saying things that dont exist in my comment. My reply was about letting each person choose their path when they are old enough to make that choice but it turned into fashion, countles stories of parents that want to have the “im progressive” stamp so they push their children to change gender, why not let them be? if they ask to change gender then you can talk about it and have specialists talk to the child to make sure that this is really what it wants, but letting doctors be the one to suggest it is crazy to me, if the child doesn’t initiate that conversation.

      • Diotima@kbin.social
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        I’ve seen space vampires enslave circus clowns in a plot to corner the world’s market on instant ramen, too.

        Source: Trust me bro.

      • harderian729@lemmy.world
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        Agreed. That’s a very rational take to have on these forums.

        Most people here get mad at you if you don’t show unwavering, blind support for their tribe.

        • otp@sh.itjust.works
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          their tribe

          …you say, as you go around supporting the one unfounded comment from “your tribe” as you argue against every single other commenter who called out that BS comment.

          I think this “tribalism” thing you’re talking about is projection. You’re aligning with what you think is your “tribe” and arguing against the dozens of people with different viewpoints and opinions who just happen to disagree with that massively downvoted comment.