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submitted 5 months ago by Wanderer@lemm.ee to c/unitedkingdom@feddit.uk

"There is no evidence of a large rise in suicides in young patients attending a gender identity clinic in London, an independent review has found."

"Prof Appleby's review concludes "the data do not support the claim".

And he added that the way the issue had been discussed on social media was "insensitive, distressing and dangerous".

"A Department of Health and Social Care spokesperson said decisions on children's healthcare must follow the evidence at all times."

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[-] IzzyScissor@lemmy.world 80 points 5 months ago

"We only saw a small rise, so until statistically significant numbers of children kill themselves, the brutality will continue."

Why is "suicide" the metric for healthcare to begin with? Imagine if dentists acted like this. "No one committed suicide from not receiving a root canal in the last 3 years, so we've determined them to be medically unnecessary."

[-] galmuth@feddit.uk 24 points 5 months ago

It's not used as a healthcare metric. This is just debunking reports that a healthcare policy was directly causing an "explosion" in suicides.

[-] IzzyScissor@lemmy.world 18 points 5 months ago

Except they also say "The evidence on suicide risk in children and young people with gender dysphoria is generally poor."

That's not debunking. That's denial of the problem.

[-] galmuth@feddit.uk 10 points 5 months ago

That's not denial, it's looking at the evidence.

[-] mecfs@lemmy.world 3 points 5 months ago

More like suggesting there is no reliable evidence.

As the law of funding bias says, only research that corroborates powerful interests will get the funding necessary to create a reliable body of evidence.

https://en.m.wikipedia.org/wiki/Funding_bias

[-] HumanPenguin@feddit.uk -1 points 5 months ago* (last edited 5 months ago)

That’s not debunking. That’s denial of the problem.

Plenty of reasons to reconsider this stupid extreme ban, And this is clearly weighing the limited evidence of suicide higher than the lack of evidence of harm.

IE, it's a bit hypocritical to ban something with no real evidence of harm. Simply because it has not been proven to be safe, And then argure the limited evidence of suicides, is a reason to continue.

But words matter. So no it is not a denial. It is saying the difference between pre ban suicides and post ban suicides is statistically irrelevant. IE the changes are not usable as evidence, because they are not high enough to prove a trend. (yet as honestly the ban is far too recent for any of this data to be of value)

Edit: QUICK look at numbers, last I heard 19 people had committed suicide since the ban in March while in some form of gender dysmorphia treatment. 5approx 6000 people a year commit suicide in the UK. Numbers being higher with any form of mental health treatment. (issue that needs addressing).

[-] IzzyScissor@lemmy.world 4 points 5 months ago

In the article, they only count 3 minors that have committed suicide since the ban, because they put additional qualifiers like that they had to already be on a specific treatment plan in order to count.

Your preliminary numbers already destroy their argument, which is kind of my point.

[-] ryannathans@aussie.zone -2 points 5 months ago

You'll find the nuance is age

[-] flamingos@feddit.uk 12 points 5 months ago

"We investigated ourselves and found we did nothing wrong."

Mr Maugham said the review considered "current and former" Gender Identity Development Service patients, while his figures were directed to the larger group of "those on the waiting list".

The DHSC has insisted that patients on waiting lists were included in the review as well.

They literally didn't, from the review:

I have examined the figures provided by NHSE on deaths in each year between 2018-19 and 2023-24. They are based on an internal audit by the Tavistock of deaths among current and former GIDS patients

[-] BluesF@lemmy.world 6 points 5 months ago

Not especially surprising, given how difficult it is to get any form of healthcare for trans kids. The change has actually quite limited scope.

[-] autotldr@lemmings.world 4 points 5 months ago

This is the best summary I could come up with:


There is no evidence of a large rise in suicides in young patients attending a gender identity clinic in London, an independent review has found.Professor Louis Appleby was asked by Health Secretary Wes Streeting to examine the data following claims made by campaigners of a rise in suicide rates since puberty-blocking drugs were restricted at the Tavistock and Portman NHS Trust in 2020.Prof Appleby's review concludes "the data do not support the claim".And he added that the way the issue had been discussed on social media was "insensitive, distressing and dangerous".The Department of Health and Social Care said it was vital that public discussion around the issue was handled responsibly.

"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," he said.There was also the risk that distressed adolescents hearing that message could be led to copy the behaviour warned about.He also said the claims placed in the public domain about an "explosion" in suicides "do not meet basic standards for statistical evidence".

The claims have been led by legal campaign group, the Good Law Project, on X, formerly known as Twitter.The group is challenging the decision by the previous health secretary to end the prescription of puberty-blocking drugs by private clinics to children and young people with gender dysphoria.That was recommended in the Cass Review, published in April, which found "remarkably weak" evidence on the use of the treatment.In response to their claims, the new health secretary launched an independent review led by Prof Appleby which analysed data from NHS England on suicides of patients at the Tavistock clinic, based on an audit at the trust.Covering the period between 2018-19 and 2023-24, he found there were 12 suicides - five in the three years leading up to 2020-21 and seven in the three years afterwards.

"This is essentially no difference," Prof Appleby says in his report, "taking account of expected fluctuations in small numbers, and would not reach statistical significance.

"The patients who died were in different points in the care system, including post-discharge, suggesting no consistent link to any one aspect of care, Prof Appleby noted.However, he said it was likely there had been a rise over a longer period as more young people at risk came forward with gender identity problems.

The Good Law Project is thought to have based its claims on unpublished figures provided by two members of staff at the now-closed Tavistock clinic.Project executive director Jo Maugham said: “I was not contacted in advance of the statement being released and will obviously need time to respond.


The original article contains 596 words, the summary contains 443 words. Saved 26%. I'm a bot and I'm open source!

[-] TimewornTraveler@lemm.ee 2 points 5 months ago

So their data set was people attending a gender identity clinic? Looks like they were at least getting Tx

[-] Flax_vert@feddit.uk -1 points 5 months ago

I have known plenty of young people who had a phase of self hatred who thought being trans can fix their problem. Unsurprisingly it didn't. Thankfully many of them snapped out of it before they could get their hands on medication/surgery.

[-] Nighed@feddit.uk 13 points 5 months ago

My understanding is that puberty blockers just delay things, letting them work that out without making permanent changes in either direction?

[-] Flax_vert@feddit.uk 0 points 5 months ago

I thought this before, but then the Cass review came out saying we actually didn't have enough data to know whether or not they did or didn't make permanent effects ¯⁠\⁠_⁠(⁠ツ⁠)⁠_⁠/⁠¯

[-] flamingos@feddit.uk 6 points 5 months ago

I've said this before and I doubt it will be the last, but this ban is not about child safety. It's about reducing the number of trans kids because they're a political inconvenience to a slice of the establishment. If it was about how unsafe they are, it wouldn't only be for kids experiencing gender dysphoria/incongruence. The ban would extend to intersex adolescents:

However, [Streeting] overlooks the fact that this ban does not include teenage patients with a difference of sex development (DSD), more commonly known as intersex. These individuals are prescribed puberty-blocking medication when they unexpectedly commence a puberty that is at odds with their gender identity. DSD patients are taking the medication for much the same reason as transgender patients – ie the puberty they are undergoing is causing distress, and pressing pause will probably manage that distress and minimise harm while a continuing care plan is developed. If we follow Streeting’s logic, the medication would also be banned for this patient cohort.

[-] Nighed@feddit.uk 5 points 5 months ago

Not knowing about permanent effects still seems better than definite permanent effects 🤷‍♂️ would help learn about them too

[-] Flax_vert@feddit.uk -4 points 5 months ago

Yeah but it would still need to be on a measured scale including placebos, etc.

[-] LycanGalen@lemmy.world 5 points 5 months ago

Randomised Controlled trials like you're asking for are neither ethical nor practical in this situation. Even the Cass report stated that. Patients and doctors will know PDQ whether puberty is happening or not.

You're right that more data is needed. More data is always needed, especially on anything regarding a marginalised group. And, in many of these situations where we know the outcome of puberty is irreversible, makes transitioning afterwards more difficult, with a decent threat of mental health decline without the treatment, waiting around and doing nothing is more harmful than pausing puberty temporarily, where, based on the 30 years worth of research done for puberty blockers to treat precocious puberty, we see the most likely risks are for them to wind up a little shorter than they might have, and maybe fatter.

If you're worried the teenagers receiving this treatment may become sterile, the above linked precocious puberty article found no evidence, but here's an article on a recent study where they used a placebo on rats (because, again, we'll never have a randomised controlled trial done on humans). It adds to the body of data that shows reproductive activity returns to normal very quickly after stopping treatment, for the teens who do discover they're OK with their assigned gender identity. We also shouldn't ignore the good percentage of teens who realise they are trans, and benefit from this in more ways than just buying time.

[-] Flax_vert@feddit.uk -1 points 5 months ago

Then why are different studies saying different things? Another thing is that puberty can be a cure for dysphoria, as I know many were uncomfortable with their body or the idea of puberty as teenagers, but they grew into it.

[-] LycanGalen@lemmy.world 2 points 5 months ago

Can you provide me with the studies saying something different? It's hard to speak to a theoretical.

And many in what way? Personal experience, a mass meta analysis of treatments? There is some data (again; always need more) showing that more than half of the children who express some level of gender nonconformity will eventually settle on identifying with their gender assigned at birth. This aligns with our overall understanding of how children learn who they are: trying on new identity "hats" to find the ones that fit. We also have evidence that even having a single person using a trans youth's chosen name results in a 29% decrease in suicidal ideation, and a 56% decrease in suicidal behavior. For the youth who are cis, it at worst makes no difference, at best communicates that they have support while they figure out who they are. So I would argue that it's the time taken for a youth to explore their gender and figure out what's correct, that actually provides a "cure for dysphoria", rather than puberty itself. In fact, a US survey of nearly 28,000 trans respondents found that for those between kindergarten and 8th grade (5 - 14 years old), those who were out as, or perceived to be trans, 54% were verbally harassed, 24% were physically assaulted, and 13% were sexually assaulted; 17% left school because of maltreatment. So what you're interpreting as youth being cured, is more likely them going back into the closet to avoid being harassed.

this post was submitted on 20 Jul 2024
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