Bigmouth Strikes Again: Carrie Marshall's blog

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Category: Health

Scare stories and newspaper nonsense

  • Spot the difference

    The UK isn’t the only place where “reasonable concerns” over trans healthcare have sparked official reviews. It’s happened in Queensland too, sparking a review very similar to NHS England’s Cass Review. But despite reviewing very similar evidence, this review resulted in a doubling of funding for trans healthcare. Here in the UK, the Cass Review has been used to stop trans healthcare for teens, and it’s increasingly being used to demand the end of healthcare for trans adults.

    The difference? The Queensland review didn’t prioritise quacks and bigots over healthcare experts. As one doctor explains:

    “If you were reviewing a neurosurgical service, you’d need to have some neurosurgeons on the review panel,” she said.  

    “You don’t put faith healers on it.  

    “You have to have people who understand how it works.” 

    The UK seems to be the only country where expertise in healthcare is simply dismissed in favour of ignorance and ideology.

  • Anatomy of a scandal

    This, by Lydia Polgreen, is superb: The Strange Report Fueling the War on Trans Kids. It’s about the Cass Review.

    As much as Cass’s report insists that all lives — trans lives, cis lives, nonbinary lives — have equal value, taken in full it seems to have a clear, paramount goal: making living life in the sex you are assigned at birth as attractive and likely as possible. Whether Cass wants to acknowledge it or not, that is a value judgment: It is better to learn to live with your assigned sex than try to change it. If this is what Cass personally believes is right, fair enough. It can charitably be called a cultural, political or religious belief. But it is not a medical or scientific judgment.

  • State-sanctioned harm

    Scientific American reports that the Cass Review has led to “a plethora of abuses and humiliations” for young trans people, which for some includes forced detransition.

    We estimate more than 1,000 trans adolescents in the U.K. now find that their treatment is illegal. Families risk an up to two-year prison sentence for supporting a child’s continued access to private medication. These adolescents face a state-mandated medical detransition, forcing them to go through a puberty they have fought hard to avoid. The alternative is to flee the country or take greater risks: continue blockers under threat of prosecution or receive alternative medication with more frequent and severe side effects. Families are telling us that fear is driving trans children to discontinue routine hormone monitoring checks and to disengage with wider health care services.

    Healthcare for trans adults is next in the firing line.

    As with abortions, ideologically-driven healthcare bans won’t stop people transitioning. What they can do, though, is make trans people’s lives much more painful and dangerous. The cruelty appears to be the point.

  • Cass: MMR all over again

    I think in years to come the Cass Review, and the media’s complicity, will be viewed in much the same way as Andrew Wakefield’s infamous MMR scare and its promotion by Private Eye and UK newspapers. Unfortunately like Wakefield, it will continue to harm people until and long after it’s been fully discredited and its author a pariah.

    One of the countries who provided supposedly expert guidance to Cass was Finland, whose Dr. Riittakerttu Kaltiala was on the Cass advisory board. Dr Kaltialia has testified in favour of banning trans-related care in Florida and a new report by Assigned Media reveals the horrific abuse and medical malpractice carried out by her gender clinics. The Cass Review has multiple other links to anti-trans activism.

    The British Medical Association has now announced it will review the Cass report and has made some mild criticisms of it already, and the bigots are furious – which makes you wonder what it is they’re so scared of. After all, if the Cass Review is so scientific, the BMA review will just confirm that. Right?

    There is already a very long list of Cass Review critiques, which have repeatedly demonstrated that this was an ideological project. Dr Ruth Pearce has been tracking them on her website and it’s already quite the collection. Even if you do as Cass did and ignore the voices of trans healthcare experts as biased, it’s hard to argue that the Endocrine Society or the American Academy of Pediatrics are trans activists. But then, this was never about listening to the experts.

  • Hypocrisy

    The Daily Mail, as I’m sure you’re aware, has spent many years now demonising “cross-sex hormones” and the people who take them for reasons such as not wanting to die.

    This is from tomorrow’s front page.

  • Ignore the experts

    There’s a good piece about the puberty blocker ban in The Guardian by Aidan Kelly, a doctor, in which he explains how we’ve ended up in the farcical situation where fashion writers, bigoted journalists and arrogant celebrities are considered experts in trans healthcare but clinicians and prestigious medical organisations are not.

    In this area of healthcare, like no other I know of, the professionals with the requisite expertise are positioned by their critics as having been “captured by ideology” and therefore lacking in credibility. Meanwhile, those without the expertise are positioned as “independent”, which critics argue makes them better able to evaluate the evidence – despite having never worked in the field and having no understanding of its complexities.

    This simply wouldn’t happen in any other kind of healthcare, but in the UK the entire discussion has been given over to people who get their information from Twitter. Which perhaps explains why there’s been virtually no reporting on the international condemnation of the Cass Review from health professionals, or of the extensive analyses that demonstrate that the government is prioritising ideology over evidence in its healthcare policies.

    There’s a good overview here, from the US organisation FAIR:

    Though there is much more evidence now to support gender-affirming care than in 2008, there is also a much stronger anti-trans movement seeking to discredit and ban such care.

    British media coverage has given that movement a big boost in recent years, turning the spotlight away from the realities that trans kids and their families are facing, and pumping out stories nitpicking at the strength of the expanding evidence base for gender-affirming care. Its coverage of the Cass Review followed suit.

     

  • Whitewashing

    If it weren’t so horrific it’d be funny: to counter whistleblowers’ claims that since the puberty blocker ban more than 16 young people on waiting lists have taken their own lives, the new government hastily commissioned a report to disprove their claims by, er, discounting the deaths of people on waiting lists.

    The report’s author follows many anti-trans activists and anti-trans journalists on social media (but not, as far as I can tell, any trans-supportive voices) and, as Professor Stephen Whittle points out, “makes no count of those lives [lost by people] on waiting lists, or [of] coroner’s reports or deaths reported in the media. That is not academic, it is a whitewash.”

    It’s very clear that despite the change of government, there has been no change of policy: dead kids are just collateral damage in this lethal culture war.

  • Facts checked

    The US advocacy group GLAAD just published an absolutely blistering fact-check of a very biased New York Times article that was yet again scaremongering about trans healthcare for teens, part of an ongoing panic that the paper has been fuelling for 16 consecutive months.

    Among the key points is a staggering statistic. The number of trans teens getting gender-affirming surgery in the US, the subject of the endless why-oh-why articles in the NYT, is around 514 per year. The number of cisgender teens getting gender-affirming surgery, which includes operations such as breast reduction or breast enhancement, is 229,000 per year. And yet the NYT is not running any articles about that.

    That’s not the only detail in the GLAAD response. It points out, using much more temperate language than I’d manage, that the supposed expert quoted by the NYT is a shill for the Alliance Defending Freedom whose testimony has previously been thrown out of court because he has no expertise whatsoever in trans-related healthcare. And the writer of the piece has been called out again and again for sloppy journalism that appears to be driven by an anti-trans agenda.

    We don’t have GLAAD in the UK, but a post doing the rounds on social media currently names the key anti-trans writers who’ve been pushing the moral panic here – a panic that’s been implicated in the deaths of at least 16 people. And when you see them listed it’s notable how many of them are friends with one another; it’s saddening to see how few people it’s taken to wage war on trans people and open the door for the extreme right.

    As someone put it on social media, you could pretty much end the UK media trans panic by poisoning the cocaine at just one dinner party.

  • Not an experiment

    One of the lies genital-obsessed weirdos like to push is that trans-related healthcare is new and experimental, so much so that it must be heavily regulated or better still, banned altogether. But trans healthcare is old. Puberty blockers have been prescribed for four decades, and trans surgeries have been performed since the 1910s.

    This BBC report suggests it’s even older than that, going back thousands of years. But while that claim is a bit of a stretch the article does make the important point that while there is a real problem with trans healthcare, it’s not the one the weirdos claim: it’s that trans people have to battle to get even basic healthcare and in some cases are simply refused it. The article was written before the current anti-trans moral panic really kicked into gear and made trans healthcare even harder to access.

    This piece, by Julia Serano, is an excellent round-up of trans healthcare from over 100 years ago to the present day. It’s not an entirely happy history:

    Throughout the mid-twentieth century… skeptical doctors subjected trans people to all sorts of alternate treatments — from perpetual psychoanalysis, to aversion and electroshock therapies, to administering assigned-sex-consistent hormones (e.g., testosterone for trans female/feminine people), and so on — but none of them worked. The only treatment that reliably allowed trans people to live happy and healthy lives was allowing them to transition.

    Not only does transition work, but it works very effectively: the surgical regret rate for gender-affirming surgery is lower than 2%, a regret rate that’s much lower than the regret rate for pretty much every other form of surgery.

    Trans healthcare isn’t dangerous. But restricting or removing our access to it is harmful and for some of us, even fatal. The UK puberty blocker ban has been implicated in at least 16 deaths so far; we have no idea how many other people have taken their lives while languishing on waiting lists that in some parts of the UK are now decades long.

    The misinformation and disinformation around trans healthcare is harmful and just adds to the difficulties we experience in a system that is even more broken for trans people than it is for everyone else even once we get past the horrendous waiting lists. I’ve just experienced an exceptionally difficult and unpleasant few weeks due to a bureaucratic mess that has stopped my healthcare completely for more than a month. The problem still hasn’t been resolved – I’m now into the sixth week of trying to get my usual healthcare restored and I’ve had to pay for private care in the interim – but if I were cis, it’d have been sorted out in a single day.

  • “Protecting children”

    Content warning: this is very, very bleak.

    Jolyon Maugham of the Good Law Project has posted a lengthy thread about what appears to be a national scandal: the deaths of multiple young trans people since the NHS began restricting their healthcare, and the NHS’s ongoing attempts at a cover-up.

    I have now seen further evidence that, since the Bell decision in the High Court (1 December 2020), there has been a huge increase in deaths of young trans people on the NHS waiting list – and that NHS management has sought to suppress that evidence.