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UK pediatrician who led review of child ‘transitions’ says US medical groups ‘misleading the public’

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Dr. Hilary Cass, author of the Cass Review

From LifeSiteNews

By Calvin Freiburger

The typically left-wing New York Times published an interview on Monday with consultant pediatrician Dr. Hilary Cass on her comprehensive review of so-called “gender medicine” in the United Kingdom, indicating that awareness of the damage due to surgical and chemical “transitioning” continues to spread despite the best efforts of LGBT activists.

Released in April, 366-page Cass Review was commissioned by National Health Service (NHS) England following ongoing scandals about the practices of British “gender clinics” such as the Gender Identity Development Service (GIDS), operated by the Tavistock and Portman NHS Foundation Trust. The four-year project consisted of comprehensive reviews of current research and international standards, as well as extensive interviews with gender-confused children and adults, family members, detransitioners, doctors, and activists.

It found that “gender medicine” is “built on shaky foundations” and that while such interventions require a great deal of caution, “quite the reverse happened in the field of [so-called] gender care for children,” and that “[w]hile a considerable amount of research has been published in this field, systematic evidence reviews demonstrated the poor quality of the published studies, meaning there is not a reliable evidence base upon which to make clinical decisions, or for children and their families to make informed choices.” Her findings led NHS to stop prescribing puberty blockers to children with gender confusion earlier this year.

Speaking to the Times, Cass explained that she was planning her retirement when she was first asked to tackle the project and was initially apprehensive about wading into the controversy.

“The most important concern for me is just how poor the evidence base is in this area,” she said. “Some people have questioned, ‘Did we set a higher bar for this group of young people?’ We absolutely didn’t. The real problem is that the evidence is very weak compared to many other areas of pediatric practice.”

The Times acknowledged that her “findings are in line with several European countries that have limited the treatments [sic] after scientific reviews. But in America, where nearly two dozen states have banned the care outright, medical groups have endorsed the treatments as evidence-based and necessary,” including groups the paper contacted for its latest story. Cass described American medical consensus as “out of date” on the issue.

“When I was president of the Royal College of Pediatrics and Child Health, we did some great work with the A.A.P. [American Academy of Pediatrics],” she elaborated. “They are an organization that I have enormous respect for. But I respectfully disagree with them on holding on to a position that is now demonstrated to be out of date by multiple systematic reviews.”

“It wouldn’t be too much of a problem if people were saying ‘This is clinical consensus and we’re not sure,” she added. “But what some organizations are doing is doubling down on saying the evidence is good. And I think that’s where you’re misleading the public. You need to be honest about the strength of the evidence and say what you’re going to do to improve it.”

significant body of evidence shows that “affirming” gender confusion carries serious harms, especially when done with impressionable children who lack the mental development, emotional maturity, and life experience to consider the long-term ramifications of the decisions being pushed on them.

Yet while mounting evidence against youth “gender transitions” is prompting European nations such as the United Kingdom and France, which are normally to the left of America, to move away from the practice, in America, the medical establishment and the Biden administration continues to dig in their heels, despite Biden’s own Substance Abuse & Mental Health Services Administration (SAMHSA) releasing a since-deleted report last year acknowledging that “lesbian, gay, and bisexual adults are more likely than straight adults to use substances, experience mental health conditions including major depressive episodes, and experience serious thoughts of suicide.”

The White House’s comprehensive pursuit of the transgender agenda has included reopening the military to recruits afflicted with gender dysphoria, promoting gender ideology within the military (including “diversity” and drag events on military bases), holding White House events to “affirm transgender kids,” condemning state laws against underage “transitions” as “close to sinful,” promoting underage “transitions” (potentially at taxpayer expense) as a “best practice,” and trying to force federally funded schools to let males into female athletic competitions and restrooms.

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So What ARE We Supposed To Do With the Homeless?

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The Audit

David Clinton

 

Involuntary confinement is currently enjoying serious reconsideration

Sometimes a quick look is all it takes to convince me that a particular government initiative has gone off the rails. The federal government’s recent decision to shut down their electric vehicle subsidy program does feel like a vindication of my previous claim that subsidies don’t actually increase EV sales.

But no matter how hard I look at some other programs – and no matter how awful I think they are – coming up with better alternatives of my own isn’t at all straightforward. A case in point is contemporary strategies for managing urban homeless shelters. The problem is obvious: people suffering from mental illnesses, addictions, and poverty desperately need assistance with shelter and immediate care.

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Ideally, shelters should provide integration with local healthcare, social, and employment infrastructure to make it easier for clients to get back on their feet. But integration isn’t cost-free. Because many shelters serve people suffering from serious mental illnesses, neighbors have to worry about being subjected to dangerous and criminal behavior.

Apparently, City of Toronto policy now requires their staff to obscure from public view the purchase and preparation of new shelter locations. The obvious logic driving the policy is the desire to avoid push back from neighbors worried about the impact such a facility could have.

As much as we might regret the not-in-my-back-yard (NIMBY) attitude the city is trying to circumvent, the neighbors do have a point. Would I want to raise my children on a block littered with used syringes and regularly visited by high-as-a-kite – and often violent – substance abusers? Would I be excited about an overnight 25 percent drop in the value of my home? To be honest, I could easily see myself fighting fiercely to prevent such a facility opening anywhere near where I live.

On the other hand, we can’t very well abandon the homeless. They need a warm place to go along with access to resources necessary for moving ahead with their lives.

One alternative to dorm-like shelters where client concentration can amplify the negative impacts of disturbed behavior is “housing first” models. The goal is to provide clients with immediate and unconditional access to their own apartments regardless of health or behaviour warnings. The thinking is that other issues can only be properly addressed from the foundation of stable housing.

Such models have been tried in many places around the world over the years. Canada’s federal government, for example, ran their Housing First program between 2009 and 2013. That was replaced in 2014 with the Homelessness Partnering Strategy which, in 2019 was followed by Reaching Home.

There have been some successes, particularly in small communities. But one look at the disaster that is San Francisco will demonstrate that the model doesn’t scale well. The sad fact is that Canada’s emergency shelters are still as common as ever: serving as many as 11,000 people a night just in Toronto. Some individuals might have benefited from the Home First-type programs, but they haven’t had a measurable impact on the problem itself.

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Where does the money to cover those programs come from? According to their 2023 Financial Report, the City of Toronto spent $1.1 billion on social housing, of which $504 million came in funding transfers from other levels of government. Now we probably have to be careful to distinguish between a range of programs that could be included in those “social housing” figures. But it’s probably safe to assume that they included an awful lot of funding directed at the homeless.

So money is available, but is there another way to spend it that doesn’t involve harming residential neighborhoods?

To ask the question is to answer it. Why not create homeless shelters in non-residential areas?

Right off the top I’ll acknowledge that there’s no guarantee these ideas would work and they’re certainly not perfect. But we already know that the current system isn’t ideal and there’s no indication that it’s bringing us any closer to solving the underlying problems. So why not take a step back and at least talk about alternatives?

Good government is about finding a smart balance between bad options.

Put bluntly, by “non-residential neighborhood shelters” I mean “client warehouses”. That is, constructing or converting facilities in commercial, industrial, or rural areas for dorm-like housing. Naturally, there would be medical, social, and guidance resources available on-site, and frequent shuttle services back and forth to urban hubs.

If some of this sounds suspiciously like the forced institutionalization of people suffering from dangerous mental health conditions that existing until the 1970s, that’s not an accident. The terrible abuses that existed in some of those institutions were replaced by different kinds of suffering, not to mention growing street crime. But shutting down the institutions themselves didn’t solve anything. Involuntary confinement is currently enjoying serious reconsideration.

Clients would face some isolation and inconvenience, and the risk of institutional abuses can’t be ignored. But those could be outweighed by the positives. For one thing, a larger client population makes it possible to properly separate families and healthy individuals facing short-term poverty from the mentally ill or abusive. It would also allow for more resource concentration than community-based models. That might mean dedicated law enforcement and medical staff rather than reliance on the 9-1-1 system.

It would also be possible to build positive pathways into the system, so making good progress in the rural facility could earn clients the right to move to in-town transition locations.

This won’t be the last word spoken on this topic. But we’re living with a system that’s clearly failing to properly serve both the homeless and people living around them. It would be hard to justify ignoring alternatives.

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Canadian media might not be able to ignore new studies on harmful gender transitions for minors

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From LifeSiteNews

By Jonathon Van Maren

When the UK National Health Service’s bombshell Cass Review condemning gender “transition” for minors was published, virtually the entire Canadian press engaged in a voluntary blackout.

Unless you were reading an alternative news source, an international news source, or the National Post, it was as if Cass Review — and its findings — had simply never existed. Many media outlets did not run a single story; the state-funded CBC ran precisely one, and it was a laughable hatchet job claiming that the massive study was “biased.” They did not interview a single person associated with the research.

The Canadian press has functioned for years as a propaganda arm for the transgender movement, even as the gender ideology house of cards topples in in the U.S. and the UK, where there have been genuinely robust debates informed by scientific evidence rather than ideology. Thus, I wonder how they will deal with new studies by Canadian researchers that reach many of the same conclusions.

As Sharon Kirkey of the National Post reported. “The evidence surrounding the use of puberty blockers and cross-sex hormones in children and teens identifying as transgender is of such low certainty it’s impossible to conclude whether the drugs help or harm, Canadian researchers are reporting.” The research was funded by the Society for Evidence-based Gender Medicine (SEGM) and McMaster University, considered to one of Canada’s top institutions of higher hearing, and published this week in the journal Archives of Disease in Childhood.

“There’s not enough reliable information,” said Chan Kulatunga-Moruzi, one of the authors of the two new reviews. “We really don’t have enough evidence to say that these procedures are beneficial. Few studies have looked at physical harm, so we have really no evidence of harm as well. There’s not a lot that we can say with certainty, based on the evidence.” (Here, I would note that there are now thousands of testimonies of detransitioners testifying to the harm that sex-change “treatments” have caused them, but this is a remarkable admission nonetheless.)

The researchers conclude that doctors should approach these “treatments” with extreme care, clearly communicating with parents and children and — notably — checking “whose values they are prioritizing” if they should decide to prescribe cross-sex hormones or puberty blockers. As Kirkey put it with devastating understatement: “Originally considered fully reversible, concerns are emerging about potential long-term or irreversible effects, the Canadian team wrote … Questions have been raised about the effects of fertility or what impact, if any, they might have on brain development.”

The researchers painstakingly went through the available evidence on both cross-sex hormones and puberty blockers (Kirkey irritatingly refers to them as “gender-affirming hormones”) for those up to 26 years old. To analyze the evidence, they “graded” it “using a scoring system co-developed by Dr. Gordon Guyatt, a celebrated McMaster University scientist who coined the phrase evidence-based medicine.” As Kirkey reported:

After screening 6,736 titles and abstracts involving puberty blockers, only 10 studies were included in their review. While children who received puberty blockers compared to those who don’t score higher on “global function” — quality of life, and general physical and psychological wellbeing — the evidence was of “very low certainty.” Very low, meaning researchers have “very little confidence in the effect estimate” and that the true effect “is  likely to be substantially different from the estimate of effect.”

It gets worse. The research also debunked the perpetually asserted claim utilized by trans activists and their political allies to enforce their agenda: that these drugs are necessary to prevent depression and suicidal ideation. According to the researchers: “We are very uncertain about the causal effect of the (drugs) on depression. Most studies provided very low certainty of evidence about the outcomes of interest; thus, we cannot exclude the possibility of benefit or harm.” Again, despite the careful understatement, this is devastating: Thousands of children have been subjected to these treatments on the premise that they prevent harm and are harmless.

Indeed, the second review, which analyzed 24 studies, reached the similar conclusion of “very low confirmatory evidence of substantive change” not just in depression or health overall but even in gender dysphoria itself. As Kirkey noted: “Many studies suffered from missing data, small sample sizes, or lacked a comparison group.” The researchers concluded: “Since the current best evidence, including our systematic review and meta-analysis, is predominantly very low quality, clinicians must clearly communicate this evidence to patients and caregivers. Treatment decisions should consider the lack of moderate- and high-quality evidence, uncertainty about the effects of puberty blockers and patient’s values and preferences.”

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Jonathon’s writings have been translated into more than six languages and in addition to LifeSiteNews, has been published in the National Post, National Review, First Things, The Federalist, The American Conservative, The Stream, the Jewish Independent, the Hamilton Spectator, Reformed Perspective Magazine, and LifeNews, among others. He is a contributing editor to The European Conservative.

His insights have been featured on CTV, Global News, and the CBC, as well as over twenty radio stations. He regularly speaks on a variety of social issues at universities, high schools, churches, and other functions in Canada, the United States, and Europe.

He is the author of The Culture War, Seeing is Believing: Why Our Culture Must Face the Victims of Abortion, Patriots: The Untold Story of Ireland’s Pro-Life Movement, Prairie Lion: The Life and Times of Ted Byfield, and co-author of A Guide to Discussing Assisted Suicide with Blaise Alleyne.

Jonathon serves as the communications director for the Canadian Centre for Bio-Ethical Reform.

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