Link: https://pediatrics.aappublications.org/content/134/4/696 … Weaknesses of the study: no counseled-only controls, have to go to a second paper to understand the type of counseling provided to patients, poor peer review(multiple different conclusions are possible from this paper).>>
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The paper’s authors conclude: “A clinical protocol of a multidisciplinary team with mental health professionals, physicians, and surgeons, including puberty suppression, >>
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followed by CSH and SRS, provided gender dysphoric youth who seek gender reassignment from early puberty on, the opportunity to develop into well-functioning young adults.” >>
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There’s other possible conclusions from the data: 1. The intensive 'modified therapeutic model' of counseling applied to GD youth and their families, as part of the Dutch Protocol, or just the aging process itself, or both, >>
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resulted in slow but steady improvements in some markers of psychological health over the course of 6 years. >>
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2. CSH&SRS resolved gender dysphoria, but that had no noticeable positive impact on psychological well being. Why do I say that? >>
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Psychological improvements did not speed up after CSH/SRS, they stayed the same, or even slowed down. CSH/SRS seemed to have had no positive impact on psychological improvement. >>
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If CSH&/orSRS was an impactful therapeutic intervention, the biggest improvements in psychological functioning would have been expected to occur after these interventions. They did not. >>
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Possible explanations? 1. Gender dysphoria is a symptom of an underlying root issue (autogynephilia, or rejection of one’s same sex attraction, or more recently of trauma, or ASC thought processes, or pubertal stress), not a stand alone primary entity. >>
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2. CSH&SRS treat the symptom, not the underlying etiology. (Tylenol treats a fever, but not the underlying cause, to borrow an analogy). 3. Intensive counseling, or brain maturation as a result of aging, or both, helps resolve conflicts of identity. >>
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The point is, definitive conclusions are not possible from a study like this, and there is not enough evidence to support PB, CSH and GRS in adolescents with GD. Hormones and surgical treatments for GD in adolescents should be restricted to clinical trials. >>
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[of last note, only MtF ID’d showed statistically significant improvements in global functioning, and no subgroup analysis was done (AGP vs same sex attracted]. ///
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To add more clarity to my position, I personally don’t see how minors can consent to any of these interventions, and so the use of hormones and surgery, even in the context of clinical trials, is highly problematic. ////
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