Gender Medicine Monthly

September - October

This is the 7th edition of my newsletter Gender Medicine Monthly, dedicated to sharing updates related to gender medicine with a particular focus on pediatric gender medicine and the affirmative model of care, for paying subscribers. 

March’s inaugural issue is free, as well as a preview of the first part of each issue. If you find the content of this newsletter valuable, please consider becoming a paid subscriber. Your support helps me dedicate my time and energy to producing quality content.

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In light of the recent terrorist attack on Israel, I found it important to delay the release of this newsletter, which was scheduled for publication two weeks ago, to make room for learning, understanding, and reflection on the current tragedy in the Middle East.

Without further ado, here are some important headlines in gender medicine from the month of September (and the first week of October) covered in this edition of Gender Medicine Monthly.

1. New analysis on puberty blockers found one-third of kids’ mental health deteriorated 

2. Two Missouri pediatric gender clinics cease transitioning minors 

3. Nebraska places age restrictions on surgery, limitations on hormones for youth

4. Detransitioner files 5th U.S. lawsuit against medical transition of minors

5. New report highlights Planned Parenthood’s lack of patient safeguarding for medical transition 

6. ACLU loses appeal to overturn age restrictions on youth medical transition in Tennessee and Kentucky

7. Genspect's 2nd 'The Bigger Picture' Conference: November 4-5 in Denver, Colorado

   

1. New analysis on puberty blockers found one-third of kids’ mental health deteriorated

Source: BBC 9/19/23

A recent re-analysis of a prominent study on puberty blockers for gender dysphoric youth in England revealed significant impacts on mental health after 12 months.

In 2011, the Tavistock's Gender Identity Development Service (GIDS), the only NHS specialist gender clinic for children in England, collaborated with University College London Hospitals (UCLH) on the early intervention study. Over three years, they enrolled 44 children aged 12 to 15 to investigate the effects of puberty blockers.

The original study, published in 2021, claimed "no changes in psychological function" after puberty blocker use. However, this conclusion was based on a group average of scores collected at various times.

Professor Susan McPherson from the University of Essex and retired social scientist David Freedman re-analyzed the data, focusing on individual trajectories of the young participants. Their findings after 12 months of puberty blocker injections indicated that 34% of the children had reliably deteriorated, 29% had reliably improved, and 37% showed no change, as per their self-reported responses.

The authors of the original report welcomed this new evidence. Hannah Barnes, author of "Time to Think," reported on this for the BBC, and a related 10-minute feature is available to watch below.

Significance: This study had a significant impact on policy, leading to the lowering of the age at which puberty blockers could be used in England, even before results were known in 2014.

This study, like many others in the field, was small and uncontrolled. Consequently, systematic evidence reviews conducted in several countries across Europe and the U.S. state of Florida consistently rate the quality of evidence for transitioning children as "very low." These assessments have resulted in restrictions on medical transitions for minors in England, Sweden, Finland, Denmark, and soon Norway.

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2. Two Missouri pediatric gender clinics cease transitioning minors 

Source: NYT  9/11/23

Two university-affiliated hospitals in Missouri have stopped providing medical transition services to gender-distressed children, going beyond the requirements of a new law. The Washington University Transgender Center at St. Louis Children’s Hospital and the University of Missouri Health Care have announced they will no longer prescribe puberty blockers or cross-sex hormones to minors for gender transition purposes. Instead, they will refer current patients to other providers while maintaining mental health services and other non-prohibited offerings.

The new law, SB 49, prohibits gender transition surgeries and the prescription of such medications for individuals under 18. However, this law does not affect minors who were already receiving treatment before its effective date. 

Additionally, the Washington University Transgender Center is under investigation following allegations from former case manager Jamie Reed, who blew the whistle on the "morally and medically appalling" treatment causing "permanent harm" to children.

Significance: Both institutions have cited a provision in the law that allows patients to sue their doctors for malpractice related to these services up to 15 years after treatment or turning 21. Additionally, the law presumes harm if the drugs result in infertility.

Despite their professed confidence in the evidence of benefit and the assertion of providing "lifesaving care," they have chosen to discontinue offering these treatments to those already undergoing them due to concerns about potential lawsuits.

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3. Nebraska places age restrictions on surgery, limitations on hormones for youth