SEGMさんのポスト

2月24日

Our recent Spotlight highlights a study from Finland, which convincingly demonstrates that suicides are uncommon in gender-dysphoric youth. The study demonstrates why youth gender transitions can’t be justified by the “suicide-prevention” argument./1

Suicide Mortality Among Gender-Dysphoric Adolescents and Young Adults in Finland

Summary A recent study published in BMJ Mental Health, All-cause and suicide mortalities among adolescents and young adults who contacted specialised gender identity services in Finland in 1996–2019,...

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The Norwegian Healthcare Investigation Board, (NHIB/UKOM) has deemed puberty blockers, cross-sex-hormones & surgery for children & young people experimental, determining that the current “gender-affirmative” guidelines are not evidence-based and must be revised. /1

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The President of the American Academy of Pediatrics has announced that gender-affirming hormones & surgery are NOT recommended for the "vast majority" of gender dysphoric youth. This realigns the AAP with Sweden, Finland & the UK's new cautious stance. /1

Opinion | Academy of Pediatrics Responds on Trans Treatment for Kids

wsj.comから

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2023年3月31日

The Director of the Belgian Center for Evidence-Based Medicine (CEBAM) Dr. Patrik Vankrunkelsven has joined a growing list of experts who are criticizing the highly medicalized "gender-affirming" treatment approach for minors with gender dysphoria as not evidence-based. /1

引用

VRT NWS

@vrtnws

2023年3月29日

Fel debat over puberteitsremmers en mannelijke/vrouwelijke hormonen: "Wat jullie doen, is een experiment op kinderen" vrtnws.be/p.mRVGnWK1E?t= #vrtnws

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A new peer-reviewed open-access study exposes deep flaws in the Dutch studies that formed the foundation for youth gender transition. These studies should have never been used to launch the practice into mainstream medicine, conclude the authors./1

The Dutch Studies and The Myth of Reliable Research in Pediatric Gender Medicine

A new open-access publication, “The Myth of Reliable Research in Pediatric Gender Medicine,” focuses on the two Dutch studies that gave rise to “gender-affirmative” care for youth worldwide. The...

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The Karolinska Hospital in Sweden has issued a policy statement regarding treatment of gender dysphoric minors at its pediatric gender services division. This policy ends the practice of prescribing puberty blockers and cross-sex hormones to minors <16. /1

Sweden’s Karolinska Ends All Use of Puberty Blockers and Cross-Sex Hormones for Minors Outside of...

Update May 08, 2021: Following a new policy statement from the Karolinska Hospital that went into effect May 2021, this article has been updated to reflect the changes. Update February, 2022: Swede...

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Uppdaterade rekommendationer för hormonbehandling vid könsdysfori hos unga

2022年2月23日

Yesterday, Sweden released its long-awaited guidelines for the care of gender-dysphoric youth. These guidelines represent a major departure from the WPATH "Standards of Care," and are a vital step towards safeguarding vulnerable youth from medical harm./1

socialstyrelsen.se

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The UKOM report asserts that future guidelines must rely on a systematic review of evidence rather than cherry-picking studies, and that all hormonal and surgical interventions must be restricted to research settings to ensure clear protocols, safeguarding & adequate follow-up./2

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The NHS has ended "gender-affirming care" in England for <18s, according to the newly-released draft guidance. Psychotherapy will be the first & usually only line of treatment. Puberty blockers will be confined to research settings. SEGM's analysis below:

The NHS Ends the "Gender-Affirmative Care Model" for Youth in England

Following extensive stakeholder engagement and a systematic review of evidence, England’s National Health Service (NHS) has issued new draft guidance for the treatment of gender dysphoria in minors,...

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2023年8月17日

The journal of the Danish Medical Association Ugeskrift for Læger has confirmed that Denmark is restricting medical transition of gender-dysphoric minors. Only 6% of the gender clinic referrals were approved for transition in 2022, down from 65% in 2018./1

Denmark Joins the List of Countries That Have Sharply Restricted Youth Gender Transitions

A major medical journal Ugeskrift for Læger, the Journal of the Danish Medical Association, confirmed that there has been a marked shift in the country’s approach to caring for youth with gender...

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A systematic evidence review by the Swedish health authority has just been published in an English-language peer-reviewed journal. It concluded that puberty blockers & cross-sex hormones in <18s are not a medical treatment but experimental procedures./1

A systematic review of hormone treatment for children with gender dysphoria and recommendations for...

onlinelibrary.wiley.comから

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In summary, Sweden has changed direction because of a lack of evidence to support medical interventions for gender-dysphoric minors. A new emphasis has been placed on psychiatric care and psychosocial support. Hormonal interventions for minors will be highly restricted. /10

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Psychological Outcomes of 12–15-Year-Olds with Gender Dysphoria Receiving Pubertal Suppression in...

2023年12月1日

Do puberty blockers improve mental health? The original Dutch studies claimed so, but a replication attempt in the UK failed, finding no impact. A new peer-reviewed reanalysis of the UK data shows that up to 34% of youth actually "reliably deteriorated"./1

tandfonline.com

The evidence base for psychological benefits of GnRHA for adolescents with gender dysphoria (GD) was deemed “low quality” by the UK National Institute of Health and Care Excellence. Limitations ide...

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The Norwegian Healthcare Investigation Board noted several worrying trends: the rapid rise of gender dysphoria in adolescents (esp. females), the high burden of mental illness (75%) & a high prevalence of neurocognitive conditions (ADHD/autism, Tourette) in the affected youth. /6

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The National Academy of Health in France has just issued a press release regarding the care of gender-dysphoric youth. The Academy is advising psychological exploration, and cautions about the risks of pursuing hormones & surgery in youth /1.

National Academy of Medicine in France Advises Caution in Pediatric Gender Transition

The National Academy of Medicine in France has issued a press release in which it cautions medical practitioners that the growing cases of transgender identity in young people are often socially-me...

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Under the current Norwegian guidelines, youth may receive puberty blockers at tanner stage 2, cross-sex-hormones at 16, and surgeries at 18. The report noted that these widely available interventions are irreversible, carry many risks, and rest on insufficient evidence. /4

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However, unlike Sweden, Finland and England, Norway explicitly calls out the group of young adults whose development is still ongoing and who are at risk for erroneously undertaking gender transitions. The report notes that the age of consent for sterilization in Norway is 25./8

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The report criticized Norway’s current "gender-affirmative" guidelines as inadequate, noting a lack of specificity regarding assessment & determination of medical necessity of risky and irreversible interventions provided to youth whose identities are still forming. /5

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The existing Norwegian treatment guidelines for gender-dysphoric youth, based on a 2015 report ”The Right to the Right Sex,” closely mirror WPATH SOC7 “gender-affirming” model. Medical gender affirmation is widely available to youth, with no psychological assessments required. /3

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NHIB/UKOM notes that the right to medical care does not include the right to experimental treatments. As an experimental intervention, gender transitions will be subject to heightened scrutiny around informed consent, eligibility criteria, and outcomes evaluation./9

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Sweden becomes the first country to stop the use of the "Dutch protocol" for treating gender dysphoric minors over concerns of medical harm and low certainty of benefit. Other countries (UK, Finland) are also moving away from medicalizing minors. /2

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The recommendations by the Norwegian Healthcare Investigation Board (NHIB/UKOM) align Norway with the changes among the growing number of European countries (Sweden, Finland, England) which aim to safeguard youth from harm by sharply restricting youth gender transitions. /7

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Norway's proposed model appears to resemble the model of care outlined in the Cass review. Gender dysphoric youth will receive care for their distress in local primary care settings with multidisciplinary support. Youth gender transitions will be an exception, not the rule. /10

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The Board also comments on the highly polarized & unbalanced nature of the discussions surrounding care for gender-dysphoric youth, which stifles scientific debate. The Board calls on all parties to treat each other with professionalism, empathy and respect. /11

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Sweden’s new guidelines emphasize that gender-dysphoric youth will continue to receive care. However, health care for gender dysphoria is no longer reduced to “hormones and surgeries.” The recommendations now call out a key role for psychiatric and psychosocial services. /3

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As international awareness of the low quality of evidence behind "gender-affirming" hormonal interventions grows, the focus is expected to shift to non-invasive options for ameliorating the distress of gender-dysphoric minors, including psychological treatment and support. /3

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2021年11月8日

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) released a position statement in which it no longer presents "gender-affirming" hormonal and surgical interventions as the preferred treatment for gender dysphoria in youth. /1

First Mental Health Guideline to Explicitly Deviate from Gender Affirmation

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) released its first position statement addressing the mental health needs of people with Gender Dysphoria/Gender Incongruence in...

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The guidelines assert that based on current evidence, the risks of hormonal interventions outweigh the possible benefits. Thus, these interventions (often referred to as "gender-affirming care") will not be available outside of research settings, except as "last-resort." /4

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The largest Norwegian daily newspaper, Aftenposten, interviewed the UKOM project leader, Stine Marit Moen. The links to the interview, the executive summary, and the full report are are provided below. /13 aftenposten.no/norge/i/jlwl19 ukom.no/rapporter/pasi

ukom.no

Sammendrag

Vi undersøker alvorlige hendelser og andre alvorlige forhold for å bedre pasientsikkerheten i helse- og omsorgstjenesten.

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The guidelines highlight the unexplained rapid rise in trans identification in youth, especially teenage girls. They also note the worrying rise of detransitioners & regretters, which contradicts prior estimates of "low regret." They cite Littman 2021. /6

Individuals Treated for Gender Dysphoria with Medical and/or Surgical Transition Who Subsequently...

link.springer.comから

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2022年12月17日

Yesterday, the Swedish Board of Health and Welfare published new treatment guidelines for youth with gender dysphoria. The guidelines explicitly instruct medical providers that psychosocial support should be the first line of treatment. /1 socialstyrelsen.se/om-socialstyre

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SEGM will be analyzing the report in more detail. Currently, our assessment is that the UKOM report is akin to UK's Cass Review in that it makes recommendations for restructuring youth gender services. How Norway's NHS will implement these recommendations remains to be seen. /12

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responded to public concern by extending comment deadline to Feb 2. WHO also clarified that it won't make any recommendations for children & adolescents due to limited evidence regarding long-term outcomes of affirmative care for youth. More below: segm.org/world-health-o

引用

SEGM

@segm_ebm

2023年12月27日

The World Health Organization has announced the complete panel developing transgender health guidelines in 2024. The panel's unmanaged conflicts of interest will undermine the guidelines' credibility. Public comment deadline (hiv-aids@who.int) is Jan 8. /1 segm.org/world-health-o

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Research previewed at SEGM's 2023 conference, examining the relationship between youth gender dysphoria (GD) & suicide, has now been published. It concludes that the GD diagnosis doesn't predict suicide when co-occurring mental illness is accounted for. /1 mentalhealth.bmj.com/content/27/1/e

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Yesterday, the UK shut down the world's biggest pediatric clinic, GIDS. The reasons for the shut-down were not mere operational failures. The entire model of care provided by GIDS, "gender-affirming care," was deemed unsafe for gender dysphoric youth. /1 segm.org/UK_shuts-down-

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2023年6月21日

A new peer-reviewed commentary argues that the medical community has a professional responsibility to recognize detransitioners as survivors of iatrogenic harm and provide them with the comprehensive medical and supportive care that they deserve. /1

Iatrogenic Harm in Gender Medicine

In a new peer-reviewed commentary published in the Journal of Sex & Marital Therapy, author, Dr. Sarah Jorgensen, argues that the medical community has a professional responsibility to recognize...

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The claim that youth whose breasts are removed "can always get them later" contributes to the U.S. gender medicine establishment's promotion of mastectomies for minors 12-13+. However, the surgical technique in masculinizing mastectomy makes reversals unfeasible in most cases. /1

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The

@AAPPres

states that the vast majority of gender dysphoric youth need "just the opposite" of hormones & surgery. We call on the

@AmerAcadPeds

to update its guidelines accordingly & articulate the alternative treatment paths including the role of exploratory psychotherapy. /2

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2022年9月29日

The wave of teens seeking gender transition in the UK continues to grow. According to the most recent data released by #GIDS and its new referral service, after a COVID dip, referrals doubled 2021-22, for a total of 5,000+ referrals. Teen girls continue to dominate this trend. /1

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Sweden is centralizing its gender care for minors to a few centers for highly specialized care. Individual clinics and private providers will not be allowed to provide "gender-affirming" services. /8

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Sweden is realigning with the classic “Dutch Protocol” model, where only early childhood-onset gender dysphoria cases will be considered for hormones and surgeries. Those with post-puberty onset of trans identity will not be candidates for hormones/surgeries as minors. /5

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