Comment by a_shovel | Hacker News Reader

Comment by a_shovel | Hacker News Reader

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"Gender-Affirming Medical Treatments for Pediatric Patients with Gender Dysphoria", College of Pharmacy University of Utah, https://le.utah.gov/AgencyRP/reportingDetail.jsp?rid=636 , states:

> Page 116: "... the consensus of the evidence supports that the treatments are effective in terms of mental health, psychosocial outcomes, and the induction of body changes consistent with the affirmed gender in pediatric GD patients. The evidence also supports that the treatments are safe in terms of changes to bone density, cardiovascular risk factors, metabolic changes, and cancer."

If you could cite these randomized controlled trials, that would be great.

In how many US states were pediatric gender treatments suspended or phased out by medical bodies because doctors examined the evidence and determined that the treatments were not beneficial? That's what I would expect if the treatments really didn't work. From what I know, this isn't the case for any of the bans. The bans are all laws passed by state legislatures, especially conservative ones, and aren't meaningful evidence of anything except conservative lawmakers' political incentives.

You didn't link to a randomized controlled trial. You linked to a meta review. This is just reading and summarizing past research publications, not a RCT.

To date, no American study has been conducted that randomly assigned patients into groups put on blockers or not. That's the best way to study the effects of blockers: Have psychiatrists identify a group of 100 people that they think should be put on blockers. Flip a coin to assign 50 of those patients into a control group that doesn't receive blocker and the other 50 do. And then monitor their lifetime outcomes.

This is how the Finnish 2019 study functioned, and they found no improvement over the control group (and the country stopped providing blockers a year later). American gender medicine researches argue that it's unethical to conduct an RCT and deprive have the patient sample access to life-saving care. But of course, they don't know that this care is beneficial - let alone "life-saving" - until they actually compare the outcomes against a control group.

It's unfortunate that the rollbacks in America had to come from politicians instead of an internal process from the medical establishment. But ultimately, North American gender medicine has thus far refused to conduct effective research into the efficacy of medicalized youth gender care like their European colleagues. Politicians, and the public, have recognized this.

If proponents of medicalized youth gender care want to try and justify that this treatment is necessary, they ought to actually do randomized controlled trials. If we have cohorts of children expressing the same levels of discomfort with their gender, and the randomly-assigned treatment group sees better outcomes than the control group, that is a much stronger piece of evidence than only having a treatment group and baselessly claiming that the control group would have fared worse.

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