>>828837>You're conflating three different claims: whether GnRH suppression itself is reversible, whether prolonged suppression can have adverse effects, and whether an adolescent can have decision-making capacity.Nope, this is a sleight of hand. I've been fairly consistent. The distinction is between the reversibility of the suppressing puberty and the reversibility of the developmental consequences of that suppression.
>There are legitimate risks and uncertainties, particularly concerning bone mineral density.>It explicitly concluded that no conclusions could be drawn about cognitive development.Are you dumb? You're proving my point. The evidence is so weak it fails to meet the basic ethical standard for medical intervention. These are big question marks that need answering if you're going to drugging children to affirm a potential temporary delusion.
>Long-term studies of GnRH agonists in precocious puberty also provide evidence that reproductive function can recover after treatment:Central precocious puberty (CPP) is a condition in which a child's hypothalamic-pituitary-gonadal (HPG) axis activates abnormally early. In the case of "gender" dysphoria, puberty blockers are used to suppress normal, healthy puberty because the child's "gender identity" is apparently incompatible with their sex. The biological context is entirely different. In CPP, the gonads are mature for the child's age but are being prematurely activated. In the so-called "transgender children," their gonads are immature and still developing.
Besides, even the studies you cite have their own limitations. Did you even read them?
Kim (2015):
<Studies of the psychosocial effects on CPP patients after GnRHa treatment are very limited.Thornton et al. (2014):
<Evidence is currently insufficient to identify agent-specific differences in outcomes, reproductive function, and health of offspring.Thus, your invocation of CPP itself does not provide robust evidence of preserved fertility. It provides weak, uncertain evidence from a completely different population.
Besides, why are you citing studies about CPP when we have perfectly good ones about transgenders?
Histological markers of testicular health and spermatogenesis in transgender adolescent girls following puberty suppression and subsequent gender-affirming hormone therapyhttps://www.endocrine-abstracts.org/ea/0110/abstracts/oral-communications/oral-communications-16-reproductive-and-developmental-endocrinology-part-2/ea0110oc165/<Results: As expected, most participants showed spermatogenic arrest at orchidectomy, although full spermatogenesis was observed in a small minority, all treated with CA. All but one had spermatogonial stem cells. A disconnected α-SMA staining pattern and (moderately or severely) increased BMT, both likely indicating testicular damage, were observed in 49,3% and 55,2%, respectively. MJS inversely correlated with BMT. GnRHa were associated with a more immature testicular morphology when compared to CA.<Conclusion: Long-term puberty suppression and subsequent GAHT induces testicular immaturity and spermatogenic arrest in most trans girls. It may in addition cause testicular damage, visible as increased BMT, which adversely correlates with MJS.Advancing the Practice of Pediatric Psychology with Transgender Youth: State of the Science, Ongoing Controversies, and Future Directionshttps://pmc.ncbi.nlm.nih.gov/articles/PMC5969520/pdf/nihms935487.pdf<Treatment with GnRHa during theearly stages of puberty suspends germ cell maturation and limits fertility preservation options (Johnson et al., 2017). Youth who initiate GAH concurrently with GnRHa or prior to discontinuing GnRHa will not have the opportunity to pursue non-experimental oocyte or sperm cryopreservation. While procedures exist to preserve prepubertal ovarian or testicular tissue, these fertility preservation techniques are considered experimental and must be conducted within the confines of an approved IRB protocol (Johnson et al., 2017), thus limiting access to care.>And “the prefrontal cortex isn't fully developed” is not an argument that automatically establishes medical incapacity. Medical decision-making capacity is assessed according to the particular decision: whether the person can understand relevant information, appreciate consequences, reason about alternatives, and communicate a choice.And? You're attacking a claim nobody has made. Children and adolescents typically over-weigh short-term benefits and under-weigh long-term risks.
>There is also research specifically examining decision-making competence in transgender adolescents. In a study of 74 adolescents aged 10–18, 93.2% were judged competent by clinical assessment and 89.2% by the MacCAT-T assessment. This obviously does not mean every 10- or 12-year-old is competent, but it does demonstrate that incomplete prefrontal development is not a substitute for actually assessing capacity.This is a massive overstatement. The MacCAT-T was designed for adults with psychiatric conditions, not children or adolescents. So you're already basing your conclusions off of the improper methodology. Indeed, the studies of MacCAT-T assessments are very inconsistent, particularly with regards to the "appreciation" portions of the test, i.e., the ability to grasp the medical treatment's significance on their lives. The 89% figure simply means that 89% of the adolescents scored as 'competent' on the test; that doesn't mean they genuinely appreciate the lifelong consequences of their actions. The MacCAT-T also doesn't account for things like values and emotions, factors which highly influences someone's decision to "transition."
Surprise, surprise, children and teenagers have a very poor understanding of the consequences of their actions:
The mature minor: some critical psychological reflections on the empirical baseshttps://pubmed.ncbi.nlm.nih.gov/23615057/<subsequent psychological studies have shown that minors generally fail to have realistic affective and evaluative appreciations of the consequences of their decisions, because they tend to over-emphasize short-term benefits and underestimate long-term risks. Also, unlike most decisionmakers over 21, the decisions of minors are more often marked by the lack of adequate impulse control, all of which is reflected in the far higher involvement of adolescents in acts of violence, intentional injury, and serious automobile accidents. These effects are more evident in circumstances that elicit elevated affective responses. The advent of brain imaging has allowed the actual visualization of qualitative differences between how minors versus persons over the age of 21 generally assess risks and benefits and make decisions. In the case of most under the age of 21, subcortical systems fail adequately to be checked by the prefrontal systems that are involved in adult executive decisions.By the way, the very same researchers you're citing, Vrouenraets, et al., qualified their findings, and they undermine your position:
Medical decision-making competence regarding puberty suppression: perceptions of transgender adolescents, their parents and clinicianshttps://pubmed.ncbi.nlm.nih.gov/36115898/<According to international transgender care guidelines, transgender adolescents should have medical decision-making competence (MDC) to start puberty suppression (PS) and halt endogenous pubertal development. However, MDC is a debated concept in adolescent transgender care and little is known about the transgender adolescents', their parents', and clinicians' perspectives on this. Increasing our understanding of these perspectives can improve transgender adolescent care. A qualitative interview study with adolescents attending two Dutch gender identity clinics (eight transgender adolescents who proceeded to gender-affirming hormones after PS, and six adolescents who discontinued PS) and 12 of their parents, and focus groups with ten clinicians was conducted. From thematic analysis, three themes emerged regarding transgender adolescents' MDC to start PS: (1) challenges when assessing MDC, (2) aspects that are considered when assessing MDC, and (3) MDC's relevance. The four criteria one needs to fulfill to have MDC-understanding, appreciating, reasoning, communicating a choice-were all, to a greater or lesser extent, mentioned by most participants, just as MDC being relative to a specific decision and context. Interestingly, most adolescents, parents and clinicians find understanding and appreciating PS and its consequences important for MDC. Nevertheless, most state that the adolescents did not fully understand and appreciate PS and its consequences, but were nonetheless able to decide about PS. Parents' support of their child was considered essential in the decision-making process. Clinicians find MDC difficult to assess and put into practice in a uniform way. Dissemination of knowledge about MDC to start PS would help to adequately support adolescents, parents and clinicians in the decision-making process.>The Cass Review/NHS position is also being overstated. NHS England restricted routine commissioning of puberty-suppressing hormones because of limited evidence concerning safety, risks, benefits and outcomes. That is a conclusion about the limitations and uncertainty of the evidence; it is not a finding that irreversible brain damage or infertility has been demonstrated.Not sure how it's being "overstated" when all I did was copy-paste their core findings. The point is that there isn't enough evidence to support prescribing these drugs to children. The Cass Review was unable to rule out harm to brain function and fertility, i.e., the risks are a real issue. Like I said, the evidence is so weak that it fails to meet the basic ethical standard for medical intervention.
>And the Levine & Abbruzzese paper you're citing is their review and interpretation of the evidence, not one of the governmental systematic reviews itself:Not sure how this changes anything, but OK.
>Finally, “unless you support universal puberty blockers, you don't have an argument” is a non sequitur.Huh? I know you're using AI to generate these replies (because you're too much of a braindead retard to articulate things on your own), but could you at least verify that your AI isn't hallucinating? I never said this.
>The relevant questions are what the evidence shows about benefits and risks, what criteria are used to select patients, and how uncertainty and decision-making capacity are handled.Indeed, and the evidence says there cost-benefit of "gender" transition ranges from unknown to unfavorable.