- “They are new and untested”
They’ve been used since 1988 for trans adolescents, with follow up studies over twenty years. There are over 30 academic papers summarised here:
- “Kids are too young to have blockers”
They are used on trans adolescents. Somehow there’s no big controversy in their use for precocious puberty, which is at a much younger age. They are used to block puberty, which, funnily enough, means they are used at the start of puberty.
- “They are powerful cancer drugs”
They are used to stop testosterone and oestrogen. This can be useful to stop puberty, or also can be useful when certain cancers are exacerbated by testosterone or oestrogen. Calling them a cancer drug is bad faith misleading scaremongering.
- “They are not reversible”
They are medically and physically reversible. If you stop taking them, puberty continues. Sometimes people then go on to say “we do not know their psychological impact” or “if adolescents have blockers, they can’t turn back time to have never had blockers”. Well unless you invent a sliding doors time machine, every single action we take is irreversible. This is such a bad faith argument.
- “They are experimental / not licensed for use in trans adolescents”
Lots of medication is not specifically licensed for that purpose – this argument is bad faith as debunked in detail in this article:
- “The existing evidence is not high quality”
Sample sizes in the studies are small, because very few trans adolescents have been treated to date. Want larger sample sizes? Then you have to prescribe to more trans adolescents.
- “There has not been a Randomised Control Trial”
A score of experts have time and again stated that a Randomised Control Trial is unethical, and would not be feasible. Some bad faith commentators even ask for a Blinded RCT – as if trans adolescents wouldn’t notice progressing through puberty! Bad Faith.
- “Z Value Bone Density decreases when adolescents are on blockers”
It took me a long while to understand why this is so bad faith. Z value bone density compares bone density to expected age-based norms of the assigned gender for cis children. Bone density rises during puberty, those on blockers do not have this bone density rise at the same time as their peers, so their bone density compared to same age cis peers decreases (even where actual bone density continues to rise, albeit more slowly than their pubertal peers. Puberty is the thing that causes bone density to increase. If you delay puberty, of course trans youth don’t get this rise in bone density at the expected age.
- “We don’t know the impact on brain”
Again, really bad faith. There are many many things we do not know about brains. Puberty blockers have been studied for their impact on many different variables, their impact on kidney function (fine) their impact on well-being (improves it), their impact on mental health (improves it), their impact on dysphoria (stays same, HRT is the thing that makes the difference to dysphoria). They even have been studied for effect on executive function (no negative impact). There is much evidence of benefits and no evidence of harm. And we make decisions based on the current evidence.
- “Just do nothing until there is much more evidence”
Doing nothing is not a neutral decision. Puberty for trans adolescents causes significant harm. Puberty blockers are proven to be beneficial. Withholding beneficial medical care is not a value neutral ethical decision.
- Other signs of bad faith include quoting fringe medical sources including the American College of Pediatricians. Quoting transphobic former GIDS psychoanalysts (with no medical qualifications). Having more interest in the brain scans of pubertal sheep than in the well-being of trans teens
- Further signs of bad faith include: Citing your own non-peer reviewed opinion piece in the journal you used to work at as evidence to justify a BBC prime time show. Using BBC funding to hire someone with no expertise in caring for trans adolescents to write a critical summary of the literature raising the bad faith concerns listed above.
- Further signs of bad faith include: Failing to report the clear well-being benefits of timely blockers including teens not in acute distress and pain, teens not dropping out of school, teens not failing at school, teens learning and growing and enjoying their adolescence.
- Yet more signs of bad faith include failing to state the global medical consensus backing puberty blockers including from the Endocrine Society, the American Academy of Paediatrics, the World Professional Association of Transgender Health, and many, many more.
- The final bad faith sign I’ll list here, is failing to clarify if your preferred medical outcome for trans youth is denial of medical support and instead psychotherapy to help them ‘accept themselves as they are’. This is conversion therapy. It causes immense harm and there is no place for it in modern medical practice.
Just admit you don’t like trans people already.