Doctor scrutiny on gender clinic reveals legal and safety fears

Doctors treating children at a major public hospital gender clinic have questioned the basis of the “gender-affirming” approach in medicine, highlighting sparse evidence justifying the use of puberty blockers, instances of serious side-effects from the drugs, ongoing mental distress following transition and the significant potential for later regret among patients.

Senior physicians at the NSW Children’s Hospital Westmead’s gender clinic have studied the physical and mental health of 79 patients in a rare academic study of the outcomes of children who presented with gender distress and gender dysphoria. The findings cast doubt on the scientific basis of the gender-affirming approach followed by the nation’s other children’s hospitals.

In an open access academic paper, CHW psychiatrists, endocrinologists and other physicians, and a senior medical ethics expert, called for a “much more nuanced and complex approach” as analysis revealed 88 per cent of children presenting at Westmead’s gender clinic had at least one co-morbid mental health condition, with more than 50 per cent diagnosed with behavioural disorders or autism. One in five children who consulted the clinic with gender-related distress later had these feelings resolved, and almost one in 10 with a formal diagnosis of gender dysphoria, some who had taken puberty blockers and cross-sex hormones, later discontinued transitioning.

Given this, the adoption of a “neutral therapeutic stance” and provision of “a much more diverse range of treatment options and pathways as an alternative to medical gender transition was necessary”, the doctors concluded.

One of the central justifications for gender-affirming medicine – that it alleviated psychological distress – was not borne out in the experience of the young people studied, with 44 out of 50 patients diagnosed with gender dysphoria reporting ongoing mental health concerns four to nine years after presentation at the gender clinic, many after transitioning.

Parents of children with gender distress are often told their child is at high risk of suicide if the gender-affirming path is not followed. “An unanswered question in the paediatric literature is whether gender-affirming medical treatment improves or does not improve mental health outcomes and quality of life,” said CHW doctors, including paediatric psychiatrist Kasia Kozlowska, paediatric endocrinologists Geoffrey Ambler and Ann Maguire and physician Joseph Elkadi.

Former Yale Law School medical ethics expert Stephen Scher was also a co-author. “In the era of evidence-based medicine, the evidence base pertaining to the gender-affirming medical pathway is sparse and, for the young people who may regret their choice of pathway at a future point in time, the risks for potential harm are significant,” the authors said.

The study comes as the approach of doctors practising gender-affirming medicine comes under scrutiny in court, as parents seeking to block prescription of puberty blockers to their children call expert witnesses to challenge the evidence. One recent Family Court case initiated by a parent seeking to halt their child being prescribed puberty blockers was settled midway through evidence as doctors from a major children’s hospital gender clinic called as witnesses came under scrutiny.

Solicitor Bill Kordos, who acted for the parent, said: “What became apparent to me running the case is that the science and the evidence didn’t seem to support the recommendations of the gender clinic. The unravelling of the science and the medicine was so telling that I in fact became alarmed that, if this is one case, and there are hundreds of children being put on what seems to be a conveyor belt, and young children are being told they have gender dysphoria without the whole picture being addressed, at the end of this court case I felt it was a form of child abuse.

“I also formed the view that they appeared to have politicised healthcare, which directly threatens the welfare of children. An inquiry should be held as to how these clinics are operating. I think they’re exposing themselves to a massive class action.”

The Australian litigation comes as senior doctors from the UK’s Tavistock Clinic spoke out in a new book by British journalist Hannah Barnes at their growing concerns the gender-affirming ­approach they were following ”wasn’t actually safe” and may amount to a medical scandal. The Cass Review in the UK, which led to the shutdown of Tavistock, has said it was now examining gender-affirming medicine guidelines set by the World Professional Association for Transgender Health.

The gender-affirming approach has been championed in Australia by paediatrician Michelle Telfer and colleagues at the Melbourne Royal Children’s Hospital. Dr Telfer helped author the Australian Standards of Care and Treatment Guidelines for trans and gender-diverse children and adolescents, following The Netherlands model and based heavily on World Professional Association for Transgender Health guidelines.

Australian Professional Association for Trans Health standards are followed by most doctors treating patients with gender dysphoria in Australia, from major children’s hospital clinics to general practitioners. Gender-affirming care is designed to support and affirm an individual’s perceived gender identity, including the prescription of puberty blockers and hormone treatments to medically affirm the patient’s perceived gender. The guidelines stipulate decision-making, including relating to medical intervention and social transitioning, “should be driven by the child or adolescent wherever possible”.

The ABC’s failure to cover the closure of Britain’s Tavistock serves as another example of the national broadcaster… not wanting to tell Australians an “inconvenient truth,” Sky News Digital Editor Jack Houghton says. Media Watch host Paul Barry pointed out the ABC had no trace of the story and, More
CHW doctors disputed that these standards amount to national guidelines. “The title is actually misleading,” the authors write. “In Australia there are no official or authorised government-commissioned standards for assessing or treating gender dysphoria.”

The Royal Children’s Hospital and Associate Professor Telfer, director of the RCH Gender Service, declined to respond to questions surrounding the standards of care, the evidence base underpinning the gender-affirmative model, risk of regret among patients and potential harms of drug treatments.

AusPATH president Clara Tuck Meng Soo did not respond to a request for comment.

The CHW doctors have raised concerns that “many unknowns remain” regarding the long-term effects of puberty blockers, which are described by the Royal Children's Hospital Melbourne as “reversible in their effects”. International evidence is in fact casting greater doubt on whether the effects of these medications are reversible. Endocrine reviews of the CHW patient cohort documented side-effects in 23 of the 49 young people prescribed puberty blockers, including low bone density, hot flushes, weight gain and anxiety. The CHW doctors raised concerns about long-term effects on patients’ sexual function in adulthood.

Within the 9 per cent cohort of patients with a diagnosis of gender dysphoria who had desisted – that is, discontinued the transgender pathway 4-9 years after consulting the gender clinic – three had undergone puberty suppression beginning at the average age of 12. Three had taken cross-sex hormones, one from as young as 15, but not prescribed by CHW. The effects of cross-sex hormones, including infertility, are irreversible.

Transgender activists claim rates of transition are in the order of less than 1 per cent. But the CHW doctors say the “emerging voices of detransitioners are identifying important issues”, and remain concerned that – even when exploratory psychotherapy is emphasised, as per the more conservative Finnish, Swedish and new British guidelines – “a serious problem remains” in identifying those young people who may regret their transition.

The hospital said it appeared many young people were accessing cross-sex hormones from unregulated sources or providers, as 51 of the cohort they studied had commenced treatment outside the institution, 20 of whom were under 16. Six young people studied had undergone gender-affirming surgery such as mastectomy.

The CHW doctors also identified concerns around the increasing prevalence of predominantly female patients with “late-onset, rapid-onset or adolescent-onset gender dysphoria” with no prior history of gender distress presenting at gender clinics. “The absence of prior history raised questions that this particular group of adolescents were being drawn to the construct of gender dysphoria because of some evolving social process,” the doctors said.

https://www.theaustralian.com.au/science/doctor-scrutiny-on-gender-clinic-reveals-legal-and-safety-fears/news-story/8af81768fde27884caf18fff345ab78a

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A bleak future for Australia's energy supply

The energy crisis that became real for many Australians in 2022 is at severe risk of becoming the norm.

Last month, the Australian Competition and Consumer Commission released their latest gas inquiry report which gave a stark warning to Australia’s leaders about the perilous state of the east coast’s energy security.

The report stated that investment in gas production is urgently required to avoid shortages and blackouts along Australia’s east coast:

‘Without additional gas supply, transportation, and storage infrastructure, there remain significant risks to domestic energy security over the medium to longer term. It is important therefore that governments continue to support the efficient, competitive, and timely development of new sources of supply and infrastructure.’

Despite this, the federal government has continued to pursue policies that deter investment in the gas sector, causing higher prices through lower supply.

The Albanese government’s announcement of reforms to the ‘safeguard mechanism’ to, effectively, re-introduce the carbon tax first pursued by the Rudd and Gillard governments, which was subsequently and overwhelmingly rejected by Australians a decade ago, is a prime example.

The reformed ‘safeguard mechanism’ will mandate that certain businesses purchase carbon credits from other businesses that emit below their regulated levels. If they cannot trade, they must pay a levy to the federal government.

Recent analysis by the Institute of Public Affairs has identified that 88 per cent of the facilities that this policy targets are in our critical resources and manufacturing sectors, and over eight in ten facilities are located in regional Australia.

BHP has indicated that Australia’s current and proposed energy policy settings will bring forward, by four years, the closure of its Mt Arthur coal mine in the Hunter Valley, which will only further increase power prices.

The Albanese government has pointed to a 205 million tonne reduction of CO2 emissions by the end of the decade, which will be equivalent to just 0.08 per cent of global carbon emissions in that period. All this economic pain, for little to no environmental gain.

Fortunately for mainstream Australians, the Federal Opposition have come out and publicly opposed this policy, which means the federal government will now have to deal with the Greens and the crossbench.

However, the Greens have publicly and repeatedly stated that their support for the reforms hinges on the federal government banning of all future coal and gas projects in Australia.

IPA research has identified such demands would see the cancellation of 86 coal and gas projects currently in the construction pipeline, 473,000 new jobs located in regional Australia foregone and up to $268.5 billion in direct and indirect economic activity squandered.

This latest energy policy proposal from the federal government follows hot on the heels of the Prime Minister’s emergency sitting of parliament to rush through a price cap on the domestic coal and gas supply.

The Prime Minister claimed without these measures, household energy bills would rise $230 per year over and above the already record increases we all face.

Unsurprisingly, the move to cap the price of gas saw a number of energy retailers cease taking on new customers, along with increasing their prices, as they struggled to secure supply from producers.

Of course, this was entirely predictable. When you artificially limit a company’s ability to get a return on investment, through a carbon tax or restricted revenue, it naturally makes them less likely to invest in the production of gas.

The policy settings being pursued by the Albanese government are diametrically opposed to the advice of Australia’s energy market experts and participants. The bottom line is, a further limited gas supply leaves everyday Australians with higher household energy bills.

These policies will also impact Australia’s trade revenue, domestic manufacturing capabilities, domestic energy generation capabilities, employment opportunities, and the development of regional Australia. Again, all for minimal future environmental gain.

Australia’s current energy crisis is entirely of our own making. It has been caused by deliberate policy decisions by our leaders and it is mainstream Australians who are paying the price daily.

https://www.spectator.com.au/2023/02/energy-crisis-households-pay-for-safety-mechanism/

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Controversial shark control

Dan Webber

It’s not easy being pro-human in the shark debate. Eco-warriors think we not only hate sharks, but nature in general. Apart from being wrong, such religious zealotry probably indicates that they hate humans, and society in general. So, it is not surprising that people avoid the conversation, no doubt fearing retribution. But, the government ought not be swayed by this vocal minority.

I recently attended a public lecture by shark scientist Victor Peddemors, who works for the NSW Department of Primary Industries (DPI). He confessed that, while the purpose of their research is to find a solution to shark attacks, it is very difficult to identify risk factors when there are so few attacks. For example, in research co-authored by Peddemors, El Niño was found to be a likely risk factor. However, two years later, a spate of attacks occurred during a mild La Niña.

It is foolish to expect that a solution will be found that does not involve reducing the population of sharks. That is why I have suggested targeting the most aggressive sharks with an electrified drumline that deters less aggressive sharks. It seems like a reasonable compromise. But, the government is afraid of the inevitable backlash from eco-warriors, who will continue to impose their values on society, disregarding the human cost, or outright celebrating it.

The problem with the debate is that it hinges on a false dichotomy pitting humans against nature. The anti-human sentiment has become so ingrained in progressive thought that the occasional shark attack is likely viewed as a necessary sacrifice. It is futile arguing with people who subscribe to this worldview. But, there is hope, if we reframe the debate, so that it focuses on protecting all mammals in the wild, not just humans.

I have argued, for instance, that the added benefit of significantly reducing the rate of shark attacks is that it would set the stage for the removal of shark nets, which regrettably catch a lot of non-target species, including dolphins and whales. But, any reduction in shark attacks would apply to all potential prey, including dolphins and whales. So, the removal of aggressive sharks could have a profound effect on their welfare, too.

The only response I have received from the government has been a stock standard reply, outlining the current suite of shark mitigation measures, designed to balance the protection of sharks with the protection of people. Their letter made no reference to my proposal. So, I requested a meeting, hoping to discuss the matter, but they didn’t reply. The reason I persist is that I don’t believe anyone in the know actually believes that lives will be saved.

For example, in research estimating the future rate of shark attacks, our most qualified shark scientists completely overlook the effect of the government’s shark mitigation programs. Of course, the numbers are buried under a mountain of obfuscation, fancifully modelled as the widespread adoption of shark shields. But, it is clear that the base rate of shark attacks, i.e. without anyone using a Shark Shield, is projected to continue rising at the present rate, despite massive investment in other shark mitigation measures.

The government needs to ask the scientists at DPI if they actually believe the current suite of shark mitigation measures is saving lives. While it is certainly true that shark attacks are rare, the resulting trauma ripples much further through society than other tragedies. Dubbed The Jaws Effect, the horrific spectacle of shark attacks haunts ocean users, despite the risk of injury or death being less than it is for cycling. Even Dr Peddemors is reluctant to swim out too far.

https://www.spectator.com.au/2023/02/the-jaws-effect/

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Why Anthony Albanese will be a oncer

Des Houghton

Today I’ll go out on a limb and say that Albo is starting to look like a oncer. Nice guy that he may be, I suspect the Prime Minister will crash and burn and lead Labor to a humiliating loss at the next election.

His election manifesto suddenly has more holes than a Swiss cheese.

A damaging recession may be looming that would sink his re-election hopes. And discontent is growing about his inability to stop the soaring cost of living or make good his pledge to deliver real wage rises. Albanese is now fighting bushfires on several fronts. His key election pledges are in tatters.

I thought he looked clumsy and unconvincing as he dodged questions in the House of Representatives this week where Opposition leader Peter Dutton clearly got the better of him.

Albo simply hasn’t got Kevin Rudd’s intellect, Bob Hawke’s charisma or Paul Keating’s rat cunning. He is starting to look like a political aberration.

He might have a heart, but he also has big trouble wrestling with his party’s hysterical commitment to untested renewables over fossil fuels. Meanwhile, Labor’s obsession with the Indigenous Voice vote has divided the nation.

And this week we saw a widening of the cultural wars with attacks on people of faith. Albanese, like Gough Whitlam, may be moving too fast in attempting to seduce Australians into embracing a socialist state they do not want and cannot pay for.

I thought so when I read with disbelief that spiritual leaders fear government meddling would undermine religious freedoms by preventing faith-based schools employing teachers who share the same faith. Labor has picked a fight with Christians, Jews and members of Islamic faiths by proposing to change anti-discrimination laws to impose state controls. Are we witnessing the sovietisation of Australia?

Church leaders were rightly shocked by Australian Law Reform Commission proposals that principals be barred from preferencing the employment of teachers with the same beliefs and spiritual outlook as their institutions.

And now Albo’s signature ­climate policy that underpins Labor’s election promise to achieve 43 per cent emissions reductions by 2030 is on the brink of collapse. The Greens want to kill it unless coal and gas is banned. It’s a ridiculous threat that would cost thousands of jobs and cut billions in royalty revenue and taxes.

And while the Greens snap at his heels, the Albanese government is under pressure from unions, the business community and the Australian Competition & Consumer Commission to unlock new gas fields or face an energy meltdown by 2027.

Albanese only has himself to blame for legislating the 43 per cent cut in carbon dioxide emissions without first having consensus on how to achieve it. If Albanese’s plans are blocked, it will punch a huge hole in his credibility as well as his agenda. Some commentators suggest it ranks with Rudd’s humiliating climate change defeat in 2009 at the hands of the Coalition and the Greens.

The fate of the government’s so-called safeguard mechanism is still unclear. It is another overcomplicated intrusion into the free market that will require big companies to reduce their carbon dioxide emissions by about 5 per cent each year or buy tradeable permits to cover them. Dutton rightly dismisses it as a stealthy and unreasonable carbon tax the Coalition wont support. Before the election Albanese and Chalmers said Labor would cut power prices and put the brakes on interest rate rises that have begun to force people out of their homes.

In the public mind this will be Albo’s biggest failure.

Government spending is fuelling inflation as battlers face savage hikes in food and petrol prices while juggling home loan repayments.

Albo’s woes come as bastard banks continue to press the boot on mortgage man’s throat. Financial guru Noel Whittaker summed up the dilemma in his last Sunday Mail column: “Most banks have a policy of moving your home loan to a ‘default interest rate’ once you are in arrears.

“This means they raise the interest rate on the home loan purely because you are having trouble making the payments now. But if you can’t make the payments at the normal interest rates, how could you possibly make them when the rate has been raised?

“It’s not rocket science – this is kicking you when you are down.”

And while Australians are being forced out of their homes, many uninvited non-citizens are about to get free housing. Labor’s election pledge to end the use of Temporary Protection Visas will ­pave the way for about 19,000 refugees who arrived by sea to stay permanently in Australia. These uninvited non-citizens will get housing, social security rights, higher education support and access to the National Disability Insurance Scheme, along with Medicare cover and mental health support.

The Australian reports our defence forces expect a possible surge in asylum-seeker boats as the visa rules are relaxed. The nation faces a new round of people smuggling.

https://www.couriermail.com.au/news/opinion/des-houghton-why-anthony-albanese-will-be-a-oncer/news-story/9679cbdc95a4bab7b164c038fe88417d

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Also see my other blogs. Main ones below:

http://dissectleft.blogspot.com (DISSECTING LEFTISM -- daily)

http://antigreen.blogspot.com (GREENIE WATCH)

http://pcwatch.blogspot.com (POLITICAL CORRECTNESS WATCH)

http://edwatch.blogspot.com (EDUCATION WATCH)

http://snorphty.blogspot.com/ (TONGUE-TIED)

http://jonjayray.com/blogall.html More blogs

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