bjn wrote: Wed Jun 19, 2024 3:21 pm
There may be a few myths out there, but the report does seem to have systemic bias as to what they considered and what they did not and draws invalid conclusions from the papers it did survey. Reasoned outlines to various objections reported by Rebecca Watson.
https://skepchick.org/2024/06/the-cass-repo
Skepchick refers us to some academic papers that draw attention to some problems with the Cass Review. Some of those problems, like a particularly unfortunate misprint of a number, are clearly quite correct. Others, I'm not convinced I'm reading something that comes from a neutral, objective position, but rather one that starts from the position that what the Tavistock Clinic was doing was the correct thing. Which at the moment I'm not very willing to accept as being a neutral, objective position.
I would be delighted to read such a review paper if I was sure that it was coming from neutral objective position, but I see a lot of signs that this is not the case here.
Skepchick refers to the "rabid anti-science transphobic mob" (RASTM). They certainly exist and make a lot of noise. And they have their own problems with the Cass Review for not confirming their particular position as they would like it, and have been telling porkies about what the Cass Review actually says to try and pretend it does, as documented earlier in the thread. But I see no reference to what I perceive as the other extreme. And I somewhat fear that a large fraction of the population is being painted as transphobic, if not quite in the rabid anti-science mob, for not signing up to what I perceive as the other extreme. I have a perception, please correct or clarify if this is wrong, that the academic gender studies area tends to exclude you if you don't come from what many would perceive as a fairly extreme position, and won't publish you unless you affirm that position. I think that has been said on this forum.
When I previously enquired on this forum about ROGD, which comes from the RASTM, I was given useful references which seemed to come from a more neutral, objective position that what I am perceiving here from Skepchick and the papers she cites.
When Skepchick refers to "gender affirming care", and the paper Skepchick particularly quotes,
Biological and psychosocial evidence in the Cass Review: a critical commentary, refers to as the established "standard of care" (SOC) as commonly applied in the US and now being denied here in England, I read that as being basically what the Tavistock Clinic was recently doing. So it seems to me that this whole argument starts from the premise that there was nothing wrong at the Tavistock Clinic, as it delivered the SOC as supported by the (limited and defective) literature. And if I think otherwise, apparently I'm transphobe, along with the great majority of the population. That seems to me to be what it is subtly implying.
There was a documentary on the BBC about the Tavistock Clinic. Now the BBC doesn't mind being, from time to time, of late, the right wing instrument of government, in fear at being abolished or defunded. But I didn't perceive that in this particular case. I was given the impression that a lot of the disquiet came from internal experts who had been frightened to speak out, as there is pressure to conform to the particular position. They also indicated that there was very little data on people who detransitioned or who were otherwise dropped out or were unhappy with their care at the Tavistock, as Tavistock dropped such patients and didn't follow up on them or record their outcomes. The documentary showed us both someone who was very happy with being helped to transition, and someone else who was very angry at being supported to transition and, after a mastectomy, was detransitioning. The issue is finding a way to make sure the first can happen while the latter doesn't happen. The perception I have is that the extreme position is more happy to support the former and sweeps the latter under the carpet, as indeed the Tavistock seems to have been doing.
The article quoted by Skepchick is in the International Journal of Transgender Health. Since I have that perception that gender studies has been largely monopolised by people coming from a particular position, that raises the suspicion that you mainly see articles from that viewpoint in that journal. So I'd prefer to see an article in a journal that doesn't have that particular specialty, with a broader editorial board. For example, the paper quotes the main peer-reviewed papers Taylor et al (2024a to d), which were put together for the Cass Review, and they were published in such a more general pediatric journal. If I have time, I'd like to look through those Taylor papers, but I was rather hoping someone else could give me an overview, someone that I wasn't suspecting of coming from a particular viewpoint.
But that is a minor point. What concerns me more is the 2nd sentence of the introduction, which runs:
"The Review was commissioned in the context of particular hostility in the UK toward trans individuals (Walters et al., Citation2020), and a high-profile legal case regarding trans children’s ability to consent to puberty blockers (de Vries et al., Citation2021)."
That is plainly completely true. But it also seems to neglect other important aspects of the context. Why does it mention only that one legal case, and not the broader concern from both experts and the general public about what was going on at the Tavistock? Is that all summarised as "particular hostility"?
One of the arguments that the Cass Review makes is that "experimental treatments" were being applied. That is not denied, or I haven't spotted that, in these articles. But it is asserted that it is the established SOC is at least supported by the (admittedly inadequate) literature and what Cass proposes is equally experimental. But I would say that from the point of view of the important medical criterion "first, do no harm", in choosing between the two "experimental treatments", what the Cass Review recommends much better meets that criterion.
So, in sum, I have a perception that this is the particular extreme position, that was never unhappy with what was going on at the Tavistock, reminding us of why it was happy with it. If that is the case, then I would not call that an objective and neutral review of the Cass Review and the research it was based on. Which we could certainly do with.