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Humanize ‘Very Low’ Evidence for Blocking Puberty of Gender-Dysphoric Children

Originally published at National Review

I am no fan of the United Kingdom’s health advisory board, known as NICE (National Institute for Health and Care Excellence). But there is one thing about which you can rest assured. It ain’t a religious fundamentalist organization.

That is why this important story needs to be amplified until the windows rattle. NICE has determined that there is “very low” evidence that blocking puberty in children with gender dysphoria is beneficial. From the BBC story:

The evidence for using puberty blocking drugs to treat young people struggling with their gender identity is “very low”, an official review has found.

The National Institute of Health and Care Excellence (NICE) said existing studies of the drugs were small and “subject to bias and confounding”.

Biased? Studies about transgenderism in children? I can’t believe it!

NICE found the same is true of “gender affirming” hormonal “treatment” — that is, administering hormones of the opposite biological sex to further the development of secondary sex characteristics in which the child identifies.

The review found the evidence of clinical effectiveness and safety of gender-affirming hormones was also of “very low” quality.

“Any potential benefits of gender-affirming hormones must be weighed against the largely unknown long-term safety profile of these treatments in children and adolescents with gender dysphoria,” NICE said.

Critics worry that these substances may cause physical harm in children to which they are given to block puberty, such as loss of bone density. Even here, there was a paucity of data:

The review said there was “very little data” on any additional interventions – such as counselling or other drug treatments – the young people may have had alongside taking puberty blockers, and this could bias the results.

The impact of puberty blockers on bone density has been raised as a potential concern by some experts previously.

However, NICE found that without a “comparator group”, it was not known whether any observed changes in bone density “are associated with GnRH analogues or due to changes over time”.

A paucity of clinical evidence of benefit and unknown risk of harm means administering these substances “off label” to block normal puberty is unethical human experimentation. There is no other way to look at it.

It also means that the activists who scream, “Haters!” at people who oppose interfering with the bodies and normal maturation of gender-dysphoric children should shut the hell up.

But they won’t. The whole puberty-blocking campaign is a raging moral panic. Hysteria is not susceptible to rational argument.

Will most U.S. news outlets report on this important finding? It might prevent parents from making a terrible mistake by agreeing to let their children receive experimental treatments that could harm them for life.

They should, but they probably won’t. Our news outlets are stoking the moral panic — as when CNN just reported that there is “no consensus” that a baby’s sex can be determined at birth. NICE’s conclusion is, to put it mildly, inconvenient to the trans-agenda.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.
Thanks for reading.
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