ArjinFerman
Tinfoil Gigachad
No bio...
User ID: 626
ArjinFerman
Tinfoil Gigachad
2hr ago
You're overstating the importance of randomized controlled trials (RCTs) in medical research.
So does this mean Ivermectin was actually great, and all the critics were Ivermectinophobes? Or do we, in fact, have some ways to judge the quality of studies, and know for a fact that the absence of certain design features tends to mean a study's finding will tend to be overturned, if done properly?
ArjinFerman
Tinfoil Gigachad
2hr ago
Sure, some of them made grumbling noises over Palestine, all of them were 100% all-in for Biden in 2020, and most of them were still dutifully campaigning for the Democrats in 2024.
ArjinFerman
Tinfoil Gigachad
5hr ago
Correct, still didin't look if I'll find the reviews (and am leaning pessimistic, I'm guessing the Alabama's AG who wrote that document would already have them, if they were uncoverable). Sorry if there was any confusion.
ArjinFerman
Tinfoil Gigachad
5hr ago
Good news, with your attitude, you are not alone.
Sure, because this includes most people. Pretty sure it even includes you (I dunno, would you teach your children to be transphobic if someone came up with some galaxy-brained study that it adds a few QALYs to their life?).
Of course, if you want to convince the grey tribe specifically, just stating that obviously blood is sacred or puberty blockers are evil.
Funnily enough, it's the pro trans side that fits better with the groups you mentioned. They have - by their own admission - no evidence that puberty blockers improve the outcomes for children / adolescents.
ArjinFerman
Tinfoil Gigachad
5hr ago
I think that there are plenty of medical interventions which can not be opted out after the fact.
Sure. No one is saying you cannot do irreversible medical procedures, just that their effects have to be justified by the effects on the patient's health, and that the patient has to be aware of their irreversibility, and the effects. None of these conditions are met for puberty blockers. Their use was so far justified by their supposed reversibility, and sold as "buying time to think".
Generally, it is fine to study such interventions -- even randomized -- if you keep within the overton window of standard practices or have good reason to believe that your treatment will lead to a better outcome for patients.
I don't think "overton window" is a valid argument, it just means a bunch of people agreed it's a good idea. In my opinion they should have good reasons to think something is a good idea, so that leaves us only with the last criterion you cited, which currently is unfulfilled.
In a world where the blockers exist, a doctor who withholds them is taking the responsibility for letting puberty happen -- just as a doctor who withholds antibiotics to let an infection kill a MAID patient is not very different from one who uses barbiturates instead.
The difference here is that in the case of an infection, you're dealing with an unhealthy body, one that is veritably under assault by foreign organisms. In the case of puberty blockers you're intervening in a perfectly healthy body, hoping to achieve purely psychological benefits. I don't think we do that very often in medicine, especially for minors.
Both puberty blockers and puberty have failure modes such as suicides.
I don't think puberty causes suicide, and I'm pretty sure neither do puberty blockers for that matter.
If and when they can be used to gain QALYs is an empirical question
It was in this case as well, but somehow the doctor had his license suspended. None of the defenders of trans medicine were bothered, some even actively campaigned for it.
ArjinFerman
Tinfoil Gigachad
7hr ago
I don't think even the truscum believe the issue is with the endocrine system, genitals, or the organs constituting secondary sex characteristics. Maybe they'd go for brain differences or something.
ArjinFerman
Tinfoil Gigachad
7hr ago
No one, and I mean absolutely no one, among trans activists believes there is an underlying issue with a trans person's endocrine system, genitals, or breasts. If for no other reason, then because it could be used for diagnosis and gatekeeping.
ArjinFerman
Tinfoil Gigachad
8hr ago
the sort of animal rights extremist who breaks into a politician's home would consider them contemptible sell-outs.
Sure, in the same way American leftists consider the Democrats sell-outs, and then dutifully campaign for them.
ArjinFerman
Tinfoil Gigachad
8hr ago
@magic9mushroom, ah, there we go
C. WPATH Hindered Publication of Evidence Reviews.
Though the SOC-8 authors and their advocacy allies didn’t seem to have much use for them,132 the Johns Hopkins evidence review team “completed and submitted reports of reviews (dozens!) to WPATH” for SOC-8.133 The results were concerning. In August 2020, the head of the team, Dr. Robinson, wrote to the Agency for Healthcare Research and Quality at HHS about their research into “multiple types of interventions (surgical, hormone, voice therapy…).”134 She reported: “[W]e found little to no evidence about children and adolescents.”135 HHS wrote back: “Knowing that there is little/no evidence about children and adolescents is helpful.”136
All the references are to the Boe v. Marshall case from the second link (which also contains a direct link to the evidence from the case).
Never heard of it going public, but I didn't go looking either. Might take stab at it later.
It's not just one review they're sitting on, by the way, I don't remember the number, but I think it's about a dozen (or half-dozen? I seem to remember the word "dozen" appearing somewhere in the context).
ArjinFerman
Tinfoil Gigachad
8hr ago
Honestly, this is one of the situations where I say "fuck it";
Yeah, I haven't settled on an opinion, but I feel you. There is currently some brouhaha about an NHS puberty blocker trial, with the anti-trans side arguing that it shouldn't be done because we already have the evidence (they also have other criticisms, but that tends to be the opener). A part of me feels like the political capital would be better spent saying "Oh, you want a trial? Fine, we'll do a trial, but we're doing this one properly", but I've been wrong on political tactics before (I was against blanket bans, until Alabama and Tennessee did them, and ACLU in their infinite wisdom decided to sue them, which allowed WPATH's internal docs to go into discovery).
The bigger issue is honestly the difficulty of actually running the trial successfully; trans activists have a lot of resources and will attempt to circumvent the prohibition on the control group transitioning (via paying for medical tourism, or if the parents are unwilling arranging for the kids to "self-extract"), at which point there's an obvious hole in your RCT due to either counting transitioned kids in the "untransitioned" group (when they're not) or not counting them (and removing the randomness).
When I was reading the papers on chemical castration, I think one of them said you can detect non-compliance with a blood test (though it may have been about taking counter-measures, instead of unauthorized taking of chemical castration / puberty blockers).
ArjinFerman
Tinfoil Gigachad
9hr ago
Europeans sometimes note the American (or perhaps Anglo) ability to get to the fucking point in an efficient manner. With law, the example I usually heard cited was constitutions, but I heard similar comparisons of academic papers, though I think in that case Europeans learned to boil things down a bit.
ArjinFerman
Tinfoil Gigachad
9hr ago
To make the analogy work, the heart would have to be perfectly healthy, and the benefits of the surgery would have to be purely psychological*. "Oh no, your girlfriend broke up with you? You must be brokenhearted! Here, have a heart transplant!". This is about as much sense as gender affirming care makes.
*) If you want the analogy to be even more accurate, the surgery would have to have fairly massive, well-known, and acknowledged by everyone downsides, it's just that they are deemed to be a price worth paying for the psychological benefits.
ArjinFerman
Tinfoil Gigachad
9hr ago
Yeah, I think what he's talking about also happens, but is obviously not the whole picture.
ArjinFerman
Tinfoil Gigachad
9hr ago
Wait... goddamn, somehow I confused you with @ControlsFreak. I already had a good gauge of your views.
ArjinFerman
Tinfoil Gigachad
10hr ago
Somehow that's even more surprising. Who even reads websites at this point? Most of the content I run into is commercial slop, and if it's not written by AI itself, it might as well have been.
ArjinFerman
Tinfoil Gigachad
10hr ago
Do we let people with a healthy heart sign up for experimental heart surgery?
ArjinFerman
Tinfoil Gigachad
11hr ago
I doubt this automatically means that the Greens are going to get the pick instead.
No, it means someone less offensive to the Greens is going to get picked, which means they get to act like they're a part of the ruling coalition without being in it.
ArjinFerman
Tinfoil Gigachad
11hr ago
I'm very right-wing!
Not unless your every post here is a devil's advocate exercise.
ArjinFerman
Tinfoil Gigachad
11hr ago
Thanks for the heads up!
By that standard, a good fraction of cars on the road don't qualify as human-driven.
How about "has to perform no worse than the worst human with a valid driver's license (without geofencing, etc. etc.), and has to perform in a manner that would not result in the driver's license being taken away from the human"? That's a pretty charitable standard, I'd say, and we should probably aim for average, rather than worst).
My idea for self-driving car laws: It has to pass a standard driver's license exam
The problem with that is that it's fairly easy to train an AI to pass an exam without it implying it can perform in general conditions. I think we already have LLM's that can pass a bar exam, for example.
SEGFAULT. Replied to the wrong comment
And there are other medical organizations and groups that reached a different finding.
Anyone you have in mind? As far as I can tell the organizations can be roughly divided into:
- Ones who did do a systematic review and came to roughly the same conclusions
- Ones who did not do one, and therefore can't really be said to have come to any conclusions
- Ones who did do a systematic review, and decided to hide the results from the public, and made researchers sign a pledge of loyalty to only publish results that will be good for the transgender movement.
Clearly there's a disagreement and we need more high quality research to settle things
Can we at least agree that no one from the third group belongs anywhere near said research?
Was there a bunch of consenting autistic people begging to be given lupron?
Since we're talking about children, they can't consent directly (and since we're talking autism, it's possible they could have been non-verbal anyway), so the relevant question would be about the parents. Yes, there were parents begging for it, that's why they went to a doctor offering it.
I think there are different standards between "studies of medicine forced on someone without their permission" and "studies of medicine done with the consent of both child and parent"
No one was forcing the parents, and if your entire objection rests on children "consenting", it's pretty trivial to manipulate them into wanting it (which is exactly what happened with trans care).
And if you're still not convinced I can give you more examples where the patients were begging for quack therapy, and it got shut down by the authorities. Burzynski's antineoplaston therapy, off the top of my head.
Ah I wasn't aware two wrongs made a right. I guess the Whataboutists had the best idea after all.
It's not whataboutism to want to defund corrupt research, and if you only criticize the defunders, you don't really believe it's "two wrongs".
Well, we might run into a problem here, because I don't care much for credentials, but I respect a sincerely held belief. If you don't really want to put your name on the argument for puberty blockers, just poke holes in the arguments against them (but never, ever, for them), I don't know how far we're gonna get, but let's give it a go.
Right, but are you going to tell me that the absence of randomization in controls is going to make the exact same study better? Like, I get that RCT might not be the be-all end-all, or that in some context might not be practically achievable, but you can't beat down any and all skepticism with "the science is settled, chud" type arguments (which is exactly what was happening in the case of transgender care for many years, even if you weren't doing it personally), and retreat to "ho hum, it's so nuanced" when people point out the poor quality of your studies.
I keep linking to that old blogpost about prescribing Lupron to autists, because I never got a good answer for it. Somehow it was clear as day that it's quack medicine back in 2006, and only hardcore libertarians ever dreamt of arguing that maybe we should let people try it if they want, but now doctors are prescribing the same drug to the children of often unwilling parents, with absolutely no evidence (by their own admission), and we're supposed to just roll with it?
I'm happy to, and I believe that if you do that, the entire edifice falls apart. Not just puberty blockers, but the entire concept of "gender dysphoria" as a diagnosis.
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