- The purported benefits of childhood cross-sex medical interventions may actually be caused by the placebo effect, according to Australian psychiatrist Alison Clayton.
- The medical environment children encounter while undergoing puberty blockers and other medical interventions constantly reinforces the idea that the drugs will resolve their mental health issues; clinicians make overstated claims about their benefits, often on social media and with support from celebrity patients.
- “The current treatment approach for [gender dysphoria] youth presents a perfect storm environment for the placebo effect,” Clayton wrote.
Studies that purport to find health benefits for children who undergo transgender medical interventions are compromised by the placebo effect, according to a recent peer-reviewed analysis.
The “gender affirmation” model of care for gender dysphoria favored by the American medical establishment encourages doctors to affirm and encourage a child’s transgender identity and offer irreversible medical procedures to transition them to the opposite sex, pointing to studies suggesting the treatments may be linked to better mental health outcomes. Those studies, however, fail to account for the effect of doctors’ enthusiasm and other environmental factors in gender medicine settings, which may actually be behind any observed mental health improvements, Australian psychiatrist Alison Clayton argued in a Nov. 14 publication in the Archives of Sexual Behavior.
“The current treatment approach for [gender dysphoric] youth presents a perfect storm environment for the placebo effect,” she wrote. (RELATED: LGBT Activist’s Study About Transgender ‘Social Contagion’ Falls Apart Under Scrutiny)
A new peer-reviewed publication questions to what extent the small and highly uncertain benefits of “gender-affirming” hormones and surgeries, reported by some recent research from pediatric gender clinics, are further weakened by the “placebo effect.”/1https://t.co/Ab9qoWifUS
— SEGM (@segm_ebm) December 8, 2022
The placebo effect includes any positive mental responses caused by the treatment context rather than the treatment itself, according to Clayton. In the context of transgender medical care, clinicians enthusiastically promote the gender affirmation model, including on social media and alongside celebrity patients, while making overstated claims about the evidence and benefits of the treatments, contributing to a placebo effect by constantly reinforcing the idea that medical interventions will resolve a patient’s mental health problems.
The combination of vulnerable patients, lack of objective diagnostic tests for gender dysphoria, reliance of studies on patient-reported rather than objectively observed outcomes and the derision of other approaches to gender dysphoria as harmful all contribute to a climate that strengthens the placebo effect within gender medicine, according to Clayton.
Clayton compared the insistence of some doctors that the procedures be performed despite a lack of solid evidence or randomly controlled trials to historical medical scandals including the widespread performance of lobotomies in the twentieth century.
Advocates of cross-sex medical interventions for minors argue that the procedures are necessary because they may alleviate the heightened risk of depression and suicide among youth who identify as transgender. This cohort views the therapy-based, skeptical approach as a harmful form of gatekeeping which prevents young people from seeking potentially life-saving care and exploring their identities.
While it could be argued that gender treatments should be continued even if children’s health gains are caused by the placebo effect rather than by the procedures themselves, if studies find that the patients do see some improvements, this line of thinking discounts the risks of cross-sex medical care, Clayton wrote. These risks include impaired fertility, sterility, cardiovascular health risks, increased risk of certain cancers, low bone mineral density and impacts on brain development, she said.
Many studies on the efficacy of cross-sex medical interventions for children, many of which are funded by pharmaceutical companies that produce puberty blockers and cross-sex hormones, are riddled with bias and methodological issues including confounding variables and a lack of control groups, multiple Daily Caller News Foundation investigations have found.
A growing group of doctors and researchers are voicing criticism of the gender-affirmation approach, pointing not only to a lack of evidence and the potential safety risks of transgender biomedical interventions, but also to the high likelihood that children with gender identity issues will naturally outgrow them by the time they reach adulthood. The affirmation approach, however, puts a child on the path to lifelong biomedical interventions which, if and when they do come to terms with their biological sex, can not be reversed.
Clayton did not immediately respond to the DCNF’s requests for comment.
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