Both: How do you feel about the High Court's decision in the Keira Bell case?

submitted by worried19 from self.GCdebatesQT

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[–]Porcelain_QuetzalTabby without Ears 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (18 children)

I'm sad and angry. While puberty blockers are a sensitive topic I don't think the courts should get involved in medical decisions. Judges don't have the expertise to make that decision. This will lead to judges either making decisions for political reasons, thus preventing treatment for those who need it or theyll leave the decision to an expert opinion which is most likely positive but costly for the paitent.

This means that transition is likely to be gatekept by either location [and thus the deciding judge] or money. A situation we have with name changes in my country.

[–]MarkTwainiac 4 insightful - 1 fun4 insightful - 0 fun5 insightful - 1 fun -  (5 children)

The UK judges who'll be making these decisions actually do have the expertise to gauge whether a minor has the capacity to consent - and also to weigh the medical evidence presented to them. The law in the UK is very big on child protection, including in medical matters. Judges who specialize in this area really know their stuff, and are quite measured and erudite. As the novel and move "The Children's Act" and the judgments in the Charlie Gard case show.

[–]Porcelain_QuetzalTabby without Ears 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (4 children)

I don't doubt that they are judges with experience in the UK. It's the same in Germany. All of the judges who deal with this stuff have experience in the field. This does not mean that they don't treat trans people vastly different. Getting a name change in Bavaria is a nightmare due to judges handling the cases beeing sexist as fuck. In more liberal states like Hamburg or Berlin it's really simple, maybe even to simple.

[–]MarkTwainiac 5 insightful - 1 fun5 insightful - 0 fun6 insightful - 1 fun -  (3 children)

What does getting a name change in certain jurisdictions in Germany have to do with kids in the UK being prescribed drugs that will cause them irreversible damage and puts them to be on the road to other medical interventions that will permanently change them such as CSH and double mastectomies - and which will leave them sterile, sexually dysfunctional, behind their peers in development, as well as with lowered bone density, IQ and impaired cognitive abilities?

This does not mean that they don't treat trans people vastly different

Who are these "trans people" you speak of? How are we to spot them? Sounds like you think children can be trans as much as adults can. But trans isn't an inherent state of being. Transitioning is a choice some people make for various reasons, and which should be open only to adults with fully developed brains who've had lots of therapy.

What's been happening in the UK (and many other places) is that children who are deemed to like "the wrong" toys, clothing, playmates, interests and fantasies for their sex are being punished for their failure to conform to the rigid, regressive sex stereotypes of the adults around them by being put on harmful drugs and a medical pathway that will leave these children sterile, sexually dysfunctional, prone to heart disease and cancers, with lowered bone density and IQ and all sorts of other negative health effects, including mutilation via surgery.

[–]Porcelain_QuetzalTabby without Ears 1 insightful - 2 fun1 insightful - 1 fun2 insightful - 2 fun -  (2 children)

Actually a lot more then you might think. Both involve a court deciding something related to our lives. And so I expect the system to have the same issues I lined out in my previous post.

What exactly is that therapy meant to accomplish and why would you need lots of it? Also yes. I believe that kids can be trans, as in dysphoric and wanting to transition. Sure they aren't trans men or women, but they can be as transsexual.

Those are some big allegations. Why would you force someone to transition as punishment? What are they supposed to learn from that?

[–]MarkTwainiac 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (1 child)

You don't seem to have any understanding of child and adolescent development. Children and adolescents aren't simply small adults.

[–]Porcelain_QuetzalTabby without Ears 1 insightful - 2 fun1 insightful - 1 fun2 insightful - 2 fun -  (0 children)

What exactly makes you thin that? My knowledge is a bit rusty since Its been a few years since I actively worked with children, but I'm still pretty knowledgeable about the basics of adolescent development.

[–]FlippyKingSadly this sub welcomes rape apologists and victim blaming. Bye! 1 insightful - 1 fun1 insightful - 0 fun2 insightful - 1 fun -  (11 children)

The problem, now exposed by this trial, is not that judges were making any decisions but that no one seems to take responsibility for making a decision. The trial shows there were not real "adults" in terms of doing things responsibly. The court wanted records of all sorts of basic stats the GIDS should be keeping, they produced none. This is not a case of a judge making a decision and usurping authority from those better qualified. The judge saw that there was no "informed consent" going on, and there was no effort by the GIDS staff to understand what was going on either with the kids coming in or after they left. They could not even provide stats regarding the outcome from putting kids on dangerous drugs used in an experimental off-label manner (edited for clarity) or how many of these teen-aged guinea pigs when on to get SRS.

[–]MarkTwainiac 5 insightful - 1 fun5 insightful - 0 fun6 insightful - 1 fun -  (0 children)

Also, this was not a decision made by one judge. The case was decided by a panel of judges. It's just that one particular judge wrote up the decision. This is customary practice in the UK and many other countries, such as the USA.

[–]Porcelain_QuetzalTabby without Ears 1 insightful - 2 fun1 insightful - 1 fun2 insightful - 2 fun -  (9 children)

I didn't assume that judges were making any decisions. I agree that some gatekeeping is necessary when talking about minors. My concern is more about the kind of gatekeeping beeing done here. Involving judges just doesn't have any tangible benefit over getting a recommendation by an actual expert in the field. Heck make these a few and regulate who gets to write these. I simply expect more issues to come out from having judges make these decisions, as I laid out, then when not involving them. So I agree with the spirit of the ruling but not the letter.

[–]MarkTwainiac 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (3 children)

You don't seem to have any clue about child safeguarding - an area that the UK is a world leader in. I suggest looking into the UK's Children's Act, as well as the UN Convention on the Rights of the Child. The novel and movie "The Children's Act" are also worth looking into.

Also, it's not the case that the judges are the ones making the decisions in these cases. The judges are brought in to be a neutral, quizzical third party to assess whether the clinicians/parents are acting in the child's best interests, and whether the child can or cannot consent. This is basic safeguarding, not "gatekeeping." And the judges always consult and take evidence from experts in the field in each case. They don't do this off the cuff.

A clinic like the GIDS should be doing safeguarding and ethics reviews in house - it's a statutory and moral duty. But as anyone familiar with what's been going on at GIDS knows, a large number clinicians there as well as governors have said there is no ethical oversight or attempt to do evidence-based treatment. What's more, the GIDS safeguarding head is suing GIDS for not allowing her to do her job.

Judicial oversight happens all the time in cases involving children and family matters, such as divorce. Even when divorcing parents come to custody, parenting and financial agreements, a judge - and usually temporary guardians ad litems appointed by the court to represent the kids' - still has/have to review the arrangements to make sure the children's rights aren't being violated.

Same thing goes when a lone parent travels internationally with their children. It's quite customary for a mother or father traveling alone with their kids to be pulled aside at airports/borders by immigration officials and the kids and parent to interrogated separately, so as to insure that the adult has the legal right to take the children cross borders and isn't trying to spirit them away into another jurisdiction to keep them from the other parent illegally. This happened to me several times when I had young kids. I never took offense at it; I took it as a welcome sign that the officials were doing their duty to protect my children's rights.

[–]Porcelain_QuetzalTabby without Ears 1 insightful - 2 fun1 insightful - 1 fun2 insightful - 2 fun -  (2 children)

Honestly I started reading the document, but I can't be bothered to read pages of laws that don't apply to the discussion and are from a country I particularly care about. If you want to point me to any specific paragraphs from the law then I'd be much obliged.im aware of the UN convention however. I think the most relevant articles are 12, and 24. Thou I'd argue that 24 can be used to argue both in favor as well as in opposition of gatekeeping. This leaves us with 12 which is inconclusive as well given that it only states that the child's interests and opinion should be considered in any matter regarding the child. Which could be used to argue in favor of the clinics method, but since I don't agree with them I won't do that. If I have overlooked anything, then feel free to point that out.

Maybe you should look into the process of name change in Germany, which I used for comparison and follows exactly this process and still has the issues I outlined, since it involves judges who, beeing part of the political system - beeing appointed by the politician - does that to you - won't necessarily decide in the patients best interests.

I don't see how divorce or immigration are more applicable examples than the one I gave. A child transitioning isn't a family matter.

[–]MarkTwainiac 5 insightful - 1 fun5 insightful - 0 fun6 insightful - 1 fun -  (1 child)

I can't be bothered to read pages of laws that don't apply to the discussion and are from a country I particularly care about.

Yet you feel qualified to opine about this case from the UK.

Your assertion that "I can't be bothered to read pages of laws" pertaining to child safeguarding doesn't reflect well on you.

[–]Porcelain_QuetzalTabby without Ears 1 insightful - 2 fun1 insightful - 1 fun2 insightful - 2 fun -  (0 children)

I'm not arguing about the legalities of the case. My only gripe with it is the following.

Even in cases involving teenagers under 18 doctors may need to consult the courts for authorisation for medical intervention

Im opposed to having courts and thus a political system involved in medical treatment on a practical basis. Not a legal one. So I don't see how knowing the intrecacies of these laws would change that stance. My issue isn't with the safeguarding itself. I actually agree that it is necessary. I just don't think that involving the courts in these cases has additional benefits compared to a solution within the nhs.

[–]FlippyKingSadly this sub welcomes rape apologists and victim blaming. Bye! 2 insightful - 1 fun2 insightful - 0 fun3 insightful - 1 fun -  (4 children)

gatekeeping implies keeping someone way from something desirable, where what is truly desirable requires actual informed consent of which minors or the mentally challenged or the mentally ill are not capable of. This is keeping kids away from ruining their bodies, ie themselves, from their mental development to their physical development while messing up their social development as the kids around them go through normal puberty all for an untested and foolish hope that puberty can be put off. Gatekeeping is the wrong term. Protection for harm, or safeguarding, are better terms. The court asked for a range of statistics and the clinic provided none. There was no safeguarding going on, no assessment of how these off-label and experimental uses of drugs affected the kids they were giving them to and no assessment of even how many went on to get SRS. There was no safeguarding and no gatekeeping either. The court simply did what the so-called professionals refused to do.

[–]Porcelain_QuetzalTabby without Ears 1 insightful - 2 fun1 insightful - 1 fun2 insightful - 2 fun -  (3 children)

Wether you call it gatekeeping or protection its goal is the sale thing. Keeping minors who don't need to transition away from transition. The only difference here is perspective. Wether you argue from the side of those that have to transition aka transsexuals, or those who desist and thus would be protected by the added burocracy. I could argue your points in reverse for trans kids, but I think you can easily enough imagine that yourself. So regardless of wether you call it gatekeeping or protection, we both agree that some is necessary. Our biggest difference seems to be the kind oand amount of bureaucracy added to the process. Still waiting for any points that adress my concerns regarding this.

[–]FlippyKingSadly this sub welcomes rape apologists and victim blaming. Bye! 3 insightful - 1 fun3 insightful - 0 fun4 insightful - 1 fun -  (2 children)

See, that's that thing: calling it gatekeeping or calling it safe guarding does treat the goals as two different things. That's why "gatekeeping" is the activist's preferred term, because it makes it sound comparable to a narrow-minded member of a fandom keeping out fans the narrow-minded don't like. Calling it safe guarding acknowledges the reality that these are children who have no idea what it means to ruin their bodies and their health in the long term over the very questionable idea that some inner identity can properly conflict with outward reality and that the inner identity is somehow "gendered" in a way that mimics what has always been seen as sexed differences and that uses those terms to abrogate the ability to described sexed differences.

Similarly, you make three assumptions that can not be proved or tested, about: 1) the existence of minors who need to transition; 2) the idea that there is some way to discern those from all other minors; 3) that this sensed "need" to transition can be isolated and assessed from other contributing (comorbidity) factors that may be overriding. The child who could be better off transitioning, where that is the sole or over-riding cause of their dilemma, can not be later shown to have been that even if they choose that path years later (edited for clarity because it's an easy sentence to make very confusing), because the decision made at that later time will be influenced by their experiences over that time. Another bad assumption you make is around the idea that a choice that appears correct and reasonable at one point in a persons life may later turn out to be the wrong choice. Making what may appear to be the best choice at one time may turn out to be the wrong turn, and the simple fact that the impact these drugs will have on a kid's life is not known makes it questionable they are ever the right choice. Trans activists are essentially lying when they say someone turns out to not be truly trans if they change their mind (or if they just reflect badly on their cause), and this reflects the ever-shifting goal posts between the idea of a fixed and gendered inner identity and the idea of a fluid spectrum of gendered identities.

If those somehow describe your points, they can not be addressed because they can not be assessed by anyone in a position to provide safeguarding. But your points willfully ignore the simple fact that the trial shows that there was no safe guarding going on and no data kept so that these experimental treatments were: better targeted towards those who need them, or not thrust upon kids who simply didn't know any better and assumed from what they heard from others about what they needed.

Your point seems to be based around the idea that these drugs should be placed in a public place so that people who want to use them off-label to monkey around with the onset of puberty can just get them in the hopes that those who would benefit from them can get them. Your point seems to have complete disregard for those who would benefit from not getting them. Your point seems somehow ignorant of the fact that these drugs are prescription drugs only given when a health professional determines they are actually needed is the only way to legally get these drugs. Should someone who browses a prostate cancer on-line forum just get luporon if they think what they read describes their situation? No, that would be stupid. But somehow a kid with autism, which Tavistock would have us believe the don't screen for, or who does not conform to gendered expectations of their parents, or who has other mental problems that they can not make sense of, should just get these drugs? Your point seems to ignore what can be known by those who prescribe the drugs, seems ignorant of how little any teenager or younger person can know about themselves and how they fit into the world, and seems ignorant of what "off-label" use of drugs means. So, I don't plan on addressing your points unless you find away to make them in away that can be addressed. Your concerns must be someone's call, and the trial showed that it was no responsible person's call. There was no safeguarding and no gate keeping.

[–]Porcelain_QuetzalTabby without Ears 1 insightful - 2 fun1 insightful - 1 fun2 insightful - 2 fun -  (1 child)

Anyways. As I have said the terms gatekeeping and safeguarding describe the same thing: rules that let those in who need it and keep those out who don't. I don't like arguing over semantics, but I think the term gatekeeping is more applicable in this situation, because getting judges involved any time another trans child below 16 seeks treatment just adds another imo unessecsry step. Because what data are these judges going to rely on. They aren't experts in the field and likely don't have the time do an in depth screening. I'm assuming they'll ask actual psychologists. If theyre going to ask them anyway you can just cut out the middle man. I have proposed this in my previous post, since I think that some gatekeeping or safeguarding is necessary. Getting courts involved just doesn't give any significant benefits, besides added costs and a dependency on the political climate in the UK. I'm not as you think, in favor of putting drugs for off label use in a public place so those who want to get access to it. I actually never said anything remotely like that. So that whole last paragraph actually addresses none of my concerns.

Also "off label" doesn't mean a lot. It just means that the manufacturer hasn't paid to test their medication for this use case in this country. In my country off Label drugs [cytotec] are given during child birth, heck all of the ones im currently using are beeing prescribed off label. It's not the big "experiment on harmless children" you make it out to be.

Honestly writing my response I feel like you're misunderstanding the issue I have with the topic. It's not that there was a trial. Its not the court mandated that safeguarding be done. It's the kind of gatekeeping that's beeing implemented, which I take issues with. Something your entire response unfortunately doesn't adress. I can gather from it that you seem to be opposed to children transitioning in any capacity, which I completely disagree with. There is no reasonable assumption that some kids wouldn't benefit from transition and that the issues of screening for them can't be solved in some capacity.

[–]FlippyKingSadly this sub welcomes rape apologists and victim blaming. Bye! 4 insightful - 1 fun4 insightful - 0 fun5 insightful - 1 fun -  (0 children)

I really think you are either being disingenuous or you really did not read and understand the reason this legal action was taken by Tavistock's victims nor understand just how badly the defense portrayed themselves.

The side effects of Luporon should make you take the off-label use of that drug more seriously, but you clearly are not interested in that. To dismiss the testing needed to determine if a drug is safe is reckless and it is obvious you don't have any expertise in what that entails. The drug safety does not assess how safe a drug is compared to say a placebo but how safe it is considering that doing nothing might well be expected to lead to death from the disease, such as prostate cancer which Luporon is used for. The damage done by the drug to the older person with prostate cancer is compared to the damage done by the cancer and the age matters. To pretend it is no big deal that a drug used on old people and tested with that in mind is being used on adolescents shows a profound ignorance on your part.

Your issue with the topic is really your own ignorance of the trial and how it showed there was no safeguarding going on. That which you would prefer is what should have been done, but wasn't. The matter behind this was: did the clinic fail in their role of safe guarding Keira Bell when they considered if she should get these drugs. The answer is clearly yes, and more than that the court concluded that there likely can not be any "informed consent" that these kids are capable of. That you obviously ignore. Do you think that the kids are capable of it? The defense didn't even really try to demonstrate that, they put kids up who showed the opposite-- that they were kids thinking like kids.

It most certainly is the big experment on children you pretend it isn't and without testing you can't say it isn't. Basically when you say "It's not the big 'experiment on harmless children' you make it out to be" are are flat-out lying because you can not possibly know that. This experiement on children has not been gone on long enough and Tavistock didn't keep records to find out what the results of this experiment was. If that doesn't bother you, you have your priorities wrong. The bottom line still is, these kids who come in to the clinic because they suspect they are trans (Please, define that. What is trans, what causes it, and what are the solutions, and why is some innner sense of identity "gendered"? That has to be firmly established before giving kids drugs comes close to sounding reasonable) have to assessed to see if that is true and if other factors are not the biggest problems they face. It may turn out that even if the get the drugs and go through all the steps, the other factors may lead to the same disastrous outcome-- suicide-- that is the big fear now. You have to assess which path leads to the most damage physically and psychologically, to the entire population that walks into that clinic: being cautious and assessing and dealing with all the comorbidities, or what is obviously your preference of leave the drugs on a table with a sign saying "take these, you might be fine".

But, you need to accept that there was no gate-keeping nor safeguarding and court is not stepping in to do it on a case by case basis, but they instead concluded that informed consent (which can only be a choice given to a kid after the safeguarding and due diligence is done) is likely not even possible. The court is not doing what you think they are doing. They simply saw nothing was being done and that nothing was being done in spite of the law being clear that safeguarding must be done (otherwise these "professionals" would not be professionals in a profession with professional standards and legal obligations, and it would all be one big hobby) and the court concluded that the informed consent, the end point of the due diligence and safe guarding for any kid that they would consider giving the drugs to, is probably not even possible with this.

But, if you haven't read what actually happened at the trial you probably won't now-- or you're being disingenuous. I think we can agree to disagree though as we're repeating ourselves.