Latest news with #DutchProtocol
Irish Times
2 days ago
- Health
- Irish Times
Why is Irish media so reticent about covering gender issues?
The phrase 'third rail' was originally coined to describe the electrified line that runs alongside train tracks, deadly to the touch. In politics and public discourse, it has come to signify any subject deemed too dangerous, too radioactive, too fraught to approach. And while journalism in a liberal democracy is, in theory, about touching all the rails – especially the live ones – theory and practice often diverge. Last week, the New York Times published all six episodes of The Protocol , a podcast series that represents a significant moment in the polarised US debate around youth transgender healthcare. The series explores how the standardised medical approach to gender transition in minors was developed in the Netherlands in the 1990s. Known as the 'Dutch protocol', the model recommends the use of puberty blockers and hormone therapy for carefully assessed adolescents experiencing gender dysphoria. That protocol was later exported, adapted – and contested – elsewhere, including in the United Kingdom and United States, where culture war battle lines have long since been drawn. The New York Times podcast tells a story of shifting medical consensus, political pressure, and institutional confusion. But it also carries a subtext about journalism itself – how hard it can be for newsrooms to report accurately and fairly on an issue that cuts so close to the cultural bone. READ MORE It's worth noting that the New York Times has not emerged from this process unscathed. Over the past few years, its coverage of trans issues has prompted significant internal dissent. A 2022 feature by journalist Emily Bazelon questioning aspects of the prevailing medical model and an article by Katie Baker in 2023 titled, When Students Change Gender Identity and Parents Don't Know sparked public protests, petitions signed by some of the paper's reporters, and an open letter from celebrities and activists accusing the newspaper of platforming 'anti-trans bigotry'. Senior editors responded with unusually sharp criticism of their staff, insisting that journalism 'cannot exist in service of any cause'. The Protocol feels, in part, like an attempt to reset. Bazelon is credited as an adviser on the podcast. The editorial tone is serious, sober, and almost anxious in its caution. There are no polemics. But the very act of producing it – at scale, with resources and rigour – feels like a line being drawn: a claim that this subject, however charged, can and should be reported on without fear or favour. How to manage your pension in these volatile times Listen | 37:00 Which brings us to this side of the Atlantic. In the same week The Protocol dropped, Irish psychotherapist Stella O'Malley published a blog post recounting her own experience with Irish media. O'Malley, a founder of the organisation Genspect, is sharply critical in the post and in an interview on the State of Us podcast , of what she describes as the effective blacklisting of dissenting voices on the issue of youth transition by Irish media, including The Irish Times. 'In Ireland,' she writes, 'cancel culture doesn't burn you at the stake – it quietly leaves you out in the cold'. O'Malley is particularly scathing about RTÉ, where, until 2021, she had been a regular contributor to national discussions on youth mental health. Since then, she says, her media invitations have dried up. She cites the Irish media's lack of coverage on key developments abroad, such as the closure of the Tavistock gender clinic in London following the Cass Review, or the recent UK Supreme Court ruling that sex, not gender identity, should be the basis of protections under equality law, as evidence of what she characterises as a systemic avoidance of uncomfortable facts. Of course, O'Malley is now an activist with a clear ideological stance, and reasonable people can disagree with her conclusions or question her affiliations. But if activism were a barrier to participation in Irish current affairs programmes, there would be an awful lot of silence on our airwaves. What seems harder to deny is that, in her case and others, views that challenge the prevailing orthodoxy on gender identity are seen as beyond the pale. This may explain a striking media gap. The Cass Review in the UK, a years-long, evidence-based review of youth gender services led by a respected paediatrician, concluded that the medical model developed in the Netherlands and exported widely was, in many cases, being applied without sufficient clinical oversight. It led directly to the suspension of all routine prescription of puberty blockers to under-18s in the National Health Service. The Irish media coverage of this was scant, scattered and mostly relegated to the opinion pages, even though it had a direct impact on the treatment of Irish children, or that the largest political party on the island, Sinn Féin, was forced into policy contortions on either side of the Border as a result. Why the reticence? There is a commonly heard view that to even enter this debate is to engage in a 'toxic' discourse imported from Britain and the US – best avoided in a mature, progressive society. But this is an odd position, especially in a media culture that otherwise shows little hesitation in following every twist and turn of UK and US affairs, from the post-Brexit travails of the Conservative party to the power struggles within the Trump White House. The truth may be simpler and more uncomfortable. Irish journalism, like Irish society, is small. The circles are tight. The cost of stepping on the wrong third rail – socially, professionally, reputationally – is high. Better, perhaps, to look away. And yet the issues are not going away. Ireland, like every other country, is grappling with questions of medical ethics, consent, identity, and law. Young people experiencing gender distress deserve compassionate, evidence-based care. But they also deserve a society willing to discuss that care honestly. And journalists, if they are doing their jobs, have to be part of that conversation, even when it's difficult.
New York Times
6 days ago
- Health
- New York Times
Our New Podcast
Health care for transgender youths is deeply personal and important to thousands of American families. It's also one of the most divisive cultural and political issues of our time. Twenty-seven states have banned surgery, hormone treatments or puberty blockers for minors. The Supreme Court will decide soon whether those bans are constitutional. The Times just published a special six-part podcast on the history of these treatments and the contentious debate. It reflects two years of work by Azeen Ghorayshi, who has reported on the intersection of gender and science for a decade, and Austin Mitchell, a senior audio producer. Jodi, who oversees Times newsletters, spoke to Azeen about the project's ambition, how she got people to open up, the biggest surprises in the reporting and how her own work has been weaponized. How was this project different from your prior work on this beat? What were the big unanswered questions you set out to explore? With this audio series, the interviews are more like long, in-depth conversations. People can connect more easily when they hear others in this way, and it can help challenge assumptions. The big question we were trying to answer was, How did we get here? The science and the politics have gotten so entangled, but something this reporting made clear is that politics has been baked in all along. The show is titled 'The Protocol,' after the Dutch Protocol, which grew out of the pioneering treatments in the Netherlands in the 1990s and 2000s. Why start there? Want all of The Times? Subscribe.
Sky News AU
02-05-2025
- Health
- Sky News AU
Gender dysphoria should be treated with therapy instead of transition treatments, massive Donald Trump-ordered health report urges
A sweeping review of transgender treatments on minors found 'deep uncertainty about the purported benefits' of many of those interventions — and urged doctors to put more of an emphasis on behavioral therapy when addressing gender dysphoria. Researchers also concluded that many of the protocols for treating children with gender dysphoria became widely used before outcome studies determined whether or not they were safe practices, a massive 409-page Health and Human Services study revealed. 'The umbrella review found that the overall quality of evidence concerning the effects of any intervention on psychological outcomes, quality of life, regret, or long-term health, is very low,' HHS' Gender Dysphoria Report determined in its assessment of common studies on transgender treatments. 'This indicates that the beneficial effects reported in the literature are likely to differ substantially from the true effects of the interventions.' President Trump signed an executive order in January ordering HHS to conduct a review of best practices for treating gender dysphoria within 90 days, which was released Thursday. Transgender interventions in children that were scrutinized in the blockbuster HHS report include the use of puberty blockers, hormone therapy and surgeries. While the report stressed it is not a 'clinical practice guideline,' the paper examined 17 systematic reviews of transgender treatments in minors and concluded that there was limited evidence to suggest those interventions had any 'meaningful improvement in mental health.' In some instances, this was because studies did not properly measure track patient outcomes or studied individuals whose mental health was already at a 'high-functioning at baseline.' 'Multiple SRs [systematic reviews] have concluded that the evidence supporting the benefits of pediatric transition interventions—from PBs [puberty blockers] to CSH [cross-sex hormone therapy] and surgery—is of 'very low certainty,'' the HHS report said. 'All medical interventions carry the potential for harm.' A lot of the research into transgenderism in question was conducted overseas. One of the most famous ones was the Dutch Protocol, which was originally published in 2006 and outlined 'highly medicalized' methods to treat young people with gender dysphoria, including puberty blockers. For years, the Dutch Protocol was generally regarded as the gold standard guideline for treating young people struggling with gender dysphoria. The guidance has since been weakened over time, with some of its eligibility restrictions pared down. Following the 2006 publication of the Dutch Protocol, there had been a sharp rise in transgender treatments in minors. An estimated 3.3% of US adolescents consider themselves transgender, per the HHS report. Meanwhile, about 0.1% of 17-year-olds received hormonal treatment between 2018 and 2022. But HHS researchers found that the Dutch Protocol was based on 'methodological flaws' that were 'largely overlooked' by the broader medical community since its publication. 'One of the study's limitations was its retrospective selection of 70 subjects from a larger 'intent-to-treat' group of 111 using non-randomized methods,' the HHS report said. 'This selection process inadvertently biased the sample toward cases with the most favorable prognoses, thereby limiting the generalizability of the study's findings.' The HHS study cautioned that there is an 'extreme toxicity and polarization surrounding this field of medicine.' Researchers in the HHS report frequently pointed to the United Kingdom's Cass Review, a sweeping four-year study by the National Health Service that similarly poked metholodical holes in more conventional research into transgenderism. They also acknowledged that there's a 'growing international concern about pediatric medical transition' and that foreign countries are increasingly restricting transgender treatments on minors. 'There is currently no international consensus about best practices for the care of children and adolescents with gender dysphoria,' the HHS report stressed. Still, the medical ethicists, doctors and methodologies that put the HHS review together highlighted the potential benefits of psychotherapeutic approaches to tackling gender dysphoria in minors. HHS researchers admitted that 'direct evidence for psychotherapy' in children with gender dysphoria is limited, but argued there is 'available evidence to support the role of psychotherapy intreating children and adolescents with other mental health problems, like depression. The HHS study has been met with mixed reactions from the medical community. Susan Kressly, the president of the American Academy of Pediatrics, slammed the report, arguing that it relied too heavily upon a 'narrow set of data' and 'select perspectives. 'This report misrepresents the current medical consensus and fails to reflect the realities of pediatric care,' she said in a statement. Dr. Stanley Goldfarb, chairman of Do No Harm, an organization that opposes so-called gender transition surgeries, hailed the HHS review for exposing 'a number of serious risks in the medical transition of young people.' 'The report cites a 'lack of robust evidence' for these medical procedures,' Goldfarb said in a statement. 'It is clearer now, more than ever, that we must end this misguided practice and replace it with evidence-based treatment for gender confused kids.' Trump's directive for the HHS study was nestled in a broader January executive order to cut off government funding to support or promote operations for child sex changes. National Institutes of Health (NIH) Director Dr. Jay Bhattacharya, whose agency helped conduct the HHS study, underscored the need to not let political agendas interfere with science. 'Our duty is to protect our nation's children—not expose them to unproven and irreversible medical interventions,' Bhattacharya said. 'We must follow the gold standard of science, not activist agendas.' Now that it has been released, the HHS study, titled 'Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices,' is set to get peer-reviewed. A modified version of the report is expected once the peer review process is complete. Originally published as Gender dysphoria should be treated with therapy instead of transition treatments, massive Donald Trump-ordered health report urges
New York Post
02-05-2025
- Health
- New York Post
Gender dysphoria should be treated with therapy instead of transition treatments, massive Trump-ordered HHS report urges
A sweeping review of transgender treatments on minors found 'deep uncertainty about the purported benefits' of many of those interventions — and urged doctors to put more of an emphasis on behavioral therapy when addressing gender dysphoria. Researchers also concluded that many of the protocols for treating children with gender dysphoria became widely used before outcome studies determined whether or not they were safe practices, a massive 409-page Health and Human Services study revealed. 'The umbrella review found that the overall quality of evidence concerning the effects of any intervention on psychological outcomes, quality of life, regret, or long-term health, is very low,' HHS' Gender Dysphoria Report determined in its assessment of common studies on transgender treatments. 'This indicates that the beneficial effects reported in the literature are likely to differ substantially from the true effects of the interventions.' President Trump signed an executive order in January ordering HHS to conduct a review of best practices for treating gender dysphoria within 90 days, which was released Thursday. 5 President Trump ordered the study shortly after returning to the White House. AP Transgender interventions in children that were scrutinized in the blockbuster HHS report include the use of puberty blockers, hormone therapy and surgeries. While the report stressed it is not a 'clinical practice guideline,' the paper examined 17 systematic reviews of transgender treatments in minors and concluded that there was limited evidence to suggest those interventions had any 'meaningful improvement in mental health.' In some instances, this was because studies did not properly measure track patient outcomes or studied individuals whose mental health was already at a 'high-functioning at baseline.' 'Multiple SRs [systematic reviews] have concluded that the evidence supporting the benefits of pediatric transition interventions—from PBs [puberty blockers] to CSH [cross-sex hormone therapy] and surgery—is of 'very low certainty,'' the HHS report said. 5 The Department of Health and Human Services worked with a number of researchers to produce the massive study. Getty Images 'All medical interventions carry the potential for harm.' A lot of the research into transgenderism in question was conducted overseas. One of the most famous ones was the Dutch Protocol, which was originally published in 2006 and outlined 'highly medicalized' methods to treat young people with gender dysphoria, including puberty blockers. For years, the Dutch Protocol was generally regarded as the gold standard guideline for treating young people struggling with gender dysphoria. The guidance has since been weakened over time, with some of its eligibility restrictions pared down. Following the 2006 publication of the Dutch Protocol, there had been a sharp rise in transgender treatments in minors. An estimated 3.3% of US adolescents consider themselves transgender, per the HHS report. Meanwhile, about 0.1% of 17-year-olds received hormonal treatment between 2018 and 2022. 5 Treatment for children with gender dysphoria has been a politically fraught issue. AP But HHS researchers found that the Dutch Protocol was based on 'methodological flaws' that were 'largely overlooked' by the broader medical community since its publication. 'One of the study's limitations was its retrospective selection of 70 subjects from a larger 'intent-to-treat' group of 111 using non-randomized methods,' the HHS report said. 'This selection process inadvertently biased the sample toward cases with the most favorable prognoses, thereby limiting the generalizability of the study's findings.' The HHS study cautioned that there is an 'extreme toxicity and polarization surrounding this field of medicine.' Researchers in the HHS report frequently pointed to the United Kingdom's Cass Review, a sweeping four-year study by the National Health Service that similarly poked metholodical holes in more conventional research into transgenderism. They also acknowledged that there's a 'growing international concern about pediatric medical transition' and that foreign countries are increasingly restricting transgender treatments on minors. 'There is currently no international consensus about best practices for the care of children and adolescents with gender dysphoria,' the HHS report stressed. 5 HHS researchers concluded that evidence that transgender treatments are beneficial is limited. AP Still, the medical ethicists, doctors and methodologies that put the HHS review together highlighted the potential benefits of psychotherapeutic approaches to tackling gender dysphoria in minors. HHS researchers admitted that 'direct evidence for psychotherapy' in children with gender dysphoria is limited, but argued there is 'available evidence to support the role of psychotherapy in treating children and adolescents with other mental health problems, like depression. The HHS study has been met with mixed reactions from the medical community. Susan Kressly, the president of the American Academy of Pediatrics, slammed the report, arguing that it relied too heavily upon a 'narrow set of data' and 'select perspectives. 'This report misrepresents the current medical consensus and fails to reflect the realities of pediatric care,' she said in a statement. Dr. Stanley Goldfarb, chairman of Do No Harm, an organization that opposes so-called gender transition surgeries, hailed the HHS review for exposing 'a number of serious risks in the medical transition of young people.' 'The report cites a 'lack of robust evidence' for these medical procedures,' Goldfarb said in a statement. 'It is clearer now, more than ever, that we must end this misguided practice and replace it with evidence-based treatment for gender confused kids.' 5 Prominent medical associations have hit back at HHS' findings. AP Trump's directive for the HHS study was nestled in a broader January executive order to cut off government funding to support or promote operations for child sex changes. National Institutes of Health (NIH) Director Dr. Jay Bhattacharya, whose agency helped conduct the HHS study, underscored the need to not let political agendas interfere with science. 'Our duty is to protect our nation's children—not expose them to unproven and irreversible medical interventions,' Bhattacharya said. 'We must follow the gold standard of science, not activist agendas.' Now that it has been released, the HHS study, titled 'Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices,' is set to get peer-reviewed. A modified version of the report is expected once the peer review process is complete.
