'We got it wrong': Puberty blocker pioneer admits harm
Susan Bradley, Canadian psychiatrist who founded a clinic for "dysphoric" minors in the 1970s and an authority in this field, today declares that the transition from psychological therapy to drugs was a serious mistake. Because their effects are serious and non-reversible, because those treatments are "authoritarian" and experimental. And because in 9 out of 10 cases, children's dysphoria is only temporary and masks other disorders

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In an interview with Daily Caller News Foundation, the doctor Susan Bradley, a Canadian psychiatrist and pioneer in the treatment of gender dysphoria in children, has spoken out against the popular model that involves affirming children's transgender identities and treating them with drugs that block puberty, a practice to which had taken part in the past.

Bradley had opened a pediatric clinic in 1975 for children with gender dysphoria, a deep sense of unease about one's body and one's biological sex, in which he offered a approach oriented towards psychological therapy;  Most patients stopped feeling they were transgender over time, Bradley told DCNF.

Around 2005, the clinic began prescribing puberty-blocking drugs to children suffering from gender dysphoria as a way to alleviate their suffering, which has been a model ever since widely adopted by the medical establishment around the world, including the United States.

Bradley, now in his early eighties, expressed regret that the clinic was involved in the administration of puberty-blocking drugs to cure gender dysphoria, which she now believes it can cement that sense of confusion that children might otherwise overcome. He also expressed concern about the side effects of such drugs.

“We were wrong” he has declared. “They are not as irreversible as we have always believed and have long-term effects on the growth and development of children which include infertility and a number of bone growth problems.”

Since the majority of children who suffered from gender dysphoria, before the widespread implementation of an approach aimed at affirming the gender to which children feel they belong, they overcame it and they ended up accepting their bodies and their gender, according to New York Times, Numerous doctors have expressed concern that puberty-blocking drugs may end up making children's temporary gender dysphoria permanent, consolidating their feeling of belonging to the opposite sex.

These drugs also prevent the increase in bone density that normally occurs during puberty, with some patients suffering from lifelong bone problems.

The FDA also identified six cases in which there was a “plausible” link between GnRH antagonist drugs and a condition called pseudotumor cerebri, which is caused by high fluid pressure in the brain.

Bradley told DCNF that his opinion on puberty-blocking drugs has evolved over time.

We thought they were relatively safe and endocrinologists said their effects were reversible and we shouldn't worry. Deep down I felt I was skeptical and felt that maybe we were making things worse and not helping them.

And I think it's been confirmed that when these children start taking these drugs at any age, almost everyone ends up wanting to switch to hormone therapy” Bradley said.

Bradley opened the Clarke Institute of Toronto's Child Youth and Family Gender Identity Clinic (GIC) in 1975, and it later became Chief of Child Psychiatry at the Hospital for Sick Children and Chief of Psychiatry and Chief of Child Psychiatry at the University of Toronto.

“The opinion of a specialist like Dr. Bradley has enormous potential to influence this debate because she is what Cass Sustein called “an amazing validator” he told the DCNF. John Burgo, psychotherapist and deputy director of Genspect. “It is human nature to reject even reasonable arguments and credible evidence if it comes from someone who is easily identified as belonging to the other side, if it comes from “them” such as Republicans or from famous “transphobes”. But Dr. Bradley is a pioneer in her field and is not politically aligned”.

“You are not arguing that puberty-blocking drugs are never the right choice. Instead, he invites us to have a cautious exploratory approach to discomfort regarding gender based on his decades of experience,” Burgo said.

“When a professional who was expected to align herself with one side (that of an affirmative model of gender dysphoria) utters a complex opinion and calls for caution, this can help the public not to turn against her or become polarized and reject his opinions, but can open their minds to alternative points of view.

Surprising validators like Dr. Bradley can soften conflicts and promote dialogue even more than well-balanced presentations showing both sides' arguments can.

Bradley believes the transition is helpful for some adults and says some patients consider it the best thing they've ever done for themselves, but that the metrics of its success, including patient satisfaction, are complicated.

One of his patients had transitioned from female to male, married a woman who was a childhood friend of hers, and seemed happy and satisfied, but later underwent very expensive phalloplasty surgery. Despite appearing “very masculine,” the patient was never truly satisfied and was perpetually seeking further physical improvements, according to Bradley.

Another patient Bradley had worked with had transitioned from male to female, but eventually told psychiatrists that he was no longer trans and was in a relationship with another man. This gave birth to Bradley the doubt that the transition for some patients was just the search for a way to be accepted.

“It made me realize that what we're actually talking about is their need to be accepted; ultimately we all need someone to love us,” Bradley said. “And it's very complicated. There are people for whom it works. But there are many people who end up feeling that they haven't really solved their problems regarding who and what they are... the crux of the matter is the fact that these decisions were made when these children were too young to really know how they were going to handle this. And that's not right.

Bradley chaired the subcommittee on gender dysphoria for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the official manual of the American Psychiatric Association, which is used to classify and diagnose mental disorders.

He led eight other physicians in establishing diagnostic guidelines for gender identity disorders.

He also produced research, with other clinical doctors, showing that 87.7% of the boys who had turned to their clinic for gender identity problems ended up "giving up", that is, they stopped believing that they were actually girls and came to terms with their gender.

Bradley now believes that Most child patients who identify as transgender are actually on the autism spectrum or suffer from borderline personality disorder, who she believes should be classified as part of the autism spectrum.

Autistic teenagers are particularly victims of obsessive thoughts, prone to having problems with their physical appearance and struggle to change their minds once convinced that something is true, all things that make them more vulnerable to the risk of being convinced that they are the opposite sex and having to seek medical assistance by taking, for example, puberty-blocking drugs or hormones.

“You have to put yourself in the shoes of a 12- or 13-year-old who thinks, 'This is my way of becoming normal,'” Bradley said. “These children are not doing well with today's affirmative approach. I don't know if there's a child who can do well, given thatthe ability that a 10, 12 or even 14 or 15 year old child has to understand the complexity of the choice he is making concerning his sexual functions and his long-term life. It makes no sense."

The GCI was shut down after Bradley's retirement in 2007 under intense pressure from transgender activists who believed that the clinic, which did not automatically affirm the children's gender identity or their status as transgender people, was transphobic.

Skepticism regarding puberty-blocking drugs has grown in recent years, following high-profile scandals involving pediatric gender dysphoria clinics prescribing the drugs to halt healthy puberty in children as young as 10. following psychological screening considered inadequate.

Stella O'Malley, a psychotherapist and founder of Genspect, an organization critical of gender transitions in childhood, expressed her concerns regarding this type of intervention in a previous interview with the DCNF.

“Blocking children's sexual development is a highly authoritarian intervention. Children are asexual and cannot understand the impact of impaired sexual functioning,” he said. “We're about 10 years into this large-scale experiment and we already have reports of problems regarding cognitive development, bone mineral density and fertility. All the latest evidence shows that puberty blocking drugs they are neither safe nor reversible”.

Supporters of medicalized gender transition in children claim that these drugs alleviate the discomfort that young people with gender dysphoria may experience due to puberty and may reduce the need for surgery or hormone treatments later in life as they prevent the development of certain traits associated with their biological sex, such as a deep voice in a male patient.

“The anxiety disappears,” he told al New York Times Dr. Norman Spack, a leader in the push for the use of puberty-blocking drugs in patients with gender dysphoria. “You can see those kids being so relieved.”

The Center for Addiction and Mental Health, formerly called the Clarke Institute of Toronto, did not respond to requests for comment from the Daily Caller News Foundation.


Translation by Chiara G.

Original article here.


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