The Irish government was aware that the evidence around long-term effects of puberty blockers on children was “very scarce” and that the impact was “largely unknown” – even as they were sending children to receive these treatments.
In 2021, a document entitled LGBTI+ Youth in Ireland and across Europe was released. This was a report produced by the Health Promotion Research Centre and NUI Galway, and it was published by the Irish government’s Department of Children and Youth.
Its stated aim was to examine whether or not the goals of the government’s LGBTI+ National Youth Strategy were “well supported with scientific evidence.”
Notably, the research found that the evidence around giving puberty blocking hormones to young people was severely lacking, dubbing the need for greater understanding in this area “urgent.”
EVIDENCE IS “VERY SCARCE”
Referring to “gender minority adolescents” (i.e. transgender or non-binary teenagers), the document said “There is an urgent need for a better understanding of their complex health and social needs.”
“Evidence on medical interventions to assist gender transitioning of trans young people, especially that on pubertal blocking and administration of cross-sex hormones, is very scarce,” the report reads, adding: “The long-term impact on cognitive and physical development, fertility or on other outcomes remains largely unknown.”
“…There is lack of evidence in respect to the short and long-term effects of puberty blockers and cross-sex
hormones across a variety of health domains, which is probably linked to the fact that there is an ongoing debate on whether puberty blockers should or should not be used.”
“ADVERSE IMPACT” ON FERTILITY
The report also acknowledged that there was a “potential” that these treatments can negatively impact bone density, cognitive development, fertility, and more.
While the report’s authors claimed that there were “a small number of studies that have found improved outcomes” from such treatments, they said that “concerns exist” around “the potential adverse impact of hormone therapy on bone density, cognitive development, fertility and growth.”
They added: “…Treatment with gonadotropin-releasing hormone agonists was found to decrease lumbar bone mineral density significantly in all but one study.”
“WE DO NOT FULLY UNDERSTAND THE IMPACT”
The research went on to cite other reviews which also found that the long-term effects of these interventions are not understood.
“Even authors of more recent reviews (e.g., Busa et al., 2018) emphasise that we do not fully understand the medical, psychological and psychosocial impact of these interventions,” the document says. “New clinical guidelines are needed in this area.”
DOESN’T HELP WITH GENDER DYSPHORIA
The research also found that while puberty blockers helped in multiple areas of “psychological functioning,” they did not find that it helped with gender dysphoria itself.
“In relation to psychosocial effects, the authors found that treatment with puberty blockers was associated with improvement across multiple measures of psychological functioning but not gender dysphoria itself,” the report reads.
“The research on the cognitive effects of puberty blockers was extremely limited and non-generalisable. No research was found for the review which assessed the psychosocial or cognitive effects of gender affirming treatment in trans youth with cross-sex hormones.
“It should also be noted that three of the 13 studies included in the review were funded by the pharmaceutical industry. The authors ultimately conclude that treatment appears relatively safe in the short term – however, it is not without potential adverse side-effects and little is known about the impact on cognitive and physical development, fertility or on longer term effects in respect of other outcomes.”
GOVERNMENT WAS SENDING CHILDREN FOR THESE TREATMENTS
Despite these findings, which were published by Minister Roderic O’Gorman’s Department in 2021, children are being given these hormones in Ireland to this day.
Children’s Health Ireland, which treats children with gender dysphoria at Crumlin children’s hospital, confirmed last month that some of its patients are on this kind of treatment.
Moreover, the Irish government was still sending children to the controversial Tavistock Gender Clinic in the UK over a year after the report was released. Between 2011 and 2022, the HSE sent 234 children to Tavistock, some as young as 5.
Five year olds being sent by HSE for controversial transgender treatment#gripthttps://t.co/6ENvVjnq6A
— gript (@griptmedia) May 3, 2022
Tavistock, which in many cases would recommend the prescription of puberty blockers to children and teenagers, was ordered to be closed down in 2022 by the NHS after whistleblowers and former patients said that a “gender-affirming” approach meant that some children were not properly assessed before beginning them on treatments designed to change their sex.
NHS to close Tavistock child gender identity clinic over safety fears https://t.co/YIgxVS9G3B
— The Standard (@EveningStandard) July 28, 2022
“UNQUESTIONING AFFIRMATIVE APPROACH”
An independent review commissioned by the NHS, entitled the Cass Report, found the clinic’s approach was unsafe, adopted an “unquestioning affirmative approach”, that it overlooked other mental health problems in children, failed to collect data on the safety of puberty blockers, and did not subject the treatments administered to children to normal quality controls.
Despite these findings, even after Tavistock was found to be unsafe, the HSE announced it would still be sending children to the clinic.
Irish children with gender dysphoria will continue to be referred to the Tavistock Clinic in London despite concerns over the safety of care, the HSE has confirmed. https://t.co/rCr4t1r0fD
— breakingnews.ie (@breakingnewsie) August 9, 2022
Reacting to the news at the time, psychiatrist Dr. Paul Moran, who works with Ireland’s National Gender Service, said he was “shocked” at the HSE’s decision.
“We have been raising concerns for some years about the Tavistock,” he told Newstalk Breakfast at the time.
Dr Paul Moran 'shocked' the HSE is to keep sending children to Tavistock Centre in the UK.https://t.co/0Y85eLZcfc
— NewstalkFM (@NewstalkFM) August 10, 2022
“We’ve been seeing the children, who the Tavistock have recommended starting on hormones, be very unwell and not ready to start hormones. It has led to further harm. We’ve seen their mental health being very poor, dropping out of school, self-harming and have substance problems. Clearly the assessments done were completely inadequate.”
He added: “When I heard Dr [Siobhán] Ní Bhriain say that she found no evidence that the clinic was unsafe, it was unbelievable. The evidence is overwhelming, and has been there for years.”
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