Health

We looked at the latest research from around the world to understand what knowledge was being used to inform the care of children and young people with gender dysphoria by looking for research published in the scientific literature between 2019 and 2023. This work builds on a previous report we provided to NSW Health summarising the research published between 2000 and 2019.

We found 82 research studies published since 2019. This represents a rapid growth in research in this field. Various methods of varying quality were used to gather information in these studies. While we found that there hasn’t been a significant increase in the use of gold-standard methods (such as, randomised controlled trials (RCTs)) in this emerging field of research, we were still able to draw out meaningful insights into the effectiveness and risks of gender dysphoria treatments. The research we found provides a good starting point for discussing critical issues with patients, caregivers, and healthcare providers, including deciding where to invest in future research.

NSW Health will use this review’s findings to guide various projects designed to gather more information from experts and people with lived experiences, with the aim of providing safe and effective psychological and medical treatment services for young people with gender dysphoria.

The Australian Financial Review reported that NIB’s CEO has said that the insurer needs an increase of around that mark because “ultimately, we have to cover claims inflation like any insurer because if you don’t eventually you go out of business.”

While this might seem obvious, it ignores the reality that the main reason private health insurers might go out of business is because people hate the product they offer, and even with all the carrots and sticks designed to force people to take out health insurance, a majority of Australians do not want it.

Over six years ago I pondered if private health insurance was a con. In the time since, during which we have experienced the greatest health crisis in a century, nothing has really changed the answer.

Not only does it remain untrue that private health insurance takes stress off the public system, it also remains a fib to call it private – it’s a public system merely carried out in an inefficient manner to deliver a product most people don’t want and haven’t ever wanted.

In the late 1990s, after 15 or so years of Medicare, fewer than a third of Australians held private health insurance. Then John Howard decided that the private sector needed help from the public sector.

He introduced a surcharge to penalise higher income earners who did not have private health insurance.

The stick was not enough. Howard then tried the carrot: providing a rebate on your private health insurance. These rebates are quite pricey – the government this year will spend about $7.5bn on them.

It did bugger all – you literally could not pay people to buy it.

One of the principles upon which provision of puberty blockers to young trans people was made was Gillick competence – the law that says that young people over the age of 12 can be individually assessed by medical professionals to determine whether or not they’re competent to make medical decisions for themselves. This was hard fought for by feminist campaigners back in the 1980s and it led to the passing of the Age Of Legal Capacity Act in Scotland in 1991. It’s a principle of particular importance when it comes to reproductive healthcare, as it helps young people to access the services they need even if, for instance, they feel unsafe discussing them with their parents. As such, it helps to protect them from abuse and to get used to the idea that they have ownership of their bodies, which is important as they grow up and negotiate boundaries in romantic and social relationships.

By overriding Gillick competence where trans people are concerned, Streeting has created a risk that it will be ignored in other cases too. Perhaps we shouldn’t be surprised. He seems shaky on the concept of medical consent more generally, as demonstrated by his suggestion that obese unemployed people should be given the weight loss drug Ozempic to improve their health and get them back into work. Although his initial comments on this, which provoked a public outcry, were quickly followed by assurances that it would not be compulsory, concern remains about the vulnerability of people who depend on the state for support, especially those who are disabled, who make up a significant part of the obese population. Like most drugs, Ozempic has side effects and is not appropriate for everyone.

Slimy git.

Streeting acknowledged that the decision would not be welcomed by everyone but sought to reassure young trans people. He had met many of them since taking up his post in July, he said, and listened to their concerns, fears and anxieties.

In a message directly to them, and referencing having come out as gay, he said: “I know it’s not easy being a trans kid in our country today, the trans community is at the wrong end of all of the statistics for mental ill health, self-harm and suicide.

“I can’t pretend to know what that’s like, but I do know what it’s like to feel you have to bury a secret about yourself, to be afraid of who you are, to be bullied for it and then to experience the liberating experience of coming out.

“I know it won’t feel like it based on the decisions I’m taking today, but I really do care about this and so does this government. I am determined to improve the quality of care and access to healthcare for all trans people.”

Decisions were being taken “based on the evidence and advice of clinicians, not politics or political pressure”, he added.

Some world-class hand-wringing going on in Washington. Take that, fascism! We are resolute in our misgivings about supporting you every step of the way!

The 2025 NDAA, which authorizes an astronomical military budget of $895 billion, contains numerous policy items including a 4.5% pay raise across the board, a more substantial 14.5% raise for junior service members, and over $600 million in military funding for Israel. It also includes multiple sections that would place new restrictions on gender-affirming medical care for military families on government TRICARE health plans, the military’s health insurance program for active duty members. Under Sections 708 and 709 of the bill, no Department of Defense funds or facilities may be used to “perform or facilitate sex change surgeries,” and TRICARE plans may not provide hormone therapy, puberty blockers, or “other medical interventions for the treatment of gender dysphoria that could result in sterilization” to anyone under 18. (Right-wing sources have increasingly pushed false and misleading claims that puberty blockers and hormones lead to sterilization.) Another section would prohibit the Department of Defense from establishing any new positions “relating to diversity, equity, and inclusion,” or from adding those responsibilities to existing DoD positions.

On Wednesday, members of the House approved the NDAA in a 281-140 vote, CBS reported. 81 Democrats voted in favor of the budget, while 16 Republicans voted against it. The bill will now be sent to the Senate for another vote.

Normally, party leaders “whip” members into voting one way or another based on their party’s collective goals — but House Minority Leader Hakeem Jeffries said he would not whip Democratic votes for or against the NDAA on Wednesday, even though the bill contains overtly anti-trans policy (for the second year in a row). “We’re not whipping on the National Defense Authorization Act. It’s a member-to-member, case-by-case analysis in terms of people making decisions as to what is the right thing to do,” Jeffries told reporters ahead of the vote, according to The Hill. Jeffries added that the bill contains “a lot of positive things” but “some troubling provisions in a few areas, as well.” The New York representative slammed Republican extremism in a press conference on Wednesday, but also told reporters that he and his party “are ready, willing and able to find bipartisan common ground with the incoming administration on any issue.” Jeffries was among the 81 Democrats who voted in favor of the NDAA on Wednesday.

[…] 

In a series of Bluesky posts on Wednesday, Virginia Rep. Bobby Scott called the gender-affirming care ban “reprehensible” and called on Republicans to “prioritize national security and servicemembers, not culture wars,” but voted in favor of the bill that day. As The Hill reporter Brooke Migdon observed, 50 other Democrats who signed a September letter denouncing the NDAA’s anti-LGBTQ+ provisions voted to advance it this week.

We mapped the extent to which researchers and advocates have been subject to intimidation tactics by tobacco, alcohol and ultra-processed food (UPF) companies and their associates. The tactics described include being descredited in public, legal threats, complaints, nefarious use of Freedom of Information legislation, surveillance, cyberattacks, bribery and even physical violence.

[…]

The scale of intimidation we have found is likely to be the tip of the iceberg. Many will be too scared to publicly reveal that they have been intimidated because of their work.

We found widespread intimidation across the three sectors, perpetrated by corporations themselves and their third parties. In the most serious forms of intimidation, the perpetrators remained unknown.

The World Professional Association for Transgender Health said the refusal or withdrawal of HRT for trans patients raised “ethical and clinical” concerns.

“Hormones should not be stopped for political reasons or in the absence of a recognised medical issue,” a spokesperson told TBIJ. “If GPs are withdrawing prescriptions despite recommendations, this could result in negative impacts on patients' mental and physical wellbeing.”

[…]

The issue appears to reflect a wider rollback of access to gender-affirming healthcare in the wake of April’s publication of the controversial Cass Review into health services for trans young people. This review claimed that the evidence base of using puberty blockers and gender-affirming hormones for young people was “weak”. Some of the same medicines are used in adult care.

The review did not recommend a ban on puberty blockers but resulted in one for young people experiencing gender dysphoria (they are still permitted for children experiencing early puberty). The ban was extended by the new Labour government in August. Adult gender services are now also under review.

The World Professional Association for Transgender Health said the refusal or withdrawal of HRT for trans patients raised “ethical and clinical” concerns.

“Hormones should not be stopped for political reasons or in the absence of a recognised medical issue,” a spokesperson told TBIJ. “If GPs are withdrawing prescriptions despite recommendations, this could result in negative impacts on patients' mental and physical wellbeing.”

Puberty blockers delay the onset of puberty, but don’t necessarily result in a measurable effect at the time they are taken. The main impact is seen when people are older. The physical effects of a puberty that does not match a person’s gender can have serious negative consequences for transgender adults.

In my role as a GP, I regularly hear from transgender adults (who have not had puberty blockers) struggling with distress related to bodily changes which occurred during puberty.

I have met people who don’t speak because their deep voice causes others to make incorrect assumptions about their gender. Some harm themselves or avoid leaving the house because of the distress caused by their breasts. Others seek costly surgical treatments.

This is when the benefits of maintaining equitable access to puberty blockers for those who need them become obvious. People are seeking hormones, surgery and mental health support for changes which could have been prevented by using puberty blockers when they were younger.

The ministry’s position statement recommends that puberty blockers are prescribed by health professionals who have expertise in this area, with input from interdisciplinary colleagues.

In my experience this describes how puberty blockers are currently being prescribed in New Zealand. Clinicians are already cautious in their prescribing. They work with multidisciplinary input to best support the young person and their family. They recognise the importance of mental health and family support for young people. 

Some high-octane anger fuel in this excellent piece:

COVID patients began raising the alarm that they weren't getting better, scientists are still racing to unravel the mystery of why a significant minority of people develop debilitating chronic symptoms while others seem to recover just fine. But if the plight of adults with long COVID remains poorly understood, the millions of children who have it worldwide are practically invisible, their suffering — and the formative years they're losing to this disease — obscured by the myths that COVID is "harmless" for kids and the pandemic is "over".

In Australia, the lack of awareness is biting in shocking ways. Too many children with long COVID are being dismissed by doctors who say there's nothing they can do to help — or worse, that their pain and fatigue is "all in their head". They're being pushed out of school by teachers who don't understand why they can't come to class or run around with their peers. Their parents have been gaslighted and blamed, too, not just by medical professionals but their closest friends and family. And experts are concerned that all this ignorance and apathy — and the unwillingness of governments to do more to curb COVID transmission — is exposing a generation of children to the same chronic illness and disability, with potentially devastating consequences.

Good grief.

SAN FRANCISCO (AP) — Tech behemoth OpenAI has touted its artificial intelligence-powered transcription tool Whisper as having near “human level robustness and accuracy.”

But Whisper has a major flaw: It is prone to making up chunks of text or even entire sentences, according to interviews with more than a dozen software engineers, developers and academic researchers. Those experts said some of the invented text — known in the industry as hallucinations — can include racial commentary, violent rhetoric and even imagined medical treatments.

Experts said that such fabrications are problematic because Whisper is being used in a slew of industries worldwide to translate and transcribe interviews, generate text in popular consumer technologies and create subtitles for videos.

More concerning, they said, is a rush by medical centers to utilize Whisper-based tools to transcribe patients’ consultations with doctors, despite OpenAI’ s warnings that the tool should not be used in “high-risk domains.”