> notwithstanding my hesitation about surgical and hormonal interventions being pushed for pre-pubescent children
Surgical and cross-hormonal therapies are, by most nationally recognised and implemented standards of care, reserved until the patient reaches at least 16 years of age. Pubertal suppression is used as a method of reducing harm and is widely associated with improved mental health outcomes.
> Perhaps you know of some other, higher quality work I could look at?
Yes, I do. It's the same one covered by the PinkNews article you cited. A "careful" reading is insufficient. A careful, statistically literate reading is required. Such a reading of the study shows that the data do support the conclusion. The "contradictions" you cite are derived from statistically insignificant correlations. Please read up on P-value and the necessity of corrections in multi-variate analysis.
The claimed reduction effect with P 0.001/multivariate corrected is total lifetime suicidality in individuals with a history of suicidal ideation, who wanted pubertal suppression and received it. Absolutely none of the "contradictions" you cite are claimed and the study isn't powerful enough to give realistic results for any of them.
Please, in the future, try to criticise studies like this. I certainly don't agree with many of Bigg's points but they do raise the right questions. More data is certainly needed - but that doesn't mean that the proposed treatment is necessarily wrong. That remains a clinical decision with this as but a small input factor.
> Surgical and cross-hormonal therapies are, by most nationally recognised and implemented standards of care, reserved until the patient reaches at least 16 years of age.
Those standards of care are transphobic and a violation of trans children's human rights, according to trans rights groups. Policies that seek any kind of age limits are universally attacked by trans activists.
For example, observe the storm around Tavistock in the UK, which has for years aggressively pushed children into transition surgeries and hormone treatments, and censored and persecuted internal dissenters and wistleblowers with accusations of transphobia.
Last year's High Court ruling that Tavistock must limit these treatment to children over 16 was attacked by trans activists. Here's Mermaids:
"It’s frankly a potential catastrophe for trans young people across the country and it cannot be exaggerated the impact that this might have, not only on the population of trans young people that require hormone blockers, but it may potentially open the floodgates towards other questions around bodily autonomy and who has the right to govern their own body."
And in a recent example from the US, in response to South Dakota's effort to limit surgeries and hormonal treatments to kids older than 16, the Trevor Project said, "[these bills] not only contradict reality and majority medical opinion in the United States — they would also put young lives in jeopardy".
Regarding the study, you're looking at the wrong one. The one cited at the Pink News link is here:
No, there's no p-value fuckery going on here (and yes, I understand p-values; I worked at a medical device company analysing statistics from human trials.) This is just bad analysis. And I see bad analysis and bad data everywhere I look within this admittedly fraught subject.
Thanks for the other material though, I'll take a look.
Surgical and cross-hormonal therapies are, by most nationally recognised and implemented standards of care, reserved until the patient reaches at least 16 years of age. Pubertal suppression is used as a method of reducing harm and is widely associated with improved mental health outcomes.
> Perhaps you know of some other, higher quality work I could look at?
Yes, I do. It's the same one covered by the PinkNews article you cited. A "careful" reading is insufficient. A careful, statistically literate reading is required. Such a reading of the study shows that the data do support the conclusion. The "contradictions" you cite are derived from statistically insignificant correlations. Please read up on P-value and the necessity of corrections in multi-variate analysis.
The claimed reduction effect with P 0.001/multivariate corrected is total lifetime suicidality in individuals with a history of suicidal ideation, who wanted pubertal suppression and received it. Absolutely none of the "contradictions" you cite are claimed and the study isn't powerful enough to give realistic results for any of them.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/
Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation
Pediatrics. 2020 Feb; 145(2): e20191725. doi: 10.1542/peds.2019-1725
See also Erratum, perhaps the rephrasing of the conclusion there will be helpful for you - https://pubmed.ncbi.nlm.nih.gov/31974216/
Now, this is certainly valid criticism of the study (or rather, the study and the data upon which the study was based): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8169497/
Please, in the future, try to criticise studies like this. I certainly don't agree with many of Bigg's points but they do raise the right questions. More data is certainly needed - but that doesn't mean that the proposed treatment is necessarily wrong. That remains a clinical decision with this as but a small input factor.