Quick Notes
Endocrinologist Will Malone joins Sasha and Stella to discuss the pivotal position that endocrinologists have in the new practice of childhood transition. In this conversation, Will describes attending a conference in 2017 run by the Endocrine Society where suddenly everything related to trans healthcare appeared to shift, without any discussion or analysis.
Extended Notes
● A quick introduction about Dr. Will Malone.
● How did Dr. Will get involved in this field?
● Dr. Will was seeing small clusters of females declaring they were trans. What was going on?
● Primary doctors were calling Dr. Will for help. They had never seen anything like this before.
● Dr. Will explains what he’s been seeing in his practice when it comes to teens experiencing gender dysphoria.
● Stella notes that the three main professionals needed are surgeons, endocrinologists, and psychologists to help teens through this journey.
● What is the role of an endocrinologist and what kind of guidelines should they be following when helping at teen transition?
● Dr. Will doesn’t agree with the treatment protocol for hormone blockers in teens.
● Dr. Will was surprised by the study they based this new treatment protocol off of. It referenced only one study and the quality of evidence, he believes, is questionable.
● Endocrinologists prescribing puberty blockers or sex hormones to teens outside of clinical trials — they are engaged in experimental medicine.
● “Let’s see what we can do.” Is not an approach any medical professional should take. People will be harmed by this.
● Sasha recaps how medical professionals were treating gender dysphoria prior to 2010 vs. how they’re treating it now. It’s alarming.
● Where’s the data?
● What are Dr. Will’s peers and colleagues saying about the Endocrine Society’s stance on this?
● The harms can be significant. We’re talking about infertility, increase in heart disease, and irreversible effects in children.
● Dr. Will has attended conferences where counterpoints are presented when it comes to prescribing new medicine, but he did not see this occur when it came to gender dysphoria. It was difficult even to submit questions.
● What type of person/endocrinologist pursues this field of work (sex hormone blockers)?
● How did SEGM get started?
● The UK recently had a ruling about puberty blockers. Dr. Wil shares more details.
● On a chemical and medical level, what happens when you stop puberty?
● Can a simulated puberty be the same as biological puberty?
● Why halt puberty with a mental intervention? Why aren’t we getting more psychologists on board during this process to help distressed teens navigate their new bodies?
● The medical field is more than happy to provide solutions to client demand, even if it is to the detriment of the client.
● Sasha is seeing something very shocking happening with parents and their gender dysphoric children right now.
● Parents are being ignored. It seems to be culturally acceptable by medical professions to skip the due diligence and go straight to hormone blockers. Any questions parents bring up — they are deemed bigotted.
● UK medical professionals think the guidelines are rubbish and are not biting. U.S. medical professionals see it differently: These are the guidelines, therefore it must be okay!
● It’s a difficult position for Dr. Will to be in. He’s going against the herd and he’s receiving peer pressure from it.
● Dr. Will says it again: If you intervene when there’s no evidence, there is likely to be harm.
● Stella shares what’s happening in Ireland right now when it comes to puberty blockers.
Links:
Will Malone twitter: Twitter.com/will_malone
SEGM: Segm.org
SEGM Tweets: Twitter.com/SEGMtweets
Michael Biggs
Video: Youtube.com/watch?v=9VHlkE40cFk&t=971s
Academic Paper:
Link.springer.com/article/10.1007/s10508-020-01743-6
Endocrine Society's Guidance on Gender Dysphoria:
Endocrine.org/clinical-practice-guidelines/gender-dysphoria-gender-incongruence
UK Ruling in Kiera Bell Case:
Bbbc.com/news/uk-england-cambridgeshire-55144148
Pressure to Medically Intervene:
Theguardian.com/society/2015/sep/12/transgender-children-have-to-respect-who-he-is
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This podcast is partially sponsored by ReIME, Rethink Identity Medicine Ethics:
Learn more about our show: Linktr.ee/WiderLensPod
5 - Hormonal Interventions — from Fringe to Mainstream: A conversation with Dr. Will Malone