Hi all

'I have never encountered the kinds of concerns that some of the reviewers expressed in response to my review of puberty blockers. In this case, it wasn’t the methods they objected to, it was the actual findings.' (Baxendale 2024)

Attached are pdfs of two articles by Sallie Baxendale, a UK neuropsychologist, about puberty blockers, illustrating the (widespread) suppression of evidence about the potential harms of 'gender-affirming care':

• Baxendale S (2024) The impact of suppressing puberty on neuropsychological function: A review. Acta Paediatrica. 2024;00:1-12. https://doi.org/10.1111/apa.17150. (Open Access).
• Baxendale S (2024) Why did three journals reject my puberty-blocker study? UnHerd. https://unherd.com/2024/02/why-did-three-journals-reject-my-puberty-blocker-study/

 

Here is the abstract and 'Key notes' of Baxendale's review article in Acta Paediatrica:

Abstract

Aim Concerns have been raised regarding the impact of medications that interrupt puberty, given the magnitude and complexity of changes that occur in brain function and structure during this sensitive window of neurodevelopment. This review examines the literature on the impact of pubertal suppression on cognitive and behavioural function in animals and humans.

Methods All studies reporting cognitive impacts of treatment with GnRH agonists/antagonists for pubertal suppression in animals or humans were sought via a systematic search strategy across the PubMed, Embase, Web of Science and PsycINFO databases.

Results Sixteen studies were identified. In mammals, the neuropsychological impacts of puberty blockers are complex and often sex specific (n = 11 studies). There is no evidence that cognitive effects are fully reversible following discontinuation of treatment. No human studies have systematically explored the impact of these treatments on neuropsychological function with an adequate baseline and follow-up. There is some evidence of a detrimental impact of pubertal suppression on IQ in children.

Conclusion Critical questions remain unanswered regarding the nature, extent and permanence of any arrested development of cognitive function associated with puberty blockers. The impact of puberal suppression on measures of neuropsychological function is an urgent research priority.

Key notes

• Adolescence is a critical window of neurodevelopment and puberty plays a critical role in these neurodevelopmental processes.
• The suppression of puberty impacts brain structure and the development of social and cognitive functions in mammals, the effects are complex and often sex specific.
• No human studies have systematically explored the neuropsychological impact of pubertal suppression in transgender adolescents with an adequate baseline and follow-up, this is an urgent research priority.

 

Baxendale's commentary article in UnHerd includes:

Last year, I wrote a paper [that] explained in relatively simple terms why we might think that blocking puberty in young people could impact their cognitive development. In a nutshell: puberty doesn’t just trigger the development of secondary sex characteristics; it is a really important time in the development of brain function and structure. My review of the medical literature highlighted that while there is a fairly solid scientific basis to suspect that any process that interrupts puberty will have an impact on brain development, nobody has really bothered to look at this properly in children with gender dysphoria.

…

I was surprised at just how little, and how low quality, the evidence was in this field. I was also concerned that clinicians working in gender medicine continue to describe the impacts of puberty blockers as “completely physically reversible”, when it is clear that we just don’t know whether this is the case, at least with respect to the cognitive impact.

…

The paper has now been accepted for publication in a well-respected, peer-reviewed journal. However, prior to this, the manuscript was submitted to three academic journals, all of whom rejected it.

… I have never encountered the kinds of concerns that some of the reviewers expressed in response to my review of puberty blockers. In this case, it wasn’t the methods they objected to, it was the actual findings.

… the most astonishing response I received was from a reviewer who was concerned that I appeared to be approaching the topic from a “bias” of heavy caution. This reviewer argued that lots of things needed to be sorted out before a clear case for the “riskiness” of puberty blockers could be made, even circumstantially. Indeed, they appeared to be advocating for a default position of assuming medical treatments are safe, until proven otherwise.

 

This sort of academic capture is part of a much broader regulatory/institutional capture that is strongly suppressing evidence/discussion/debate about gender-affirming care and gender identity/ideology.

 

Regards

Melissa

 

Melissa Raven

MPsych(Clin) MMedSc(ClinEpid) PhD

Psychiatric epidemiologist and policy analyst

Research Fellow

Critical and Ethical Mental Health research group (CEMH)

www.adelaide.edu.au/robinson-research-institute/research/groups/cemh/

Robinson Research Institute

Faculty of Health and Medical Sciences

University of Adelaide

55 King William Road, North Adelaide SA 5006, AUSTRALIA

PhD: Depression and antidepressants in Australia and beyond - a critical public health analysis https://ro.uow.edu.au/theses/3686/

 

To leave, manage or join list: https://listserv.yorku.ca/cgi-bin/wa?SUBED1=sdoh&A=1