Archive for the ‘Hormone Clinic’ Category
Report Cites ‘Misinformation,’ ‘Remarkably Weak’ Evidence to Support Use of Puberty Blockers and Cross-Sex … – CatholicVote org
A long-awaited final report on the state of treatment for gender dysphoria in children and teens under the care of Englands National Health Service (NHS) has revealed the current clinical approach utilizing puberty blockers and cross-sex hormones is based on remarkably weak evidence stemming from poor quality of the published studies, and misinformation while exhibiting expectations of care that are far from usual clinical practice.
In the foreword to the report, British pediatrician Dr. Hilary Cass, who led an independent review team from the University of York, wrote that while the medical field is usually cautious in recommending new treatments for children and teens, quite the reverse happened in the field of gender care for children:
This is an area of remarkably weak evidence, and yet results of studies are exaggerated or misrepresented by people on all sides of the debate to support their viewpoint. The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.
[T]he toxicity of the debate is exceptional, Cass said about the issue of medical gender treatments for children. The knowledge and expertise of experienced clinicians who have reached different conclusions about the best approach to care are sometimes dismissed and invalidated.
The reports summary clearly asserts that, while some think the clinical approach should be based on a social justice model, the NHS works in an evidence-based way.
Our current understanding of the long-term health impacts of hormone interventions is limited, the review notes as it also acknowledges the rapid surge in referrals for such medical treatment.
The numbers of children and young people presenting to the UK NHS Gender Identity Service (GIDS) has been increasing year on year since 2009, with an exponential rise in 2014, the report observes, noting the use of puberty blockers began following the emergence of the Dutch Protocol.
The review team stressed the rapid push to utilize puberty blockers, despite any evidence showing effectiveness:
Preliminary results from the early intervention study in 2015-2016 did not demonstrate benefit. The results of the study were not formally published until 2020, at which time it showed there was a lack of any positive measurable outcomes. Despite this, from 2014 puberty blockers moved from a research-only protocol to being available in routine clinical practice and were given to a broader group of patients who would not have met the inclusion criteria of the original protocol.
The systematic review by the University of York found multiple studies that show puberty blockers not only suppress puberty, but also compromise bone density.
Yet, evidence regarding the use of puberty blockers and cross-sex hormones to treat gender dysphoria had already been shown to be weak, with a lot of misinformation easily accessible online and remaining currently, the review stated.
The World Professional Association of Transgender Healthcare (WPATH) has been highly influential in directing international practice, although its guidelines were found by the University of York appraisal process to lack developmental rigour, the report asserts.
In March, leaked internal files from WPATH, often touted by Dr. Rachel (born Richard) Levine, a top Biden HHS official, as the premier organization for evidence-based treatment recommendations, revealed its doctors acknowledging children and teens were not capable of comprehending the possible long-term effects of the treatments and surgeries they were prescribed.
The review team notes that while research suggests gender expression is influenced by biological predisposition, early childhood experiences, sexuality and expectations of puberty, and, therefore, requires a multi-disciplinary team approach to assessing the problem areas for each individual child, the most striking problem is the lack of any consensus on the purpose of the assessment process.
Some service users and advocates view an extensive exploration of other conditions and diagnoses as an attempt to find any other reason for the persons distress other than them being trans, the team observes.
While the report states there are some young people for whom medical treatment for gender dysphoria will be the best outcome, it notes as well young adults looking back at their younger selves would often advise slowing down as they and their parents weigh the ramifications.
Some may transition and then de/retransition and/or experience regret, the review acknowledges, concluding a medical pathway is not the best treatment protocol for the majority of young people:
[T]he focus on the use of puberty blockers for managing gender-related distress has overshadowed the possibility that other evidence-based treatments may be more effective. The intent of psychosocial intervention is not to change the persons perception of who they are, but to work with them to explore their concerns and experiences and help alleviate their distress regardless of whether or not the young person subsequently proceeds on a medical pathway.
[N]o changes in gender dysphoria or body satisfaction were demonstrated as a result of puberty blockers, the report plainly asserts.
The review team also addressed the controversy over social transition what has become known as the initial phase of so-called gender-affirming care.
The systematic review showed no clear evidence that social transition in childhood has any positive or negative mental health outcomes, and relatively weak evidence for any effect in adolescence, the report concludes. However, those who had socially transitioned at an earlier age and/or prior to being seen in clinic were more likely to proceed to a medical pathway.
Reviewers similarly found no support for the claim by transgender activists that administering puberty blockers allows time for children and their families to consider further medical intervention:
[G]iven that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinising/ feminising hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development.
There is a lack of high-quality research assessing the outcomes of hormone interventions in adolescents with gender dysphoria/incongruence, and few studies that undertake long-term follow-up, the review team explains.
In addition, reviewers found no evidence to support the transition or die claim that hormone treatment prevents a high risk of suicide in minors with gender dysphoria.
>> FINNISH STUDY: GENDER-AFFIRMING CARE DOES NOT REDUCE YOUTH SUICIDE <<
The primary predictor of death in gender-dysphoric young people is psychiatric morbidity, the researchers said. Medical gender reassignment does not have an impact on suicide risk.
The current evidence base suggests that children who present with gender incongruence at a young age are most likely to desist before puberty, although for a small number the incongruence will persist, the Cass report concludes.
This final report stresses the need for a holistic assessment of children and teens referred for gender services:
This should include screening for neurodevelopmental conditions, including autism spectrum disorder, and a mental health assessment.
Standard evidence based psychological and psychopharmacological treatment approaches should be used to support the management of the associated distress and cooccurring conditions, the team recommends. This should include support for parents/carers and siblings as appropriate.
The release of the Cass report comes only days after Dignitas Infinita on Human Dignity, the most recent document from the Dicastery for the Doctrine of the Faith (DDF), was issued.
The DDF declaration addresses human dignity and reaffirms traditional teachings of the Church, including those on gender ideology and sex-change surgery.
>> READ CVS ANALYSIS OF DIGNITAS INFINITA HERE <<
Review of evidence for puberty blockers and hormone treatment in youth – New Zealand Doctor Online
What the public may not be aware of, is that it is relatively common for treatments to be offered in health and mental health, where the research evidence is still emerging and/or limited"
Dr Paul Skirrow, clinical psychologist and neuropsychologist, and strategic advisor at the New Zealand College of Clinical Psychologists, comments:
"We would urge the public to interpret the findings of these reviews with some caution - many people will assume that this research suggests that puberty blockers and hormone treatments should never be offered, which would be mistaken.
The authors ultimately conclude that: No conclusions can be drawn [about the effect of puberty blockers]. This research highlights that we currently do not know how effective these treatments are, or who they are most effective with, but there are many reports of benefit from the people who use them and clinicians who provide them. What research we do have, albeit of limited quality at present, appears to suggest there may be benefits overall, however, we do not currently know who specifically is likely to benefit.
With regard to hormone treatments, the authors do conclude that There is suggestive evidence from mainly pre-post studies that hormone treatment may improve psychological health. However, again, they clearly state that robust research with long-term follow-up is needed.
What the public may not be aware of, is that it is relatively common for treatments to be offered in health and mental health, where the research evidence is still emerging and/or limited. The choice for clinicians is frequently whether to offer nothing - which is unlikely to be helpful - or offer something that we agree can be helpful for some people.
"In doing so, we recommend that the person undergoing these treatments gets the best possible information on what we know about their risks and benefits. For this reason, we very much welcome research studies, such as those released today, which help us fully understand what they may be."
Conflicts of interest statement: I'm not aware of any potential conflicts of interest. My role with the NZCCP involves speaking on behalf of the organisation, specifically the executive leadership team. We have approximately 1800 members, who hold a wide range of views, and so my comments may or may not reflect those of individual members. I also hold a senior lecturer position at Otago University, specialising in neuropsychology.
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Review of evidence for puberty blockers and hormone treatment in youth - New Zealand Doctor Online
What To Expect in Each Stage of Menopause – Health Essentials
Menopause is a natural part of aging that marks the end of the female reproductive years but many people dont know what to expect until theyre in the midst of it. Did you know, for example, that you could experience symptoms up to a decade before menopause actually begins?
Menopause specialistPelin Batur, MD, walks us through the stages of menopause and what you may be able to expect during each one.
The menopause process is all about hormones. Your body begins to produce less of the hormone calledestrogen, which regulates your menstrual cycle, and your ovaries start running low on eggs. But it doesnt happen all at once.
Heres a quick overview of the three stages of menopause:
Dr. Batur explains each stage in greater detail, including the symptoms you might experience andhow to find relief.
You can think about perimenopause as the runway to the big event. It can start as early as a decade before menopause, though the average amount of time spent in perimenopause is four years.
During this time, your body is, little by little, winding down its naturalovulation process. The most common sign of perimenopause isirregular periods and menstrual cycles.
As your estrogen levels start to decrease, your periods and menstrual cycles may start getting a little wonky sometimes, closer together, sometimes skipping cycles, Dr. Batur explains. You may also have some of the typical menopausal symptoms.
Not everyone experiences noticeable symptoms during perimenopause, but they can include:
There are two stages to perimenopause early menopause transition and late menopause transition though theyre not always cut-and-dry and distinguishable from one another.
This first stage of perimenopause is the very beginning when your body is just starting to experience hormonal changes. During this time, your periods and menstrual cycles are still coming regularly, but you may notice other symptoms:
This is a natural phase of life, so if your symptoms are mild, you may be able to make do with lifestyle changes like getting more sleep and upping your cardio, Dr. Batur says. But if theyre really bothersome, speak to your healthcare provider, even if youre still having regular menstrual cycles.
The late menopause transition is when youre gettinga little closer to menopause. Youre more likely to start experiencing irregular periods and menstrual cycles.
During perimenopause, youre not ovulating as regularly, Dr. Batur says. You have up-and-down levels of estrogen, and you may not make progesterone as consistently, so you may skip a menstrual cycle and then have heavy bleeding during the next period because your uterine lining has thickened up from the impact of the estrogen.
Eventually, as you get closer and closer to menopause, you start skipping periods for months at a time, she continues.
If this happens, bring it up with your healthcare provider especially if youre in your early 40s or younger, which can be a sign ofpremature menopauseor a condition calledprimary ovarian insufficiency.
When youve gone a full 12 months without having your period, youve entered menopause (assuming you havent stopped bleeding because of another medical condition or a medication).
That typically happens around age 52, Dr. Batur shares, and then, you live the rest of your life in menopause, where youre no longer ovulating and you no longer have the ability to bear children.
Menopause symptoms typically last for seven to 10 years (though your timeframe may vary), and they can range from mild to severe. If youre in the latter camp, experiencing bothersome symptoms that you just cant shake, dont feel like you have to soldier on in silence.
Just saying, grin and bear it and eat healthier and lose some weight doesnt cut it for people who are really suffering during this time in their lives, Dr. Batur states. Your healthcare provider will also want to make sure that your symptoms arent related to other medical conditions.
Once you enter menopause, youre in menopause for the rest of your life; this is also called the postmenopause stage.
But now, youre at a higher risk for other health concerns. A decrease in estrogen is a risk factor in conditions like:
The older you get, the more tuned in your healthcare provider should be to menopauses impact on your health. But if theyre not bringing it up, you definitely should even if youre feeling fine, but especially if youre not.
The stages of menopause shouldnt make you feel miserable. If your symptoms are especially bothersome and having an impact on your quality of life, its time to ask for help.
Tell your Ob/Gyn or your primary care doctor, Hey listen, I think my hormones are going haywire, Dr. Batur advises. They can talk you through the options, which may include any of the following (or a combination of them):
Just remember: Theres no quick fix for the symptoms of menopause. If you raise concerns about themduring an annual visit, your healthcare provider may ask you to come back for another appointment so the two of you can go more in-depth about what youre experiencing and thats OK.
This is a very individual thing, and it can be very complicated, especially depending on your medical history, Dr. Batur says. Schedule another appointment, if you need it, and make sure your concerns are being addressed during dedicated time with your provider.
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What To Expect in Each Stage of Menopause - Health Essentials
How much does it cost to use our services – GenderGP
The GenderGP Appraisal Pathway
This is a pathway designed by GenderGP which allows you to be in charge of your gender journey.
We believe that you are the expert in your gender, and by offering our expertise in healthcare, we can make sure that your medical transition is suited to what you need and is delivered in the safest way possible.
By going through this process you will be able to provide us with information about you and your health and your gender feelings. This will allow us to come to a joint agreement on the best treatment for you.
If you are in the UK or the EU, we can use our private prescription service. If you are outside the EU then we will carry out any necessary assessments and then issue you with a Treatment Summary for your provider so they can do blood testing and prescribe under our direct supervision.
We will make all the decisions on medication and blood results to keep you safe.
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How much does it cost to use our services - GenderGP
PROTECT TEENAGERS FROM HARMFUL AND IRREVERSIBLE MEDICAL TREATMENT – CrowdJustice
The Care Quality Commission (CQC) has registered Gender Plus Hormone Clinic to provide hormone treatments to 16 and 17-year-old children.
This paves the way for other private clinics to be registered, which would offer controversial medical treatments with lifelong consequences to vulnerable teenagers. The decision of the CQC to license a private clinic, creates a significant risk of a two tier approach, with less protection for those who seek help from the private sector. This further risks undermining the work of the Cass review for NHSE practice.
I want the court to set aside the registration by the CQC of Gender Plus Hormone Clinic to provide hormone treatment for teenagers. I also hope that this litigation will prevent the registration of other private clinics providing this controversial treatment. I want to ensure that those under 18 years old, do not suffer irreversible, lifelong harms both physical and psychological, from taking a controversial hormonal treatment which is not evidenced as safe or effective.
Why I am asking for this Judicial Review
I was in the NHS for nearly 40 years and I am now a psychotherapist in private practice. I have worked with people who present with issues around their gender identity for over 20 years. In my clinical experience of working with children and young people, I have not, to date, encountered a 16 to 17-year-old who I would have assessed to be sufficiently fully informed and psychologically ready to make such a life changing, potentially harmful decision. They are in the process of development from child to adult which involves significant mental and physical adjustments. Many of the young people with gender dysphoria/incongruence have no clear understanding of their underlying motivations to take cross, sex, hormones. However they are usually very aware of the discomfort they experience, and often hold a strong belief that the medication will help them feel better. They hope a change to their physical body will bring about a comfort in their mind. Some also receive strong messages from certain groups that medication is the answer to their difficulties which creates an urgent pressure on them and those around them for a solution. As a result, they are rarely able to give a full, in-depth psychological consideration to the implications and consequences of commencing a physical treatment, which is known to have serious, harmful side-effects, and, as yet has a very low level evidence base for it's efficacy and safety.
Under its current registration by the CQC, Gender Plus Hormone Clinic (GHPC) is not prevented from providing GnRH analogues (blockers) for the purpose of suspending puberty. There are some 16-year-olds who have not reached pubertal maturation. Further, the GPHC has said that it would prescribe puberty blockers alongside oestrogen therapy to achieve feminising effects. The NICE report (National Institute of Clinical Excellence) and the Cass review both state that this treatment model is not proven.
There is also considerable risk of complications due to this powerful medication. There are many known side-effects, including blood clots, gallstones, vaginal atrophy and male pattern baldness for females and potential loss of fertility, amongst many others.
The evidence base
The Cass review was commissioned by the NHS to provide a comprehensive review of the appropriate treatment for children and young people with gender dysphoria. The Cass Review sought advice from the National Institute for Health and Care Excellence (NICE) which conducted two separate evidence reviews.
Neither of them has found sufficient evidence to support the use of either puberty blockers or cross sex hormones as safe and effective.
In her interim report published in February 2022, Dr Cass has emphasised the gaps in the "evidence base regarding hormone treatment" (Para 1.41). Although some of her observations related specifically to puberty blockers, she also addressed cross-sex, hormones, and hormone treatment more generally. She said, among other things:
"The Review is not able to provide definitive advice on the use of puberty blockers and feminising/masculinising hormones at this stage, due to gaps in the evidence base; however, recommendations will be developed as our research programme progresses.
The lack of available high-level evidence was reflected in the recent NICE review into the use of puberty blockers and feminising/masculinising hormones commissioned by NHS England, with the evidence being too inconclusive to form the basis of a policy position(para 5.21)
At present we have the least information for the largest group of patients birth- registered females first presenting in early teens(para 5.11).
Your help:
I need your help to ensure that the registration of GPHC is cancelled and the other private clinics are unable to prescribe this controversial treatment to children under 18. We should not be careless or look away from the potential harms this medical treatment might cause to childrens previously healthy bodies.
Please support me with the legal fees required to mount a judicial review and challenge the CQC decision. I was the original claimant who started the Kiera Bell JR with Mrs A and our application on that occasion was successful in providing further scrutiny and attention in this area of paediatric healthcare. That judicial review potentially helped prevent irreversible harms to much younger children too as it led to a much wider scrutiny of the model of treatment in the GIDS.
I have assembled an expert legal team and will be lodging my claim with the High Court in the next few days. Please join me in seeking to protect vulnerable young people and share this crowdfunder link. I know these cases keep coming but we need to protect the next generation.
My X (twitter) handle is @sueevansprotect
Thank you very much.
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PROTECT TEENAGERS FROM HARMFUL AND IRREVERSIBLE MEDICAL TREATMENT - CrowdJustice
Home – CHS Hormone
Stephanie is professional, personable, and a joy to be around. She puts you right at ease. Explains all procedures. She is very knowledgeable in all aspects of her profession.
(Injectable and hormone patient TS from Awendaw)
I really bonded with Stephanie! She explained things so well. I am looking forward to seeing her again
(Hormone patient- MS from James Island)
Stephanies the best!
(hormone and injectable patient BR from Mount Pleasant)
Stephanie is a life changer! I know my body well, and going through changes she makes me feel like I am not loosing my mind. Going to my regular OB doctor in regards to hormonal issues I have been told that what I am going through is not pre- menopausal. Wrong!!! Stephanie has me set up on hormone replacement therapy that has been a game changer. I feel great, I have a ton of energy and I most importantly I feel balanced all day long. Her knowledge and expertise is top notch! I highly recommend her. Not only is she knowledgeable, she goes the extra mile to explain things, she also gives you options to what you as a patient are comfortable with. I love that she supports the route (you as a patient) decides to do. I highly recommend Stephanie at Charleston Hormone Replacement and Aesthetic Services.
Hormone Patient
Stephanie Donovan is the absolute best at what she does. She takes her time to review your labs and to talk about any aesthetic procedures in detail so that you feel completely comfortable with what your goal is. Shes knowledgeable about the latest technology and knows how to customize the right solution just for you. I trust my face, lips, and everything with her!
Hormone Patient
Stephanie is amazing! Love the new office. She has helped me improve my quality of life so much I cant even explain how good I feel all the time now. Super friendly, professional, and always caring and super helpful. Cant recommend her enough!
Hormone Patient
Stephanie is amazing at what she does! She has changed my life with educating me on the importance of hormone therapy and has provided excellent care. She has a heart for what she does and truly cares about her patients.
Hormone Patient
Cannot say enough good things about my experience with Stephanie! She thoroughly takes the time to listen and care for her patients. The best in Charleston for injectables and hormones!
Hormone and Cosmetic Patient
So happy I finally found Steph again!!! She is the BEST in Charleston. Definitely give her a try for all your aesthetic needs as well womens health!! Hormone guru!!! Highly recommend !!!!
Aesthetic patient from Isle of Palms, SC
Everyone should get their levels checked at one or more points in life to optimize our health and general feeling of wellness and this is a great place to do it! The initial consult was very attentive and detailed. Stephanie spent a lot of time explaining my results so that I felt confident in the drivers of my symptoms and next steps I needed to take. Definitely recommend. 🙂
-Hormone Patient from Charleston, SC
I went today to have a pellet as Im visiting from out of town and it was time. I was nervous because it was my first time here and I wanted to make sure it would be pain-free. Stephanie was fantastic. Put my mind at ease. It was not painful at all and she was wonderful to deal with!
-Hormone Patient from Delray Beach, FL
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Home - CHS Hormone
Hormone Evaluation and Replacement Therapy | Amen Clinics
The adrenal glands are part of what is called the HPA (hypothalamic-pituitary-adrenal) axis, which controls how your body reacts to stress. When faced with a stressful situation, your adrenal glands release a cascade of hormones, including adrenaline, DHEA, and cortisol as part of your fight-or-flight response. Once the threat has passed, your body processes normalizeyour heartbeat and breathing slow to their usual rate, your muscles relax, and your adrenals turn off production of those hormones until they are needed again.
In cases where stress becomes chronic, there can be a seemingly constant flow of stress hormones, that in turn, overwhelm your body and contribute to brain health/mental health issues. Chronically high cortisol levels also cause your blood sugar and insulin levels to spike. This can lead to harmful changes in the brain, including a drop in the calming neurotransmitter serotonin. High levels of cortisol are linked to mental health conditions, such as anxiety, depression, and PTSD.
In the brain, chronic stress produces more white matter and fewer neurons (gray matter) than normal, skewing their balance and disrupting communication within the brain.
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Hormone Evaluation and Replacement Therapy | Amen Clinics
Depression can hit hard during the winter months, here’s how to prevent it – NewsCenterMaine.com WCSH-WLBZ
Depression can hit hard during the winter months, here's how to prevent it NewsCenterMaine.com WCSH-WLBZ
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Depression can hit hard during the winter months, here's how to prevent it - NewsCenterMaine.com WCSH-WLBZ