So far the polling’s not looking bad for LizT – politicalbetting.com

williamglenn said:

Yes she did. You don't understand Theresa May's deal if you think it didn't involve new Irish Sea border checks.

You are right of course that even under the superb deal she managed to reach, there would still have been some very limited checks. Far less than those Boris signed up to, though.

bondegezou said:

Cyclefree said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

I'm not sure what you are saying about the Cass Report is quite accurate. The report seemed to cover both the treatments themselves and the whole approach by the Tavistock. Puberty blockers are, AIUI, drugs developed for other purposes being used for this. The evidence for their medical efficacy vs the side effects for children has not really been established or tested. One of the worrying things which has come out is the lack of records and follow up for patients put on such treatments. I thought NICE was meant authorise drugs for use. If it didn't how was such use authorised? The issue of informed consent is also an interesting one.

NICE don't authorise drugs for use.

OK, it's a bit complicated! The MHRA authorises drugs. The MHRA has authorised puberty blockers... for certain uses. However, doctors can and routinely do use all sorts of drugs for purposes other than which they are licensed. (On the grounds that the drugs have been authorised for some use, ergo we know they're reasonably safe, and that their usage to date has also proven them safe.) The checks on whether doctors are making sensible prescribing/treatment decisions are either at the level of the individual practitioner or at the level of the service. The service is covered by the CQC. Individual practitioners are covered by licensing and, ultimately, the threat of being done for malpractice if they can't justify their decision(s), which would be judged against the Bolam standard.

NICE assesses cost effectiveness and recommends best treatments. NICE has a massive backlog and there are many aspects of medicine where there is no NICE guidance at present. NICE generally concentrates on the bigger stuff and the numbers here are pretty small. NICE could be asked to recommend best practice in this area. (Maybe they have been? I don't know.)

Thank you. Helpful.

CarlottaVance said:

Phil said:

Cyclefree said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

I'm not sure what you are saying about the Cass Report is quite accurate. The report seemed to cover both the treatments themselves and the whole approach by the Tavistock. Puberty blockers are, AIUI, drugs developed for other purposes being used for this. The evidence for their medical efficacy vs the side effects for children has not really been established or tested. One of the worrying things which has come out is the lack of records and follow up for patients put on such treatments. I thought NICE was meant authorise drugs for use. If it didn't how was such use authorised? The issue of informed consent is also an interesting one.

They’re exactly the same drugs as those used to treat precocious puberty. (In adults they’re used to treat endometriosis & a bunch of other things.) These are fairly well characterised drugs, as healthcare treatments go

NICE:

This evidence review found limited evidence for the effectiveness and safety of gender- affirming hormones in children and adolescents with gender dysphoria, with all studies being uncontrolled, observational studies, and all outcomes of very low certainty. Any potential benefits of treatment must be weighed against the largely unknown long-term safety profile of these treatments.

https://cass.independent-review.uk/wp-content/uploads/2022/09/20220726_Evidence-review_Gender-affirming-hormones_For-upload_Final.pdf

Thanks.

So NICE were asked, by Cass, and produced that, which will influence future care, but obviously this came too late in terms of what was happening at the Tavistock.

(This doesn't appear to be a formal NICE guideline, I couldn't see it on the NICE website, but I don't think that really matters.)

I note it says that one male puberty blocker *is* licensed for gender dysphoria, which I hadn't realised.

Let's look at the full conclusion there:

"Any potential benefits of gender-affirming hormones must be weighed against the largely
unknown long-term safety profile of these treatments in children and adolescents with
gender dysphoria.

"Results from 5 uncontrolled, observational studies suggest that, in children and adolescents
with gender dysphoria, gender-affirming hormones are likely to improve symptoms of gender
dysphoria, and may also improve depression, anxiety, quality of life, suicidality, and
psychosocial functioning. The impact of treatment on body image is unclear. All results were
of very low certainty using modified GRADE.

[...]

"This review did not identify sub-groups of patients who may benefit more from gender-affirming hormones.
No cost-effectiveness evidence was found to determine whether gender-affirming hormones
are a cost-effective treatment for children and adolescents with gender dysphoria"

So, they're saying the evidence is crap ("All results were of very low certainty using modified GRADE."), but what evidence there is seems positive ("gender-affirming hormones are likely to improve symptoms of gender dysphoria, and may also improve depression, anxiety, quality of life, suicidality, and psychosocial functioning"). That is not a conclusion that says never use these drugs. That is a conclusion that says, we need more research on using these drugs and clinicians should proceed with caution. The Cass report indeed recommends further research, which seems very sensible.

Any legal cases against the clinic or individual doctors are going to hit the Bolam standard. There's enough in that NICE report to bolster a defence on those grounds.

AIRLIVE @airlivenet

BREAKING Russian airlines ordered to stop selling tickets to Russian men aged 18 to 65

https://www.airlive.net/breaking-russian-airlines-ordered-to-stop-selling-tickets-to-russian-men-aged-18-to-65/

CarlottaVance said:

Phil said:

Cyclefree said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

I'm not sure what you are saying about the Cass Report is quite accurate. The report seemed to cover both the treatments themselves and the whole approach by the Tavistock. Puberty blockers are, AIUI, drugs developed for other purposes being used for this. The evidence for their medical efficacy vs the side effects for children has not really been established or tested. One of the worrying things which has come out is the lack of records and follow up for patients put on such treatments. I thought NICE was meant authorise drugs for use. If it didn't how was such use authorised? The issue of informed consent is also an interesting one.

They’re exactly the same drugs as those used to treat precocious puberty. (In adults they’re used to treat endometriosis & a bunch of other things.) These are fairly well characterised drugs, as healthcare treatments go

NICE:

This evidence review found limited evidence for the effectiveness and safety of gender- affirming hormones in children and adolescents with gender dysphoria, with all studies being uncontrolled, observational studies, and all outcomes of very low certainty. Any potential benefits of treatment must be weighed against the largely unknown long-term safety profile of these treatments.

https://cass.independent-review.uk/wp-content/uploads/2022/09/20220726_Evidence-review_Gender-affirming-hormones_For-upload_Final.pdf

That’s par for the course for a lot of drugs frankly.

These drugs were being used for exactly the thing they were made to be prescribed for, there are far worse off-label uses: That use may or may not have been a bad idea, but it is exactly what the drugs were for.

CarlottaVance said:

Due to security reasons, Latvia will not issue humanitarian or other types of visas to those Russian citizens who avoid mobilization, nor will it change the border crossing restrictions for Russian citizens with Schengen visas introduced since September 19th,

says Latvian FM.

https://twitter.com/visegrad24/status/1572529226435424256

Is the road to Kaliningrad unclosable?

OnlyLivingBoy said:

Phil said:

Leon said:

Phil said:

Leon said:

The famous American transgender clinic exposed in that video has just taken down its entire website. The whole damn thing

https://www.vanderbilthealth.com/clinic/clinic-transgender-health

Vanished

Given that Tucker Carlson is calling on his viewers to commit acts of terrorism against gender identity clinics, can you blame them?

This is the same playbook used against abortion clinics: make outrageous claims & then leave the rest to stochastic terrorism.

What is this fashionable new word on the Victim Left. "Stochastic". You see it everywhere

Consider the murder of Jo Cox. This was an entirely forseeable consequence of the ramping up of accusation by certain pro-Leave groups accusing remainers of being traitors: It was inevitable that somewhere within the fascist elements active in Britain at the time there would be someone who heard the message loud and clear and acted upon it.

Did those pro-Leave groups intend for an MP to die? Probably not. Was it a forseeable outcome of their choice of words? Yes.

Or, alternatively, the way ISIS used their propaganda to stir up anti-Western sentiment amongst Muslims in the west - they had no control over who & where any attacks might happen, but they knew that with enough effective propaganda targetted at the right people, such attacks would become inevitable.

That’s stochastic terrorism. For political groups inside countries it allows deniability, whilst taking advantage of the mentally vulnerable to do ones dirty work. For those acting from the outside, it allows them to provoke attacks without the risk of compromising their own operatives.

The summary on Wikipedia is decent: https://en.wikipedia.org/wiki/Lone_wolf_attack#Stochastic_terrorism

Stochastic just means random. It isn't a new word.

Indeed, but “Stochastic Terrorism” is a relatively recent coinage, as Leon notes.

The premier current example of this kind of deniable incitement to violence is Trump of course, which is probably why you’re seeing it used a lot on the left right now. But in the past it’s been applied to ISIS & other ideological groups.

Leon said:

Richard_Nabavi said:

AIRLIVE @airlivenet

BREAKING Russian airlines ordered to stop selling tickets to Russian men aged 18 to 65

https://www.airlive.net/breaking-russian-airlines-ordered-to-stop-selling-tickets-to-russian-men-aged-18-to-65/

Ahahaha


So it is basically Full Mobilisation but they are pretending it isn't

No, no, no

These men are not mobilised.

They are un-mobilised.

Prevented from mobilising their asses out of Russia...

Phil said:

Leon said:

Phil said:

Leon said:

The famous American transgender clinic exposed in that video has just taken down its entire website. The whole damn thing

https://www.vanderbilthealth.com/clinic/clinic-transgender-health

Vanished

Given that Tucker Carlson is calling on his viewers to commit acts of terrorism against gender identity clinics, can you blame them?

This is the same playbook used against abortion clinics: make outrageous claims & then leave the rest to stochastic terrorism.

What is this fashionable new word on the Victim Left. "Stochastic". You see it everywhere

Consider the murder of Jo Cox. This was an entirely forseeable consequence of the ramping up of accusation by certain pro-Leave groups accusing remainers of being traitors: It was inevitable that somewhere within the fascist elements active in Britain at the time there would be someone who heard the message loud and clear and acted upon it.

Did those pro-Leave groups intend for an MP to die? Probably not. Was it a forseeable outcome of their choice of words? Yes.

Or, alternatively, the way ISIS used their propaganda to stir up anti-Western sentiment amongst Muslims in the west - they had no control over who & where any attacks might happen, but they knew that with enough effective propaganda targetted at the right people, such attacks would become inevitable.

That’s stochastic terrorism. For political groups inside countries it allows deniability, whilst taking advantage of the mentally vulnerable to do ones dirty work. For those acting from the outside, it allows them to provoke attacks without the risk of compromising their own operatives.

The summary on Wikipedia is decent: https://en.wikipedia.org/wiki/Lone_wolf_attack#Stochastic_terrorism

Stochastic being used out of context by social scientists is the same as their use of quantum, without understanding that either.

wooliedyed said:

For anyone who likes to totally scare themselves to death over Nuclear War I recommend War Plan UK by Duncan Campbell, it details the UK and others preparedness (or not!) for nuclear exchange in the Cold War.
Operation Square Leg simulated a 205 megaton, 130 warheads all out attack on the UK killing 29 million and injuring 7 million with 19 million short term survivors. The following is the diary entry for day 13 after the attack from the Warwickshire regional command response (Square Leg was the main driver of the scenario depicted in Threads)

Feeding to commence at 1800 hrs. Calorific content of meals will be six hundred + one pint of water (non- workers), 800 + two pints of water (workers). Meals provided for infant feeding totally inadequate, request additional supplies. Known casualty figures 37,000; seriously injured 67,000. Radiation sickness entering the third stage. Disease control absolute priority. All Essential Service Routes cleared. Identify and prepare additional burial resources. Advise public on location and times Feeding Centres will be open, safe routes to them (and) emphasize subsistence level of feeding in operation.

These were to be the first feedings of survivors, a full fortnight in.
800 calories for workers! A bowl of thin soup and a roll basically. Youd get maybe a week of work before malnutrition started to set in.

The 'good' news is we wont get hit by 130 warheads now if it goes hot.
Grim grim grim

My father was, in the mid 80s, Provost Marshal Navy (basically Chief Constable of the Royal Navy). Included in that post was the role of post-nuclear war military governor for south central England (not sure of the exact boundaries he'd have been in charge of). He went on a course about plans, and his role and responsibilities. He came back utterly depressed and somewhat terrified, and having been (understandably as a RN lifer) completely pro-nuclear weapons, did a 180 and was anti for the rest of his life. He did want the cash spent on other goodies for the RN however.

Leon said:

Richard_Nabavi said:

AIRLIVE @airlivenet

BREAKING Russian airlines ordered to stop selling tickets to Russian men aged 18 to 65

https://www.airlive.net/breaking-russian-airlines-ordered-to-stop-selling-tickets-to-russian-men-aged-18-to-65/

Ahahaha


So it is basically Full Mobilisation but they are pretending it isn't

That leaves roads, boats and rail

A ferry to Turkey?

Up to 65 is a bit desperate. I'm 57 and I guess I could fight if I had to but I'd be a bit shit at it.

paulyork64 said:

Leon said:

Richard_Nabavi said:

AIRLIVE @airlivenet

BREAKING Russian airlines ordered to stop selling tickets to Russian men aged 18 to 65

https://www.airlive.net/breaking-russian-airlines-ordered-to-stop-selling-tickets-to-russian-men-aged-18-to-65/

Ahahaha


So it is basically Full Mobilisation but they are pretending it isn't

That leaves roads, boats and rail

A ferry to Turkey?

Up to 65 is a bit desperate. I'm 57 and I guess I could fight if I had to but I'd be a bit shit at it.

Volkssturm.

jamesdoyle said:

wooliedyed said:

For anyone who likes to totally scare themselves to death over Nuclear War I recommend War Plan UK by Duncan Campbell, it details the UK and others preparedness (or not!) for nuclear exchange in the Cold War.
Operation Square Leg simulated a 205 megaton, 130 warheads all out attack on the UK killing 29 million and injuring 7 million with 19 million short term survivors. The following is the diary entry for day 13 after the attack from the Warwickshire regional command response (Square Leg was the main driver of the scenario depicted in Threads)

Feeding to commence at 1800 hrs. Calorific content of meals will be six hundred + one pint of water (non- workers), 800 + two pints of water (workers). Meals provided for infant feeding totally inadequate, request additional supplies. Known casualty figures 37,000; seriously injured 67,000. Radiation sickness entering the third stage. Disease control absolute priority. All Essential Service Routes cleared. Identify and prepare additional burial resources. Advise public on location and times Feeding Centres will be open, safe routes to them (and) emphasize subsistence level of feeding in operation.

These were to be the first feedings of survivors, a full fortnight in.
800 calories for workers! A bowl of thin soup and a roll basically. Youd get maybe a week of work before malnutrition started to set in.

The 'good' news is we wont get hit by 130 warheads now if it goes hot.
Grim grim grim

My father was, in the mid 80s, Provost Marshal Navy (basically Chief Constable of the Royal Navy). Included in that post was the role of post-nuclear war military governor for south central England (not sure of the exact boundaries he'd have been in charge of). He went on a course about plans, and his role and responsibilities. He came back utterly depressed and somewhat terrified, and having been (understandably as a RN lifer) completely pro-nuclear weapons, did a 180 and was anti for the rest of his life. He did want the cash spent on other goodies for the RN however.

The only slight problem with unilateral nuclear disarmament is whether a potential opponent thinks that nuking people without nukes is OK or not.

The USSR war plans included nuking Australia and New Zealand. And Ireland. Just in case. Because why not?

CarlottaVance said:

bondegezou said:

CarlottaVance said:

Phil said:

Cyclefree said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

I'm not sure what you are saying about the Cass Report is quite accurate. The report seemed to cover both the treatments themselves and the whole approach by the Tavistock. Puberty blockers are, AIUI, drugs developed for other purposes being used for this. The evidence for their medical efficacy vs the side effects for children has not really been established or tested. One of the worrying things which has come out is the lack of records and follow up for patients put on such treatments. I thought NICE was meant authorise drugs for use. If it didn't how was such use authorised? The issue of informed consent is also an interesting one.

They’re exactly the same drugs as those used to treat precocious puberty. (In adults they’re used to treat endometriosis & a bunch of other things.) These are fairly well characterised drugs, as healthcare treatments go

NICE:

This evidence review found limited evidence for the effectiveness and safety of gender- affirming hormones in children and adolescents with gender dysphoria, with all studies being uncontrolled, observational studies, and all outcomes of very low certainty. Any potential benefits of treatment must be weighed against the largely unknown long-term safety profile of these treatments.

https://cass.independent-review.uk/wp-content/uploads/2022/09/20220726_Evidence-review_Gender-affirming-hormones_For-upload_Final.pdf

Any legal cases against the clinic or individual doctors are going to hit the Bolam standard. There's enough in that NICE report to bolster a defence on those grounds.

Given the long term effects are “unknown” how is a patient able to give informed consent, even if they pass Gillick (which some may not)?

You say to the patient, simplifying somewhat, "We don't know what the long-term effects are. Are you OK with that?" Informed consent does not require that there are no unknowns, just that the patient is aware of the unknowns. Medicine would grind to a halt if you required there to be no unknowns.

rcs1000 said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

Which, by the way, is the good thing about the US.

If someone does something stupid - like this - then they get sued into oblivion. In 18 months, no hospital in the US which performs sex change operations on under 18s will be able to get insurance.

Which will probably be the single biggest factor reversing this trade. It all comes down to the money factor.

Putin has kicked off absolute chaos, and painfully destabilised his regime - even more

Any Russian man with any sense and any money will now try and escape Russia, this could be millions of people. Carnage at the borders. How do you stop it? Shoot them as they scale the wire? Your own people?

I think this calls for a rare all-caps

BRACE

Leon said:

Putin has kicked off absolute chaos, and painfully destabilised his regime - even more

Any Russian man with any sense and any money will now try and escape Russia, this could be millions of people. Carnage at the borders. How do you stop it? Shoot them as they scale the wire? Your own people?

I think this calls for a rare all-caps

BRACE

"Shoot them as they scale the wire? Your own people?"

Well, he does yearn for the Goode Olde Days of the Soviet Union.

https://www.youtube.com/watch?v=LxUdL0CGgOU

jamesdoyle said:

wooliedyed said:

For anyone who likes to totally scare themselves to death over Nuclear War I recommend War Plan UK by Duncan Campbell, it details the UK and others preparedness (or not!) for nuclear exchange in the Cold War.
Operation Square Leg simulated a 205 megaton, 130 warheads all out attack on the UK killing 29 million and injuring 7 million with 19 million short term survivors. The following is the diary entry for day 13 after the attack from the Warwickshire regional command response (Square Leg was the main driver of the scenario depicted in Threads)

Feeding to commence at 1800 hrs. Calorific content of meals will be six hundred + one pint of water (non- workers), 800 + two pints of water (workers). Meals provided for infant feeding totally inadequate, request additional supplies. Known casualty figures 37,000; seriously injured 67,000. Radiation sickness entering the third stage. Disease control absolute priority. All Essential Service Routes cleared. Identify and prepare additional burial resources. Advise public on location and times Feeding Centres will be open, safe routes to them (and) emphasize subsistence level of feeding in operation.

These were to be the first feedings of survivors, a full fortnight in.
800 calories for workers! A bowl of thin soup and a roll basically. Youd get maybe a week of work before malnutrition started to set in.

The 'good' news is we wont get hit by 130 warheads now if it goes hot.
Grim grim grim

My father was, in the mid 80s, Provost Marshal Navy (basically Chief Constable of the Royal Navy). Included in that post was the role of post-nuclear war military governor for south central England (not sure of the exact boundaries he'd have been in charge of). He went on a course about plans, and his role and responsibilities. He came back utterly depressed and somewhat terrified, and having been (understandably as a RN lifer) completely pro-nuclear weapons, did a 180 and was anti for the rest of his life. He did want the cash spent on other goodies for the RN however.

I think South Central btw was Hampshire, Surrey, West Sussex

Eabhal said:

So, with the new rates cap + the £400 relief, my energy bill will be cut by 65% from October 1st for 6 months (from what I'm currently on).

A huge saving for me, which I don't really need. Deeply unfair.

My bill from EDF arrived today. It says my monthly payment will go from £265 to £298. Which to be honest is way less than I was expecting.

You can still get a ferry from southern Russia, across the Black Sea to Turkey

http://anapaweb.ru/anapa/seaport/siflait.php

Unless the ships are full. I have a feeling they will certainly be "busy"

bondegezou said:

CarlottaVance said:

bondegezou said:

CarlottaVance said:

Phil said:

Cyclefree said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

I'm not sure what you are saying about the Cass Report is quite accurate. The report seemed to cover both the treatments themselves and the whole approach by the Tavistock. Puberty blockers are, AIUI, drugs developed for other purposes being used for this. The evidence for their medical efficacy vs the side effects for children has not really been established or tested. One of the worrying things which has come out is the lack of records and follow up for patients put on such treatments. I thought NICE was meant authorise drugs for use. If it didn't how was such use authorised? The issue of informed consent is also an interesting one.

They’re exactly the same drugs as those used to treat precocious puberty. (In adults they’re used to treat endometriosis & a bunch of other things.) These are fairly well characterised drugs, as healthcare treatments go

NICE:

This evidence review found limited evidence for the effectiveness and safety of gender- affirming hormones in children and adolescents with gender dysphoria, with all studies being uncontrolled, observational studies, and all outcomes of very low certainty. Any potential benefits of treatment must be weighed against the largely unknown long-term safety profile of these treatments.

https://cass.independent-review.uk/wp-content/uploads/2022/09/20220726_Evidence-review_Gender-affirming-hormones_For-upload_Final.pdf

Any legal cases against the clinic or individual doctors are going to hit the Bolam standard. There's enough in that NICE report to bolster a defence on those grounds.

Given the long term effects are “unknown” how is a patient able to give informed consent, even if they pass Gillick (which some may not)?

You say to the patient, simplifying somewhat, "We don't know what the long-term effects are. Are you OK with that?" Informed consent does not require that there are no unknowns, just that the patient is aware of the unknowns. Medicine would grind to a halt if you required there to be no unknowns.

You'd never run another clinical trial, for instance. And therefore never license another new medicine.
Which would be sub-optimal.

bondegezou said:

CarlottaVance said:

bondegezou said:

CarlottaVance said:

Phil said:

Cyclefree said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

I'm not sure what you are saying about the Cass Report is quite accurate. The report seemed to cover both the treatments themselves and the whole approach by the Tavistock. Puberty blockers are, AIUI, drugs developed for other purposes being used for this. The evidence for their medical efficacy vs the side effects for children has not really been established or tested. One of the worrying things which has come out is the lack of records and follow up for patients put on such treatments. I thought NICE was meant authorise drugs for use. If it didn't how was such use authorised? The issue of informed consent is also an interesting one.

They’re exactly the same drugs as those used to treat precocious puberty. (In adults they’re used to treat endometriosis & a bunch of other things.) These are fairly well characterised drugs, as healthcare treatments go

NICE:

This evidence review found limited evidence for the effectiveness and safety of gender- affirming hormones in children and adolescents with gender dysphoria, with all studies being uncontrolled, observational studies, and all outcomes of very low certainty. Any potential benefits of treatment must be weighed against the largely unknown long-term safety profile of these treatments.

https://cass.independent-review.uk/wp-content/uploads/2022/09/20220726_Evidence-review_Gender-affirming-hormones_For-upload_Final.pdf

Any legal cases against the clinic or individual doctors are going to hit the Bolam standard. There's enough in that NICE report to bolster a defence on those grounds.

Given the long term effects are “unknown” how is a patient able to give informed consent, even if they pass Gillick (which some may not)?

You say to the patient, simplifying somewhat, "We don't know what the long-term effects are. Are you OK with that?" Informed consent does not require that there are no unknowns, just that the patient is aware of the unknowns. Medicine would grind to a halt if you required there to be no unknowns.

The interim Cass report suggests that was not done at Tavistock and there was little evidence of the clinicians considering long term effects - such was the drive of “affirmative care”. I’m sure it will all come out in the wash. “Truth is the daughter of time”.

Do you have a view of the WPATH 8 guidelines?

Cyclefree said:

CarlottaVance said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

Whoever is responsible I hope they are scrutinising this very closely:

https://sex-matters.org/posts/updates/wpath/

The Standards of Care are not official standards, but are influential around the world. WPATH calls them “internationally accepted guidelines”. The NHS refers to the WPATH Standards of Care in a variety of medical documents (including the previous service specification for the Tavistock Gender and Identity Development Service clinic). The Scottish government also relies on them in its decision-making. The Standards of Care featured heavily in the significant case of Bell v Tavistock. These guidelines have been used by numerous private health clinics throughout the UK, to justify irreversible treatment on children and young people…..

…..The guidelines have removed any minimum age limit for a child to be given puberty blockers, cross-sex hormones or sex-reassignment surgery (so long as that child has reached ‘Tanner Stage 2’ of puberty, which can be as young as nine years old)….

…Abandonment of mental-health safeguarding – The guidelines explicitly state that therapy or counselling should “never be mandatory” before prescribing irreversible medication or surgery, including for children. Therapeutic professionals are told that they must not impose their own narratives or preconceptions, yet are also told that they must be “gender affirming”. These principles are fundamentally incompatible.

The more important point to note is that many of the people behind W-PATH are not doctors at all and some of those who are have very clear conflicts of interest. More worryingly it has worked closely with some very odd individuals, who really should be nowhere near medical care of any kind - see for instance the person who was apparently involved in writing the chapter on eunuchs.

The wider point is perhaps this: even the medical establishment is not immune from fads or for allowing ideologies to influence treatment. See the sterilisation of "simple-minded" women during the 20th century or the treatment of homosexuality, considered a mental disorder at one time. So it really matters to get care which is based on sound and properly tested evidence not as a result of wish fulfilment or ideology of self-interest. The evidence in the Keira Bell case is really interesting on this aspect, as is the Court's reaction, even if the decision - on the issue of Gillick competence - was the right one.

W-PATH is an international, interdisciplinary body. Most of them are doctors. This is the current executive committee: https://www.wpath.org/about/EC-BOD You will see nearly all of them are MDs or MBBSs (i.e., doctors). The four people there who aren't are a JD, a PsyD and a PhD, plus a medical student representative. These would appear to be relevant qualifications.

You're right about fads, of course. Doctors can be wrong about things. Doctors often are wrong about things.

bondegezou said:

CarlottaVance said:

bondegezou said:

CarlottaVance said:

Phil said:

Cyclefree said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

I'm not sure what you are saying about the Cass Report is quite accurate. The report seemed to cover both the treatments themselves and the whole approach by the Tavistock. Puberty blockers are, AIUI, drugs developed for other purposes being used for this. The evidence for their medical efficacy vs the side effects for children has not really been established or tested. One of the worrying things which has come out is the lack of records and follow up for patients put on such treatments. I thought NICE was meant authorise drugs for use. If it didn't how was such use authorised? The issue of informed consent is also an interesting one.

They’re exactly the same drugs as those used to treat precocious puberty. (In adults they’re used to treat endometriosis & a bunch of other things.) These are fairly well characterised drugs, as healthcare treatments go

NICE:

This evidence review found limited evidence for the effectiveness and safety of gender- affirming hormones in children and adolescents with gender dysphoria, with all studies being uncontrolled, observational studies, and all outcomes of very low certainty. Any potential benefits of treatment must be weighed against the largely unknown long-term safety profile of these treatments.

https://cass.independent-review.uk/wp-content/uploads/2022/09/20220726_Evidence-review_Gender-affirming-hormones_For-upload_Final.pdf

Any legal cases against the clinic or individual doctors are going to hit the Bolam standard. There's enough in that NICE report to bolster a defence on those grounds.

Given the long term effects are “unknown” how is a patient able to give informed consent, even if they pass Gillick (which some may not)?

You say to the patient, simplifying somewhat, "We don't know what the long-term effects are. Are you OK with that?" Informed consent does not require that there are no unknowns, just that the patient is aware of the unknowns. Medicine would grind to a halt if you required there to be no unknowns.

It's not quite as simple as that when you are dealing with children though. One of the possible side effects of all these drugs and surgery is that it may not be possible to have orgasms or satisfactory sexual function later. How can a prepubertal child consent to a treatment which may impair their sexual function as an adult when they have had no experience of sexual function at all?

It is a very delicate, sensitive and complicated area of medicine - which is one reason why it is so important not to have those who are pushing for or against it for ideological or other non-medical reasons anywhere near the decisions.

And that those medical reasons are subject to the most rigorous scrutiny and testing and oversight.

Twitter claims Russian railways have been given the same instructions as the airlines. Do not sell international tickets to men between 18-65

Tho I am not sure how many Russian railways cross still-open borders anyway. The Trans-Siberian which dips down into Mongolia and China? Is that border even open?

Dura_Ace said:

AlistairM said:

Sandpit said:

AlistairM said:

Two B-52s having left from RAF Fairford this morning are currently flying up through the length of Norway. I'm sure intended to give Moscow pause for thought.

https://www.flightradar24.com/RUMOR12/2d8bfd83

There’s been a few of those around Eastern Europe recently, last couple of weeks.

A step up from the usual NATO surveillance planes and drones hanging around the Ukraine borders, that have been a feature of this conflict, just to remind Putin who he’s up against.

The occasional airbourne USAF F-35 too, just in case something needs shooting down in a hurry. Can’t see that one up today though - but that doesn’t mean it’s not there!

The B-52s are flying circuits over northern Sweden now.

Quadruple dose of Imodium all round! If you have to crap on a Buff, you have to bag it and take it with you like a dog.

You know some clever dogs

MISTY said:

Leon said:

You can still get a ferry from southern Russia, across the Black Sea to Turkey

http://anapaweb.ru/anapa/seaport/siflait.php

Unless the ships are full. I have a feeling they will certainly be "busy"

Could Britain not cherry pick people with skills, training and talent and give them work visas? doctors, nurses, scientists, engineers etc. They have many talented people. Better than robbing them off poor countries to fill our skill shortages.

Or we could go the Ali G route and let in da fit ones.

Despite the fact that we are apparently locked in a total war of extinction with Russia (in the minds of tories) the UK is still issuing tourist visas to Russian citizens. So they could come here and claim asylum if they wanted.

CarlottaVance said:

"How to break an arm" is trending on Russian Google.

https://twitter.com/visegrad24/status/1572593191899041792

Direct them to the WW2 classic 'Escape to Victory'

CarlottaVance said:

bondegezou said:

CarlottaVance said:

bondegezou said:

CarlottaVance said:

Phil said:

Cyclefree said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

I'm not sure what you are saying about the Cass Report is quite accurate. The report seemed to cover both the treatments themselves and the whole approach by the Tavistock. Puberty blockers are, AIUI, drugs developed for other purposes being used for this. The evidence for their medical efficacy vs the side effects for children has not really been established or tested. One of the worrying things which has come out is the lack of records and follow up for patients put on such treatments. I thought NICE was meant authorise drugs for use. If it didn't how was such use authorised? The issue of informed consent is also an interesting one.

They’re exactly the same drugs as those used to treat precocious puberty. (In adults they’re used to treat endometriosis & a bunch of other things.) These are fairly well characterised drugs, as healthcare treatments go

NICE:

This evidence review found limited evidence for the effectiveness and safety of gender- affirming hormones in children and adolescents with gender dysphoria, with all studies being uncontrolled, observational studies, and all outcomes of very low certainty. Any potential benefits of treatment must be weighed against the largely unknown long-term safety profile of these treatments.

https://cass.independent-review.uk/wp-content/uploads/2022/09/20220726_Evidence-review_Gender-affirming-hormones_For-upload_Final.pdf

Any legal cases against the clinic or individual doctors are going to hit the Bolam standard. There's enough in that NICE report to bolster a defence on those grounds.

Given the long term effects are “unknown” how is a patient able to give informed consent, even if they pass Gillick (which some may not)?

You say to the patient, simplifying somewhat, "We don't know what the long-term effects are. Are you OK with that?" Informed consent does not require that there are no unknowns, just that the patient is aware of the unknowns. Medicine would grind to a halt if you required there to be no unknowns.

The interim Cass report suggests that was not done at Tavistock and there was little evidence of the clinicians considering long term effects - such was the drive of “affirmative care”. I’m sure it will all come out in the wash. “Truth is the daughter of time”.

Do you have a view of the WPATH 8 guidelines?

If informed consent was not obtained, then they can be sued for that. IANAL, but I understand it can be a difficult thing to prove. Informed consent doesn't mean that you explain absolutely everything in detail. You have to prove that something should've been raised and then that it wasn't, which is 2 steps. As you say, it will come out in the wash.

I do not have a view of WPATH 8 guidelines. I do not know whether the Tavistock did the right things or not. I am not a clinician and would probably be a terrible one. I merely offer some comment as someone who works in health research. The Cass report seems to me to be valuable.

https://twitter.com/EdConwaySky/status/1572588027406614528
Ed Conway
@EdConwaySky
👀
If gas prices stay high (possible) and govt has to extend its business support scheme for a full two years - as per the household energy guarantee (possible) then my back-of-envelope sums suggest the combined cost of these schemes could come to a quarter of a trillion pounds.

Cyclefree said:

Richard_Nabavi said:

AIRLIVE @airlivenet

BREAKING Russian airlines ordered to stop selling tickets to Russian men aged 18 to 65

https://www.airlive.net/breaking-russian-airlines-ordered-to-stop-selling-tickets-to-russian-men-aged-18-to-65/

Presumably they'll be building a wall next to stop people getting out .......

They must have some old plans they could dust down and use.

Seems to me it’s all about messaging to Ukraine and it’s supporters though - the one thing we are not supplying Ukraine enough of Russia signalling it can take this deep with 🥺

My understanding of end of First World War was the amount of running out of fighters wore heavily on governments of the protagonists - it wasn’t a clear military win but stalemate and amount of your own casualties draining the pool to call on leading to truce and talks.

particularly if Kremlin now choose more limited seize and hold options, with a much smaller front to defend, switching from attack to defend, then today for me is all about Russia signalling it’s up for a very long one ☹️

Razedabode said:

Leon said:

Twitter claims Russian railways have been given the same instructions as the airlines. Do not sell international tickets to men between 18-65

Tho I am not sure how many Russian railways cross still-open borders anyway. The Trans-Siberian which dips down into Mongolia and China? Is that border even open?

What a horrifying situation. The public may be pro Putin at the moment, but you do have to wonder if reality is about to hit.

I just feel sorry for the numbers who will be sent to their deaths. And for what?

The mad thing is just how out of touch Putin is about all this, he clearly is lashing out like a misbehaving toddler having a tantrum. He is acting like he expects the world to be intimidated by him, and six months ago many people were and were talking about the need to be "realistic" about Russia and giving them an "off ramp".

But the curtain has been pulled back and the whole world is basically rolling their eyes at Putin's tantrum today. No nation, not even Germany, really seems threatened anymore. From Wallace to von der Leyen and more people are responding patiently that this is a sign of Putin's desperation, rather than being afraid.

Putin has long acted like a bully, but the worst thing for a bully is when people stop being afraid of them. Once that aura of invincibility is gone, its almost impossible to get it back.

eek said:

https://twitter.com/EdConwaySky/status/1572588027406614528
Ed Conway
@EdConwaySky
👀
If gas prices stay high (possible) and govt has to extend its business support scheme for a full two years - as per the household energy guarantee (possible) then my back-of-envelope sums suggest the combined cost of these schemes could come to a quarter of a trillion pounds.

Is that why you are called eek, to bring us messages like that 😟

Cyclefree said:

Phil said:

Leon said:

Phil said:

Leon said:

The famous American transgender clinic exposed in that video has just taken down its entire website. The whole damn thing

https://www.vanderbilthealth.com/clinic/clinic-transgender-health

Vanished

Given that Tucker Carlson is calling on his viewers to commit acts of terrorism against gender identity clinics, can you blame them?

This is the same playbook used against abortion clinics: make outrageous claims & then leave the rest to stochastic terrorism.

What is this fashionable new word on the Victim Left. "Stochastic". You see it everywhere

Consider the murder of Jo Cox. This was an entirely forseeable consequence of the ramping up of accusation by certain pro-Leave groups accusing remainers of being traitors: It was inevitable that somewhere within the fascist elements active in Britain at the time there would be someone who heard the message loud and clear and acted upon it.

Did those pro-Leave groups intend for an MP to die? Probably not. Was it a forseeable outcome of their choice of words? Yes.

Or, alternatively, the way ISIS used their propaganda to stir up anti-Western sentiment amongst Muslims in the west - they had no control over who & where any attacks might happen, but they knew that with enough effective propaganda targetted at the right people, such attacks would become inevitable.

That’s stochastic terrorism. For political groups inside countries it allows deniability, whilst taking advantage of the mentally vulnerable to do ones dirty work. For those acting from the outside, it allows them to provoke attacks without the risk of compromising their own operatives.

The summary on Wikipedia is decent: https://en.wikipedia.org/wiki/Lone_wolf_attack#Stochastic_terrorism

Presumably "stochastic" could also be used for those using violent words against women for standing up for their rights while then distancing themselves from a lunatic arrested and charged with assault and possession of a knife at a women's right meeting. As has happened in the last few days.

If we’re talking about Brighton here, then this GC women thinks he had nothing to do with either side: https://twitter.com/JocastaMoney/status/1572515479734091776

(I think I have her allegiance correct, but could be wrong...)

So he was just a drunk from the pub, not someone who deliberately brought a knife to a demo (on either side). Bringing a knife to a demo is a stupid idea: there are bound to be police everywhere & there’s a high risk of you being caught.

bondegezou said:

Cyclefree said:

CarlottaVance said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

Whoever is responsible I hope they are scrutinising this very closely:

https://sex-matters.org/posts/updates/wpath/

The Standards of Care are not official standards, but are influential around the world. WPATH calls them “internationally accepted guidelines”. The NHS refers to the WPATH Standards of Care in a variety of medical documents (including the previous service specification for the Tavistock Gender and Identity Development Service clinic). The Scottish government also relies on them in its decision-making. The Standards of Care featured heavily in the significant case of Bell v Tavistock. These guidelines have been used by numerous private health clinics throughout the UK, to justify irreversible treatment on children and young people…..

…..The guidelines have removed any minimum age limit for a child to be given puberty blockers, cross-sex hormones or sex-reassignment surgery (so long as that child has reached ‘Tanner Stage 2’ of puberty, which can be as young as nine years old)….

…Abandonment of mental-health safeguarding – The guidelines explicitly state that therapy or counselling should “never be mandatory” before prescribing irreversible medication or surgery, including for children. Therapeutic professionals are told that they must not impose their own narratives or preconceptions, yet are also told that they must be “gender affirming”. These principles are fundamentally incompatible.

The more important point to note is that many of the people behind W-PATH are not doctors at all and some of those who are have very clear conflicts of interest. More worryingly it has worked closely with some very odd individuals, who really should be nowhere near medical care of any kind - see for instance the person who was apparently involved in writing the chapter on eunuchs.

The wider point is perhaps this: even the medical establishment is not immune from fads or for allowing ideologies to influence treatment. See the sterilisation of "simple-minded" women during the 20th century or the treatment of homosexuality, considered a mental disorder at one time. So it really matters to get care which is based on sound and properly tested evidence not as a result of wish fulfilment or ideology of self-interest. The evidence in the Keira Bell case is really interesting on this aspect, as is the Court's reaction, even if the decision - on the issue of Gillick competence - was the right one.

W-PATH is an international, interdisciplinary body. Most of them are doctors. This is the current executive committee: https://www.wpath.org/about/EC-BOD You will see nearly all of them are MDs or MBBSs (i.e., doctors). The four people there who aren't are a JD, a PsyD and a PhD, plus a medical student representative. These would appear to be relevant qualifications.

You're right about fads, of course. Doctors can be wrong about things. Doctors often are wrong about things.

It rather depends on what their speciality is and whether they have a financial or other interest in the recommendations they are making. Conflicts of interest make for bad decisions, whether by doctors or anyone else.

eek said:

https://twitter.com/EdConwaySky/status/1572588027406614528
Ed Conway
@EdConwaySky
👀
If gas prices stay high (possible) and govt has to extend its business support scheme for a full two years - as per the household energy guarantee (possible) then my back-of-envelope sums suggest the combined cost of these schemes could come to a quarter of a trillion pounds.

We could pay that off with a one month tax on journos using that fucking 'eyes on' emoji

One particularly nasty aspect of Russia's current annexation plans is that it can, after those "referendums", start to conscript Ukrainians in the occupied territories to go into the fight with their countrymen. It's been the Russian model throughout the history of its empire: invade and annex an area, then conscript its young men to invade and annex the next one.

I would hope that if they attempted something similar in the newly occupied territories they'd start to see a fair few friendly fire incidents.

wooliedyed said:

eek said:

https://twitter.com/EdConwaySky/status/1572588027406614528
Ed Conway
@EdConwaySky
👀
If gas prices stay high (possible) and govt has to extend its business support scheme for a full two years - as per the household energy guarantee (possible) then my back-of-envelope sums suggest the combined cost of these schemes could come to a quarter of a trillion pounds.

We could pay that off with a one month tax on journos using that fucking 'eyes on' emoji

Don't forget 🚨🚨🚨

Credit default swaps are a form of insurance against default - so they give a sense of how concerned investors are about an issuer's ability to service its debts.
Earlier this year the UK’s sovereign CDS spread was among lowest in developed world.
That all changed in Aug
Red line https://twitter.com/EdConwaySky/status/1572605889974083584/photo/1

BartholomewRoberts said:

wooliedyed said:

eek said:

https://twitter.com/EdConwaySky/status/1572588027406614528
Ed Conway
@EdConwaySky
👀
If gas prices stay high (possible) and govt has to extend its business support scheme for a full two years - as per the household energy guarantee (possible) then my back-of-envelope sums suggest the combined cost of these schemes could come to a quarter of a trillion pounds.

We could pay that off with a one month tax on journos using that fucking 'eyes on' emoji

Don't forget 🚨🚨🚨

Thats for the tax cuts!

Cyclefree said:

bondegezou said:

CarlottaVance said:

bondegezou said:

CarlottaVance said:

Phil said:

Cyclefree said:

bondegezou said:

Cyclefree said:

Phil said:

Cyclefree said:

Leon said:

This whole thread is desolating: when American capitalist medicine meets a crazy new ideology


American clinics are pushing radical trans surgery and puberty blockers on kids "because they make so much m money for us". Here they are ADMITTING it

"Vanderbilt opened its trans clinic in 2018. During a lecture the same year, Dr. Shayne Taylor explained how she convinced Nashville to get into the gender transition game. She emphasized that it's a "big money maker," especially because the surgeries require a lot of "follow ups""


"Just a few vaginoplasties can finance the whole clinic"

https://twitter.com/MattWalshBlog/status/1572313523232931840?s=20&t=KWigxdGdSfnRBOqe_Fu_Zg


How have we allowed this madness to prosper?

They had better have some bloody good insurance in place for the inevitable lawsuits, which have already started.

There’s an ambulance chasing law firm running around the UK trying to drum up business. Have they actually managed to find more than a single digit numbers of clients?

I was referring to law suits in the US.

As far as the U.K. is concerned, I don't know the answer to your question. The name of the law firm was unknown to me and is not one I've heard of in relation to medical negligence claims.

Rather than suing after the event (when damage, possibly or reversible damage, is done), it would be more sensible to get a properly evidenced basis for the right sort of treatment for those with properly diagnosed gender dysphoria, especially in the case of children. Hopefully, the final Cass Report will help with that and those with a financial or other interest in pushing drugs or surgery will not be involved in making recommendations. Medical treatment should only be given for sound medical reasons and only if it is in the best medical interests of the patient.

I am curious as to why NICE has not been involved in relation to the Tavistock issue. Perhaps it was.

Isn't it more a CQC matter than a NICE matter? NICE advise on specific treatments, generally new ones, with a focus on more common conditions. CQC oversees care more generally. The Cass Report suggests the problems at the Tavistock are more general rather than in terms of the efficacy of specific treatments. Also, CQC regulates while NICE advises.

I'm not sure what you are saying about the Cass Report is quite accurate. The report seemed to cover both the treatments themselves and the whole approach by the Tavistock. Puberty blockers are, AIUI, drugs developed for other purposes being used for this. The evidence for their medical efficacy vs the side effects for children has not really been established or tested. One of the worrying things which has come out is the lack of records and follow up for patients put on such treatments. I thought NICE was meant authorise drugs for use. If it didn't how was such use authorised? The issue of informed consent is also an interesting one.

They’re exactly the same drugs as those used to treat precocious puberty. (In adults they’re used to treat endometriosis & a bunch of other things.) These are fairly well characterised drugs, as healthcare treatments go

NICE:

This evidence review found limited evidence for the effectiveness and safety of gender- affirming hormones in children and adolescents with gender dysphoria, with all studies being uncontrolled, observational studies, and all outcomes of very low certainty. Any potential benefits of treatment must be weighed against the largely unknown long-term safety profile of these treatments.

https://cass.independent-review.uk/wp-content/uploads/2022/09/20220726_Evidence-review_Gender-affirming-hormones_For-upload_Final.pdf

Any legal cases against the clinic or individual doctors are going to hit the Bolam standard. There's enough in that NICE report to bolster a defence on those grounds.

Given the long term effects are “unknown” how is a patient able to give informed consent, even if they pass Gillick (which some may not)?

You say to the patient, simplifying somewhat, "We don't know what the long-term effects are. Are you OK with that?" Informed consent does not require that there are no unknowns, just that the patient is aware of the unknowns. Medicine would grind to a halt if you required there to be no unknowns.

It's not quite as simple as that when you are dealing with children though. One of the possible side effects of all these drugs and surgery is that it may not be possible to have orgasms or satisfactory sexual function later. How can a prepubertal child consent to a treatment which may impair their sexual function as an adult when they have had no experience of sexual function at all?

It is a very delicate, sensitive and complicated area of medicine - which is one reason why it is so important not to have those who are pushing for or against it for ideological or other non-medical reasons anywhere near the decisions.

And that those medical reasons are subject to the most rigorous scrutiny and testing and oversight.

Sure, it's a very difficult and sensitive area. I am glad I'm not in those clinicians' shoes.

I was writing specifically about the puberty blockers. There would, I presume, be separate consent procedures for taking the puberty blockers and for any other drugs or surgery. I believe it is surgery that is most likely to have an impact on sexual function, but surgery is not done on children (in the UK). I'm not aware of the puberty blockers being thought to have long-term impacts on sexual function. Worry there appears to be focused on bone density, blood pressure, weight and lipid profile.

All healthcare needs to be subject to rigorous scrutiny, testing and oversight - absolutely agreed. This is one very difficult context, but I suggest it is not unprecedented in its complexity. Consent is a difficult concept when you get into it. Let's say it is recommended that you should have a leg amputated. (Hopefully this is an entirely hypothetical example, but it's something that can happen.) Can someone who hasn't had a leg amputated ever fully understand what it is like to have had a leg amputated? Such decisions are inherently difficult. Some of us may one day face a medical decision where one of the options is death (a lot sooner if Bart becomes PM) and none of us can ever know what that is like! And yet the thing about medicine is that you sometimes can't put off these decisions.

turbotubbs said:

MoonRabbit said:

Cyclefree said:

Richard_Nabavi said:

AIRLIVE @airlivenet

BREAKING Russian airlines ordered to stop selling tickets to Russian men aged 18 to 65

https://www.airlive.net/breaking-russian-airlines-ordered-to-stop-selling-tickets-to-russian-men-aged-18-to-65/

Presumably they'll be building a wall next to stop people getting out .......

They must have some old plans they could dust down and use.

Seems to me it’s all about messaging to Ukraine and it’s supporters though - the one thing we are not supplying Ukraine enough of Russia signalling it can take this deep with 🥺

My understanding of end of First World War was the amount of running out of fighters wore heavily on governments of the protagonists - it wasn’t a clear military win but stalemate and amount of your own casualties draining the pool to call on leading to truce and talks.

particularly if Kremlin now choose more limited seize and hold options, with a much smaller front to defend, switching from attack to defend, then today for me is all about Russia signalling it’s up for a very long one ☹️

Nope - go and read some history. Germany capitulated when the army was just about still intact. Another few months and the allies would have been in Berlin, just as in 1945 (except all coming from the west). For sure the French and British (Empire) had lost a lot of men, and strategy and tactics had evolved to use arms not men, but with the US entry into the war there was not going to be a shortage of manpower.
In hindsight it was Germany agreeing to the Armistice that ultimately allowed the myth of the Stab in the Back to take hold - in 1918 German troops still fought outside the Reich, not so much in May 1945.

As Syrians rocked up on the beaches of Greece, the locals shouted get back and fight for your country you cowardly twits. How are the Ukrainians making new lives in places like UK thought of by those still fighting back home? What seems to me is not everyone is made the same, not everyone is made for the fight are they?

I’m up for a fight for England if invaded, not run away, though I am not at all sure how I would do my hair for fighting, it would be mostly in a hat would it? But what would we think of those who fled England for new lives in Canada and Australia the more it went on?

Scott_xP said:

#Breaking: just in - The traffic jam at the border with #Russia/#Finland has pilled up to 35KM and is rising by the hour, it is the only border who is still open for Russian civilians with shengen visas, after #Putin announced he will send 300.000 new troops to #Ukraine. https://twitter.com/sotiridi/status/1572568782748680194/video/1

Philski Schofieldski is the first name through

ydoethur said:

Malmesbury said:

Leon said:

Putin has kicked off absolute chaos, and painfully destabilised his regime - even more

Any Russian man with any sense and any money will now try and escape Russia, this could be millions of people. Carnage at the borders. How do you stop it? Shoot them as they scale the wire? Your own people?

I think this calls for a rare all-caps

BRACE

"Shoot them as they scale the wire? Your own people?"

Well, he does yearn for the Goode Olde Days of the Soviet Union.

https://www.youtube.com/watch?v=LxUdL0CGgOU

Saves the Ukrainians a job, and reduces still further the amount of ammunition that could be sent to the front line.

I'm sure they will be grateful.

Young Russian men? And their parents, spouses and children? Rather less so.

A close Russian relative still cries when she talks about the crippled young men begging, after Afghanistan.

turbotubbs said:

MoonRabbit said:

Cyclefree said:

Richard_Nabavi said:

AIRLIVE @airlivenet

BREAKING Russian airlines ordered to stop selling tickets to Russian men aged 18 to 65

https://www.airlive.net/breaking-russian-airlines-ordered-to-stop-selling-tickets-to-russian-men-aged-18-to-65/

Presumably they'll be building a wall next to stop people getting out .......

They must have some old plans they could dust down and use.

Seems to me it’s all about messaging to Ukraine and it’s supporters though - the one thing we are not supplying Ukraine enough of Russia signalling it can take this deep with 🥺

My understanding of end of First World War was the amount of running out of fighters wore heavily on governments of the protagonists - it wasn’t a clear military win but stalemate and amount of your own casualties draining the pool to call on leading to truce and talks.

particularly if Kremlin now choose more limited seize and hold options, with a much smaller front to defend, switching from attack to defend, then today for me is all about Russia signalling it’s up for a very long one ☹️

Nope - go and read some history. Germany capitulated when the army was just about still intact. Another few months and the allies would have been in Berlin, just as in 1945 (except all coming from the west). For sure the French and British (Empire) had lost a lot of men, and strategy and tactics had evolved to use arms not men, but with the US entry into the war there was not going to be a shortage of manpower.
In hindsight it was Germany agreeing to the Armistice that ultimately allowed the myth of the Stab in the Back to take hold - in 1918 German troops still fought outside the Reich, not so much in May 1945.

Shortage of Ukrainian manpower in a long conflict is at the heart of what Russia is signalling today isn’t it?

Malmesbury said:

turbotubbs said:

MoonRabbit said:

Cyclefree said:

Richard_Nabavi said:

AIRLIVE @airlivenet

BREAKING Russian airlines ordered to stop selling tickets to Russian men aged 18 to 65

https://www.airlive.net/breaking-russian-airlines-ordered-to-stop-selling-tickets-to-russian-men-aged-18-to-65/

Presumably they'll be building a wall next to stop people getting out .......

They must have some old plans they could dust down and use.

Seems to me it’s all about messaging to Ukraine and it’s supporters though - the one thing we are not supplying Ukraine enough of Russia signalling it can take this deep with 🥺

My understanding of end of First World War was the amount of running out of fighters wore heavily on governments of the protagonists - it wasn’t a clear military win but stalemate and amount of your own casualties draining the pool to call on leading to truce and talks.

particularly if Kremlin now choose more limited seize and hold options, with a much smaller front to defend, switching from attack to defend, then today for me is all about Russia signalling it’s up for a very long one ☹️

Nope - go and read some history. Germany capitulated when the army was just about still intact. Another few months and the allies would have been in Berlin, just as in 1945 (except all coming from the west). For sure the French and British (Empire) had lost a lot of men, and strategy and tactics had evolved to use arms not men, but with the US entry into the war there was not going to be a shortage of manpower.
In hindsight it was Germany agreeing to the Armistice that ultimately allowed the myth of the Stab in the Back to take hold - in 1918 German troops still fought outside the Reich, not so much in May 1945.

Ironically the Germans quit at a fairly sensible point - they had definitely lost the war, but the war was still outside Germany.

The pictures of the Destroyed Zone are something else. Even into the mid 1920s...

Also the longer they fought, the more of their people literally starved to death.

MoonRabbit said:

eek said:

https://twitter.com/EdConwaySky/status/1572588027406614528
Ed Conway
@EdConwaySky
👀
If gas prices stay high (possible) and govt has to extend its business support scheme for a full two years - as per the household energy guarantee (possible) then my back-of-envelope sums suggest the combined cost of these schemes could come to a quarter of a trillion pounds.

Is that why you are called eek, to bring us messages like that 😟

No but it's was my reaction to that tweet as well....