As a PhD researcher, as someone who actually cares a lot about my research and academic freedom, I find this all so deeply, deeply tedious.
The actual threats to academic freedom are coming from defunding our universities – as anyone actually in the sector can tell you.
Like this is a really annoying thing on a personal level but it also makes accessing care harder - our systems simply aren't set up for people to start out at 'a bit different to usual'
Nothing like (probably) developing another chronic illness when you are already on the first line treatment for it!!
Once again I’d really like it if VCs remembered that’s its academic and professional services staff that make universities and not shiny new buildings.
I am drowning in systematic reviews.
Everyone should stop what you are doing and read about @notrightruth.bsky.social receiving an important award for her excellence in trans and feminist scholarship and action. Ruth has been setting the bar for years & its great to see that recognised:
www.scenemag.co.uk/trans-femini...
They definitely do!!! Evidently they don't segment their email list well enough!
My travel insurance provider, which specialises in cover for people with medical conditions, just sent me an email asking if I'm spending Easter with the grandkids.
Maybe my diagnosis list is more typical of being twice my age, but I promise I'm only 27! 😂
Highlighted text: CSSs are not permitted to use lifts while lone working due to the risk of becoming trapped Full text: The night shift CSS was not booked on for duty at the time they undertook this check. This was because it was the night shift CSS’s normal practice to arrive on a westbound train into platform 1 and to complete the check of that platform before going to the station office to book on for duty. CSSs are not permitted to use lifts while lone working due to the risk of becoming trapped, so undertaking
When the lifts on tfl are so reliable they don't allow their staff to use them...
(Fascinating that TfL understand being trapped in a lift as a greater risk than falling down the stairs - would be really interested to see the frequency of each - I'm sure the policy exists for a reason)
Trans healthcare needs to be led by trans people, to be accountable to trans communities and trans youth.
Folks who don't believe in the existence of a trans child cannot continue to hold the reins of healthcare policy and governance.
This is where we start.
There are very real limitations in the evidence around trans healthcare, like many areas of healthcare.
I desperately want better research and evaluation into trans health and for everyone to be able to work together towards that goal with respect for trans people and our autonomy at the centre.
There is also clearly thoroughness, rigor and transparency in some ways within these most recent reviews. I don't doubt that some of the challenges arise from what was asked for and that many people involved were dealing with multiple competing concerns.
We should also be critical of reviews where these concerns are ignored or dismissed.
The questions that underly some of the decisions in this most recent set of reviews on hormones (how can we tell the difference between the effect of puberty blockers and hormones when they are often used together? Are there difference in how hormones work for nonbinary people?) are legitimate.
I also want to acknowledge that my criticisms of how we review evidence relating to trans health are criticisms of systems rather than of individuals. And that all research and evidence review has limitations and flaws (mine certainly does).
I think it's important that we have discussions about what makes good evidence quickly and in places where the communities affected by evidence review can understand how decisions are made about us.
I do get nervous criticising approaches to evidence review on short-form platforms that aren't made for nuance like Bluesky - in part because the narratives lose some of the nuances, and in part because it can definitely be frowned on to criticise others work outside of peer reviewed environments.
And as @fiercemum.bsky.social points out later in their thread, these decisions are about power more than evidence methods - the decision makers know the limitations of the evidence they are relying on.
We need to evaluate in a way that accounts for all these other factors (e.g. considering mechanistic evidence) rather than just dismissing all existing evidence.
*Note: I'm using complex intervention here in a very specific way in evaluation to mean 'a treatment or action we are doing and want to evaluate that interacts with and is affected by lots of other things', not to imply that HRT is complicated or that trans people need to be fixed or intervened on
Gender affirming care is made up of 'complex interventions'* because a lot of things outside of the treatment or drug itself are likely to impact on a trans person's outcomes (things like wider transphobia, social support, experiences of 'passing' or 'not passing', experiences of discrimination)
If you chop your population into tiny pieces you'll quickly find there's no evidence for each population slice.
Yes, previous blocker use and whether someone is nonbinary might have some level of impact on outcome of hormone use. So might 1000 other things we can't control for.
Or if we decided that we didn't know whether a treatment would work for a non-dominant wrist injury because most of the research doesn't distinguish between between injuries on dominant and non-dominant hands?
Can you imagine if we tried to evaluate the effectiveness of a drug for an autoimmune condition by excluding all studies to where participants had previously taken NSAIDs (painkillers)?
I'm heading to bed, solidarity to everyone still digging through the reviews. Structured thoughts will hopefully come tomorrow
This is because they've excluded all studies where participants have had GnRHA to block puberty (as opposed to post-puberty/concurrent with HRT), which given that's the main way these treatments have been used in under 18s, wipes out most of the evidence base
Cool poster for life drawing session, with text "FLINTA home session, eve sketch, Tuesday 17th March 7pm, £5 DM to confirm your spot, Flinta/queer only session"
The evening sketch FLINTA session coming up next Tuesday 17th ✨️
This session is open to FLINTA only - Female, Lesbian, Intersex, Non-binary, Trans, and Agender individuals
Modelled by the lovely Diana Taylor (she/her) (me!) ♡ @nocomment.bsky.social
Hosted by Cora @merrylemontree on insta 🌟
Good shout, from first glance they haven't gone specifically for 16-18 but have sliced and diced the reviews to pieces to discount a lot of evidence
Reminder that when they tell you they can't give trans young people a treatment because there's not enough evidence that their alternatives always have even less evidence
I agree this is probably mostly a stepping stone to a legal ban similar to puberty blockers though.