A world-renowned expert who discovered that puberty blockers can harm children’s IQ says academics initially dismissed her research as “biased.”
Professor Sallie Baxendale, a neuropsychologist at University College London, published a review of the potential impact of these powerful medications on adolescents who take them.
Their alarming study highlighted cases in which girls apparently lost between 7 and 15 IQ points while taking the drugs, which halt bodily changes in puberty.
But despite the worrying findings, Professor Baxendale initially struggled to find a publisher for her review.
Three different journals rejected his article calling for “urgent” research into the impact of medications on children’s brain functions.
Sallie Baxendale, professor of clinical neuropsychology at University College London, called for “urgent” research into the impact of drugs on children’s brain functions.
Puberty blockers, known medically as gonadotropin-releasing hormone analogs, stop the physical changes of puberty in adolescents who question their gender. An example of these medications, called Triptorelin, is shown in the photo.
This graph from Professor Baxendale’s article shows the results of one of the studies on puberty blockers and neurodevelopment that she analyzed. It shows IQ scores on a number of parameters such as memory and verbal comprehension in a single case study, a girl who started taking puberty blockers at the age of 11. She lost 15 points in one category over three years.
Detailing his experiences in UnherdProfessor Baxendale revealed that anonymous reviewers cast suspicion on her motives and reasons for exploring the topic in the first place.
Some criticized the fact that it only found negative studies, despite being unable to point the expert to any positive ones, while others said it risked stigmatizing trans people.
But others surprisingly accused her of “bias” by questioning whether puberty blockers were safe, and another said her use of terms like “masculine” and “feminine” showed her “pre-existing skepticism” about the issue.
Puberty blockers, known medically as gonadotropin-releasing hormone analogs, stop the physical changes of puberty in adolescents who question their gender.
For example, they stop the development of breasts in girls and facial hair in boys.
This gives those suffering from gender dysphoria time to “consume their options” and “explore their developing gender identity” through therapy before beginning more permanent forms of treatment, according to the NHS.
The NHS says the physical effects of the drugs, which were previously administered by the health service’s Gender Identity Development Service in Tavistock, are reversible and a person who stops taking them will simply resume puberty as normal.
However, the health service acknowledges that the psychological effects of the drugs on the sensitive teenage brain are unclear.
This is partly why the NHS stopped routinely prescribing these drugs in June, with sites now only offering puberty blockers through clinical research due to “significant uncertainties” surrounding their use.
However, the drugs are still available, prescribed privately and without authorization by some doctors in non-NHS gender clinics.
Scientific reviews such as the one carried out by Professor Baxendale are not unusual and are a mainstay of academic literature.
Its objective is to collect, compare and contrast the findings of individual studies on a particular topic from different scientific journals and countries.
The experts then analyze whether there is a general consensus between the different studies, as well as whether there are specific areas that need more research.
But given the widespread use of puberty blockers among gender-questioning young people, what Professor Baxendale found in her review of the drugs and their impact on neurological development raised alarm.
Of the 16 good quality studies he found, the vast majority (11) were conducted on animals, and eight of these different experiments were conducted on a single flock of sheep.
The remaining five in humans were limited in both their methods and scale, and one consisted of a single case study.
Professor Baxendale said the limited nature of this area of ​​research was in itself worrying, but also highlighted that what little had been done suggested that puberty blockers had a negative impact on brain development.
He said this raised several critical questions that needed answers.
Tavistock and Portman NHS Foundation Trust have been accused of rushing children into puberty with blocking drugs by former patients who feel they were not challenged enough.
In the paper now published in the peer-reviewed journal Acta Paediatrica, he said: “What impact does any delay in cognitive development have on an individual’s educational trajectory and later life chances, given the critical educational window in the “Are these treatments normally prescribed?” ?’
‘If cognitive development “recovers” after stopping puberty suppression, how long does it take and is the recovery complete?’
And in its conclusion, it says that transgender and gender diverse patients have been “poorly served by the absence of research in this area” and this needed an “urgent” correction given the growth of young people questioning gender and seeking help.
Professor Baxendale added that the “highly polarized socio-political atmosphere” surrounding the topic may be deterring academics from researching this area.
Evidence reviews like Professor Baxendale’s are subject to anonymous peer review by academic colleagues before publication.
In principle, this ensures that the work meets scientific publication standards and any critical errors or flaws are exposed. The anonymous nature also ensures, in theory, that academics provide honest feedback without fear of professional repercussions.
But Professor Baxendale said the anonymous reviews she received for her latest work were unlike any she had experienced before in 30 years of publishing.
Writing on the website disinheritedHe said, contrary to the usual academic questioning of his methods, the reviewers attacked his findings directly.
“None of the reviewers identified any studies that I had missed that demonstrated safe and reversible impacts of puberty blockers on cognitive development, nor presented any evidence contrary to my conclusions that the work simply had not been done,” he wrote. .
‘However, one suggested that the evidence might be available, it simply had not been published.
“They suggested I review non-peer-reviewed conference presentations to look for unpublished studies that might tell a more positive story.”
Others expressed concern that the findings could stigmatize trans people, while another said the focus should be on the positive aspects of puberty blockers.
Another dismissed the review entirely given the lack of studies on the topic, one of the points Professor Baxendale was trying to make.
his use of sex-based terms such as “masculine” and “feminine” was also questioned and cited as evidence of his “pre-existing skepticism” about puberty blockers.
One critic even suggested she was “biased” simply by asking whether puberty blockers were safe.
“This reviewer argued that many things needed to be resolved before a clear argument could be made about the ‘risk’ of puberty blockers, even circumstantially,” he wrote.
“They seemed to be advocating a default position of assuming that medical treatments are safe until proven otherwise.”
Professor Baxendale said this attitude went against the basic principles of medical intervention, that doctors cannot simply take the default position that a treatment is safe and fully reversible.
He highlighted how this opposition occurred despite the fact that his article does not call for puberty blockers to be banned and that most medical treatments are not risk-free and are administered on the basis of balancing the risks and benefits for a patient. .
NHS England’s decision to restrict puberty blockers was held as part of the health service’s new gender incongruence service for children and young people, which will replace the Tavistock and Portman NHS Foundation Trust clinic.
Tavistock was heavily criticized in an interim review by pediatrician Dr Hilary Cass in 2022, who called its model “unsustainable”.
The clinic has also been accused of rushing children onto puberty-blocking medications by former patients who feel they were not challenged enough.