I continue to be astonished by the lack of ethics in trans "health care". I would like to continue to emphasize that there is an extremely poor or even non-existent evidence base for every facet of what is practiced in this field. To me it doesn't even count as health care.

Most trans care, from puberty blockers to SRS, has not been clinically shown to improve health or quality of life or even reduce suicidality over the long term. Yet transition is treated by laypeople & even clinicians as a panacea which will solve all your problems.

Viewing transition as a panacea reduces trans peoples' ability to obtain a full spectrum of care for comorbidities. Many trans people, especially adolescents, have severe MI comorbidities from depression to PTSD to schizophrenia that are not diagnosed or treated appropriately.

Even the sanitized, non-medical language used ("puberty blockers," "top surgery" orchie" "bottom surgery" etc) strips away reality - changes to healthy bodies & organs that will have significant physical, cognitive and psychological ramifications, known & unknown, down the line.

I'm so done with uneducated halfwits who parrot bribed physicians that puberty blockers are "reversible," even though there is quite literally zero research showing that to be the case when they're used into a patient's teenage years.

I truly dread the health minefield that awaits the thousands of people who have been given puberty blockers & surgery. It is absolutely going to become a public health problem and there is little infrastructure and no research to support these people when the fallout occurs.

Reproductive hormones aren't strictly reproductive. They have receptors all over your body & brain. When you remove them, it stops the one-time pubertal hormone surge & neuroplasticity window that occur during maturation. These cannot ever be replicated.

The first thing a physician learns in bioethics is that it's better to stand by & do nothing than to engage in a treatment that could cause harm. This is the principle of primum non nocere. I hope someday soon my profession remembers the principles of evidence-based medicine.

To sum up: this isn't health care, it's cosmetic, whimsical transhumanism-on-demand masquerading as health care, preventing real comprehensive care & differential diagnostics, & in many cases being practiced upon people who cannot properly consent to what's being done to them.