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Transmission on 4zzz Amplifying the trans and gender diverse community of Meanjin, Brisbane and beyond. Hello, hello, you're listening to Transmission on 4 Triple Z. My name as I use he them pronouns.

My name is Bette, I use she.

Them pronouns and yeah, we've got a big episode lined up for you today. BET will be dissecting more dissection. More dissection from bet.

Yes, maybe when we get to that part we'll give some trigger warnings. Yes, we're getting heavy again, people.

I'm sorry, we are getting heavy again and we've also got some news that's less heavy, but there are some heavy things. Yes, bit of both. A bit of both. Yeah, we'll try and sandwich it today. So the week in community events and news. So first up, New research finds no athletic advantage for trans women A major review published in the British Journal of Sports Medicine has found no significant athletic advantage for trans women compared with cisgender women after hormone therapy. Researchers analysed dozens of studies and found similar results in strength, endurance and aerobic capacity between the two groups. The analysis showed that while trans women may retain slightly higher muscle mass, overall functional performance, the kind that determines sporting competitiveness, is comparable to CIS women. This study, led by researchers at the University of Sao Paulo, reviewed more than 50 studies encompassing data from just a little under 6,500 individuals, including 3,000 trans women. This large scale review examined a range of metrics including body composition, strength measures and cardiovascular fitness before and after hormone treatment. Experts say the findings challenge long standing claims that transgender women have an inherent physical advantage in sport and highlight the need for evidence based and inclusive policies as debate continues globally.

New data released by the Good Law Project in the UK indicates a rise in suicides among transgender young people in England following restrictions on gender affirming health care. Figures obtained through a Freedom of information request show 46 deaths by suicide of trans under 18s between 2019 and 2025. The data shows a sharp increase in 2022-23 when suicides rose to 22 cases, about a 400% increase on previous years. The spike followed the first ban on puberty blockers after the Kira Bell court case, according to information from the NHS National Child Mortality Database. Campaigners say the findings raise concerns about the impact of healthcare policy, long waiting times and access to support for trans young people, while acknowledging suicide is complex and rarely caused by a single factor. I just want to add something here as there was a report into this sponsored by the nhs. It was a very flimsy piece of research and it claimed that there had been no spike. So I'm going to be very curious to hear how the NHS try to.

Cover their tracks on how we justify the data. Lily Wachowski to executive produce new trans LED science fiction Film filmmaker Lily Wachowski, also known as one half of the Wachowski sisters, whom you may know as directors and creators of the Matrix franchise, have signed on as executive producers of Dolls, a new sci fi thriller directed by model and activist Gina Rocero. The short film the short film Sorry, there's some noise in my Microphone in my Ears. The short film marks Rosera's directional debut and features a predominantly trans cast and crew. The Storey follows a junior private investigator who goes undercover at a dating workshop for trans women while searching for a missing person, exploring themes of identity, community and resistance. Creators say the project aims to centre authentic trans storytelling and representation on screen. Dolls has been submitted to film festivals, further release details yet to be confirmed and also Australian metal singer Josie Scott Comes out as Transgender, which is awesome. Australian heavy metal musician Josie Scott, lead singer and guitarist of the Mark of Cain, has publicly come out as transgender woman at age 63. In a personal message to fans, Scott said she had experienced gender dysphoria since childhood and described it as a liberate as liberating to finally live authentically. Scott, who co founded the band in 1984, said a period of illness and reflection during the pandemic helped her decide to embrace her identity later in life. She also said themes of alienation and personal struggle are present in the band's music, which shaped, yeah, part of her internal experience. She confirmed her transition will not change the band's direction, with plans to continue writing, recording and performing. Fans and fellow musicians have responded with strong messages of support. So that's so wonderful. Yeah. Also, Paris Hilton has a message for trans people.

Really?

Yeah, she said. Keep shining, slaying and sliving. You're beautiful.

Oh, that's sweet.

Thanks, Paris. And coming up, if you are looking for something to do this Lover's Day weekend coming up or if you hate capitalism, fair enough. But this if you are looking for somewhere to be. Pink Noise Valentine's Day at the Cave Inn Saturday 14th of February from 6pm it's completely free entry. Pink Noise Valentine's is a celebration of love. The myriad forms it takes and the way it weaves throughout our lives. Songs of queer joy, romance, lust, friendship, family, heartbreak and loss filtered through the lens of our diverse community voices and shot like an arrow into your heart. No matter who you love or how you express it, you're welcome here and you are loved. So yeah, head to the Cave in which is fully wheelchair and disability friendly venue with a fully accessible toilet on the ground floor which is brand new. Go cheque it out. Go enjoy Pink Noise transmission. My name is ez he him bet she they. And we're diving into the Pathways programme.

The Pathways. Firstly we should say if you recognise this name, it's because this is. Well, the Pathways trial, which is one of the components of the Pathways programme is the trial on puberty blockers that the Queensland government is waiting for, apparently before they can give us an intelligent review and decide whether or not they're gonna make puberty blockers accessible through the public system again. Right, so we're waiting until 2031, although I just heard yesterday that that's been extended quietly behind the scenes to 2032.

Okay.

Now as we've said before, there could be an election before then, so who knows. But the government has the intention of waiting till 2032 before they're going to review whether or not they are going to make gender affirming medical treatment available through the public system in Queensland again. And they're waiting for the outcome of this Pathways trial, which is part of the Pathways programme, which comprises five different studies and cost £10 million.

Oh, that's nothing.

And it's been done done in the UK. So it's a 10 million pound series of studies on service users, young people who are so service users of the newly established Children and Young People's Gender Services in the uk, which replaced the Gender Identity Development Service after the CAS review. So the Children and Young People's Gender services, or the CYPGs, in the words of Cal Horton, focuses on non affirmative exploration and investigation of a child's identity.

Right.

And we're going to be referring to the fabulous Cal Horton throughout this episode. I was hoping to get Cal Horton on the show. Haven't been able to do that. I think they're leading a stressful existence Perhaps. And communication with them is sporadic. They were the keynote speaker at OSPA at the OSPATH Conference last year, as you know, because you were there with me. Yeah, yeah. It was a great speech and they're all over this stuff, so I'll be referring to them throughout. Do you want to run us through the. The UK government's view of what Pathways programme is all about?

Yeah. So this is what on the King's College London website under their research tab. Pathways Pathways Study projects all. Pathways Horizons is a longitudinal observation study, observational study of young people attending the NHS children and young people's gender services who take. Who want to take part. It is the largest part of the Pathways study and will explore the well being of young people, including their mental and. And physical health and experiences, and how these change or not as they grow up.

And there are 3,600 children they're aiming. Or children and young people they're aiming to have in that study, as well as one or more of their parents or carers.

Interesting. The Pathways trial is focusing on the effects of puberty suppressing hormones on young people's physical, social and emotional well being. It involves young people who want to delay puberty and whose parents and gender service agree with the status statement option. This treatment option.

And there are 113 young people who will receive puberty blockers following an intensive assessment and approval process. And again their parents. Sorry, 113 young people will receive puberty blockers straight away and 113 will have to wait an additional year after the trial starts and then they will receive puberty blockers.

Right. Pathways Connect. We'll look at young people's thinking and brain development and will follow both those who are and are not taking puberty suppression suppressing hormones. And then there's also. Pathways Voices involve speaking to young people about their experiences of living with gender incongruence and of their care in the NHS children and young people's gender service, including for some taking puberty suppression hormones. We will talk to young people and parents several times while they are attending the services. We will also find out from staff working within the services about what they think helps.

So I just wanted to point out the last one.

Voices.

Voices. That appears to be a way of kind of legitimising the whole thing by saying that like the Cast review did and like the vine review did, by saying that there was input from service users and from their parents. They don't. Young people and their parents and carers don't have any say in the design of any of the studies, they haven't been involved at any stage in designing these studies. There are no trans people involved. And the, the two main people in charge of the whole Pathways programme are Professor Emily Siminoff, a professor of Child and Adolescent Psychiatry at King's College London. She seems to have no experience, experience in the care of trans young people. I certainly couldn't find any evidence of it and neither could Cal Horton. And second in charge, Deputy Chief investigator of Pathways is Michael Absud. Now he spoke at the 2024 segum conference.

Oh Lord.

On autism and gender dysphoria in adolescence. So obviously he's one of those Segum folks with an axe to grind about autistic young people accessing this care. And that is a big component of this, of this study is screening young people for autism and going deeply into all that. So that's worrying. Also, in order to access the study, as I said, you have to go through the children and young people's gender services, which as Cal Horton said, focuses on non affirmative exploration. So basically they use the term exploratory therapy on the website. They don't say gender exploration exploratory therapy, but I mean, we know what they're talking about. Later today I'm gonna go into some of the questions that they routinely ask these young people as part of this study and you can get a bit of a flavour of the type of interrogation that these young people are going to have to go through just to be included in the study in the.

Hopes that they get the hormones too.

That they want, you know. Exactly. And also one last thing I just wanted to point out for now, actually two things. One thing, gender incongruence. They use the term gender incongruence, which is my favourite term. Right. And I would be glad that they've used it, but I can't work out why they're using it given that the entire cast review focused on either dysphoria or gender related distress. These reviews don't generally focus on gender incongruence. They generally want kids to, to be in distress before they're going to get help. And they're supposed to be studying whether the distress is improved or lessened by accessing the treatment. And because I'm so suspicious and because Michael Absood, who is affiliated with Segum, is the deputy chief investigator. And because this grew out of the cast review, I can't help thinking that they're talking about gender incongruence because they want to make the results of the study less equivocal, unequivocal like they want to. They want. If the more kids who only were were diagnosed with gender incongruence who are in the study, that means they don't have clinically significant distress. And that means that puberty blockers are not necessarily going to lead to a radical decrease in distress either. Well, actually they wouldn't lead to decrease anyway, but they, they're not going to as compared to the control group, the group that accesses care one year later. What they're going to be looking at is improvements in quality of life. And I'll get into how vague that is too. So they're looking for improvements in quality of life in the group that accesses puberty blockers straight away as compared to the group that has to wait for a year. And I can't help thinking that choosing gender incongruence as the way that you get into the study means that that is further muddying up the results because there may not be much of a difference there. But that's just a small point. The other point I'll make about that is that assessing quality of life measures, I mean, just because you access puberty blockers doesn't mean, I mean, I'll go into later what these quality of life measures are, but they're things like, you know, are you getting bullied less than, and are you happier overall with your life? Do you get along with your parents? Blah, blah, blah, things that really, you're not going to expect that those things, things are going to necessarily occur just because a young person accesses puberty blockers. So again, it seems like the questions they're asking and the way you get into the trial are all very, they're muddying the waters. And the last thing I'll say about that is that they're not letting any kids with significant distress into the trial. So they're not letting anyone who displays serious suicidal ideation into the trial. Now I understand why they're doing that. It's probably because they don't want kids to, to be dying in the trial. That would be very bad publicity and I guess you could say it would be unethical. The whole trial is unethical. What they're going to do is keep those kids out of the trial. So those kids are going to suffer anyway. They're not going to be able to access puberty blockers and we're not going to see reductions in suicidality in the group that gets the puberty blockers because there's not going to be a whole lot of suicidality there to begin with. So it's another thing that they say they want to measure for, but the study is going to be incapable of measuring for. Does that all make sense?

Yeah, no, it totally makes sense. It's also. It's not just muddy the waters, it's. It's like almost like they're cherry picking. The kind of. Yeah, they're cherry picking, which is a really great way to manipulate a research into the. To the outcome that you want.

Yeah. And look, if I'm giving them the benefit of the doubt, I could say, well, they're just doing that because they don't want young people to die during the trial. But I could also say those young people, if they're going to die during the trial, they might die outside of the trial anyway because you're not giving them the treatment that they need.

And also young people who are entering the trial who have to wait a year might. Their suicide risk might change during that time too.

That's true, but I guess they're trying to guard against the risk by leaving out the most. The most dysphoric and the kids. Kids that are suffering the most sense. But that will. I mean, it's not going to show a very meaningful result. So wpath, E Path, that's the European version of WPATH and US path, issued a joint statement of their concerns.

Yes, they did. So E Path, is that Europe? Yeah, yeah. Europath and W PATH is the world Transgender health and the United. And the us. Yeah. And so regarding the UK Pathways trial. So Epath has joined WPATH and Ozpath in issuing a joint holding statement outlining significant ethical concerns regarding the UK government's proposed Pathways Randomised Control trial on gender affirming care for adolescents. As organisers dedicated to advancing high quality evidence based transgender healthcare, we fully support rigorous research. However, the current pathway study design raises several issues that conflict with internationally recognised ethical standards for clinical research and adolescents care. Key concerns highlighted in the statement one, risk of coercion and compromised informed consent. The proposed model links access to gender affirming care with participation in the study. This structure risks undermining voluntary informed consent by placing young people and their families in a position where declining participation may limit access to clinically indicated treatment.

I just want to elaborate on that too. So the healthcare ethics professor Simona Giordano, who I've mentioned on the show before, testified recently to the Women's Inequality Committee on the harms of this study. This was in the UK and she said there is a risk that NHS England will violate fundamental principles contained in virtually all declarations and conventions on human rights as they apply to participation in research. So the 2005 Oviedo Convention. I don't know if I'm saying that. Right on Human Rights and Biomedicine says that the persons being asked to participate in a research project shall be informed of their right to refuse consent or to withdraw consent at any time without being subject to any form of discrimination, in particular regarding the right to medical care. And if. If listeners aren't sure why we're going on about this right now, maybe we didn't make clear earlier. Puberty blockers are outlawed for transgender young people in the UK at the moment, except through this trial. So this is a coercive trial. This is the only way you can get this clinically necessary care. Please go on.

So that was the first one. Risk of coercion and compromised informed consent. The second concern highlighted in the statement is delayed access to medically necessary care. The study design includes a delaying or restricting puberty blocking treatment for adolescents who could meet clinical criteria. Such delays may prioritise research objectives over patient well being and contradict established clinical guidelines. So that's not great. And then. And then the third one is ethical and clinical issues with late initial initiation of puberty blockers. So initiating puberty blockers later in adolescence introduces additional risks and may not align with the best practise care pathways.

Actually, I want to say something about that too. I'm just trying to find where I wrote the age that these young people are going to be. It's something like age of 12 to 15 and 11 months or something.

Okay.

So as we've said on the last show that we did on the vine review, there are all these UK studies that include young people who started puberty blockers at age 16. It's recommended that young people start in Tanner stage two. So that is the. Roughly when they're about 12 years old on average. I would say the pathways trial says anyone between Tanner Stage 2 and 5. Now I don't have any idea. Again, I feel like. Is this Michael Absu just making sure that the. The data is completely useless. I don't understand.

Yeah, again, it's muddying the waters, right?

Yeah, totally. So anyway, yeah.

And the fourth note or key concern highlighting statement. So there's five in total. The fourth one is need for meaningful inclusion of lived experience. The statement calls for the integration of transgender adolescents, their families and community stakeholders in the design and governance of any research that directly affects them. Patient reported outcomes and lived experience must be central to ethical and effective study design. We know this to be true in a myriad of different communities and not just with trans people. And the final key concern is no single study should determine access to care. The organisations stress that the Pathways trial should not be used as the sole basis for national policy decisions. Adolescents who choose not to participate must retain full access to the complete range of evidence based, gender affirming treatments. And yeah, we're gonna touch real briefly on some more things to do with this Pathways trial that's in the uk.

Is it going to be briefly? So I talked about the quality of life metric that they're using to assess as it's the primary outcome measure in the, in the Pathways trial, it's called the Kids Screen 10 questionnaire. So it's 10 questions. Do you know this one?

Yeah, yeah, that sounds familiar.

So it's 10 questions. I'm going to tell you what the 10 questions are and this is how they're going to. This is the primary way in which they're going to be assessing whether or not puberty blockers are working.

Right.

So it's a multiple choice question where you can answer from not at all to extremely, with five different options along the way. So question number one. Have you felt fit and well? Not at all. Slightly, moderately, very extremely. 2. Have you felt full of energy? 3. Have you felt sad? 4. Have you felt lonely? 5. Have you had enough time for yourself? 6. Have you been able to do the things that you want to do in your free time? 7. Have your parents treated you fairly? 8. Have you had fun with your friends? 9. Have you got on well at school? 10. Have you been able to pay attention? Like, I'm almost laughing at how absurd this is. I don't actually know. I mean, I guess this peripherally has something to do with good mental health, right? Yeah, but like, have your parents treated you fairly? I mean, like, that's a bit of a lottery. Like, did you get good parents or bad ones? How's puberty blockers going to change whether your parents treat you fairly? I have no idea. Have you been able to do the things that you want to do in your free time? Well, these are, these are teenagers, they're going to school in the UK and they're trans and schools in the UK are completely transphobic at the moment. So no, they haven't been able to do what they want to do in their free time.

If we think broadly about teenagers, like there's a bunch of teenagers, regardless of gender or dysphoria or anything, who'd be like, No, I don't get to do what I want to do because I want to do what I want to do because I'm a teenager and I.

Don'T feel full of energy because I've got to do six and a half hours of complete nonsense at school while putting up with transphobic teachers and bullies and then I have to come home and do my homework. You know, whether they're trans or not, they're not going to be necessarily full of energy, they're not necessarily going to be fit and. Well, I don't understand how any of these things have anything to do with getting treated.

Teenagers, puberty blockers, or like your teen years, full of fun and happiness. Easy breezy. That's all I've ever heard.

Yeah, totally. Oh, and then the last, they have one last general question, which is, in general, how would you say your health is? Is it excellent? Very good. Good, fair or poor? So I, I don't know what this is all about. Anyway, I wanted to go into, and I might give a bit of a trigger warning here for transphobic health practises just because this is a bit disturbing. Okay, I want to go into some of the secondary outcome measures in the Pathways trial. And these questionnaires are used all through Pathways Horizon, the biggest study with the 3,300 young people in it, young people and their parents. So all of the young people going through are getting asked all of these questions. And the most distressing. Well, I don't know if this is the most distressing actually, but something quite distressing and distressing to me as an outsider anyway, is the, what they call the Ultre Gender Dysphoria Scale. Gender spectrum, ugd, dsgs. Don't know what that means.

I've never even heard this before.

Oh, I guess I see what it means now. That's the abbreviation. Okay, so it's the Ultrecht Gender Dysphoria Scale. Now, you've probably not heard of it because we wouldn't use it here because it's so antiquated. They have updated it a little bit from when it was first used last century, but not very much. So hang on, where have I. Oh, there it is. Okay, so again, this is like a multiple choice where the, the young person can agree or disagree on a scale with these statements. So the statements are like, one, I prefer to behave like my affirmed gender. Now you would think that would go for all trans people. We all prefer to behave like our affirmed genders, whatever that even means. Two, every time someone treats me like my Assigned sex. I feel hurt again, sounds pretty universal. Three, it feels good to live as my affirmed gender. Four, I always want to be treated like my affirmed gender. A life in my affirmed gender is more attractive for me than a life in my assigned sex. You're getting the feeling right. These are just. These are questions that basically are testing whether the young person is trans or not.

Yeah. Like, why would they have got to this point?

I feel unhappy when I have to behave like my assigned sex. It is uncomfortable to be sexual in my assigned sex. I wish I had been born as my affirmed gender. That is the essence of gender incongruence right there. So they're measuring, are you trans enough on this scale?

Yeah, that's what that is.

And they're looking, I presume, since it's a gender dysphoria scale, I presume they're looking for reductions in it because they want to find out whether puberty blockers are a treatment for gender dysphoria. But you aren't going to get a reduction in I feel unhappy when I have to behave like my assigned sex or I wish I had been born as my affirmed gender. As Cal Horton made the point a while ago when jids, the previous UK gender clinic, the Gender Identity Development Service, used this scale in a study on puberty blockers to test whether or not young people had a reduction in gender dysphoria and they found they didn't have a meaningful reduction in gender dysphoria. No surprise, because with questions like I hate my birth assigned sex or I feel unhappy with when someone misgenders me, how on earth is puberty blockers going to affect that? Nothing's going to affect.

They're not correlated, they're completely separate.

And basically, as Cal Horton says, if you are measuring the effect of puberty blockers on this scale, what you're basically asking is, do puberty blockers convert trans kids into CIS kids? Do puberty blockers, quote, unquote, cure transness? Obviously they don't. There's no reason why they would because nothing does. So this is, again, a completely meaningless at best scale to be measuring outcomes on. And at worst, it basically is setting the trial up to fail because it's saying that if you don't improve on the gender dysphoria scale, a scale on which no trans person is ever going to improve.

So it is another corrupt trial.

Does seem to be, yeah. Then we have some other questionnaires that these poor young people have to go through. So we have like the romantic relations questionnaire. Now this one. I have no idea how this is relevant, but it's the questions that are like, in the past 30 days, have you hugged anyone? Have you held hands? Have you spent time alone? Have you kissed? Have you been kissed by anybody? Have you cuddled? Have you lain down together? Has someone put their hands under your clothing? I'm going to cry in a minute. Have you put your hands under someone else's clothing? Have you been undressed with your genitals showing? Have you touched or fondled someone's private parts? I'm glad I gave a trigger. Has someone touched. Trigger warning. Has someone touched or fondled your genitals? Have you performed oral sex? Has someone performed oral sex on you? And have you had sex?

How are these relevant? Like, how are any of these questions relevant? This is disgusting way to treat children.

I have no idea. And they're forcing these kids to answer these questions.

Surely this violates some kind of human rights.

Well, I mean, as we heard, the coercive nature of the trial violates many European conventions. I don't know about this part. I mean, this is just like I would never. I can't see any reason to ask any child these questions. And keep in mind, this is for young people 12 years and older.

Yeah.

So you're going to be asking a 12 year old. And this is not optional. This is just part of the study. Have you performed oral sex? You want to ask that to a 12 year old anyway.

But also you're asking these questions in a situation where they're under duress, where they're trying to access something that would help them hopefully become the person that they feel most comfortable being.

Exactly.

It's, it's an, it's an interrogation.

It's.

Yeah, it's so unexpected. And anyone asking children these questions, I would be asking about who the hell they are. Yeah. Because it's just such inappropriate things to talk.

It's. I know, let's. Sorry, everyone. Sorry. Yeah, I just felt like it had to be said. Keep in mind, but this is what.

What trans kids are going through, in.

Case you're wondering, this is what trans kids are going through in the UK right now. But keep in mind also this is what our government here is claiming is going to give the best evidence ever seen.

Yeah.

The evidence that's going to make the difference between giving young trans people health care and taking it away from them again is going to come from this ridiculous, unethical study, coercive study, stigmatising questions being asked in this study. I don't, I Doubt anyone in the government has even looked at this stuff. Well, I think it might be worth rubbing their faces in. Well, we know that you think this is okay to be asking 12 year olds this stuff.

Yeah. Or anyone.

Anyone.

You know, I think. You know, we know, we know that the, the current government doesn't read this stuff because it didn't even. They just. He's not even taking any of the medical research that he's, that the health minister issued. He issued for some research and he got the research and then he's completely ignored all the advice from his own inquiry.

Yeah.

You know, this is not a government who is using research, any kind of quality research, well peer reviewed and checked and everything researched. He's not. It doesn't matter because it's not. This isn't about healthcare, this is about political agenda. Yeah, yeah. So.

So I'm going to skim through this one because this is 118 questions. Don't worry, I'm not going to get anywhere near reading them all out. 118 questions from the child behaviour checklist. So the parent and the child fills this one out. I'll just pick out a few choice ones. So does your child deliberately harm themselves or attempt suicide? Again you ask the question. Do you deliberately try to hurt or kill yourself? That's the phrasing.

Gosh, I would.

Would you rather be alone than with others? So a lot of these questions are like, again, do you agree with this statement or not? So one of them is, I am not liked by other kids. So talk about a deficit model. There's so many of these questions. I physically attack people. Does your child physically attack people? Does your child play with their own sex parts in public?

What?

How is that relevant? Does your child play with their own sex parts too much?

What? Why are these even questions we're asking 12 year olds?

I have no idea. Does your child have sexual problems?

And I'm assuming that all these questions are broken up into different aspects of this child's social life and personal life.

And 118, they're not actually categorised, they're just randomly listed. All these, I mean like some of them are so bizarre as well. Like earlier, it's this one that I highlighted, it says, does your child do bowel movement?

What?

Hang on. Does your child, does your child do bowel movements outside of the toilet? Like, wait, why are we asking this? I don't understand.

Why is that relevant?

Why is it, Is your child cruel to animals?

Oh my gosh.

Cruelty, bullying, mean to others.

These sound like questions that I'm gonna find a psychiatrist and we're gonna bring them in and we're gonna have a chat about. Can you weigh in on what, what circumstances as a psychiatrist would you ask young people these questions? Because I just. Or adults. Or adults, you know, like, well, it.

Did that I'm imagining. It definitely wouldn't be just because you, you're gonna give them puberty pockets. Like why I scream a lot, I set fires. I think about killing myself again, my child thinks about sex too much or I think about sex too much. My child wets themself during the, the day. My child wets the bed.

What about a question that's like, how do you feel when you wear the clothes of the, the clothes of your, you know, opposite sex sign of birth? Like those are the questions that should, we should be asking, like be specific. If you want a study to have outcomes relating to the thing that you're supposed to be studying, then ask questions related to that.

Well, and also if you, if you want to find out about a child's mental health, does it have to be taking such a deficit approach? Like instead of saying, I think you'll.

Know where their mental health is.

Instead of saying, do you agree with this statement, I am not liked by other kids, couldn't you just say, hey, do you have some good friends at school? Or something like that? Like, it's just, I, I don't know, it's, it's all sorts of wrong. Then they've got a suicide screening. That's four questions.

Haven't they already asked this though?

That's the thing they dub, they double and triple up on a lot of these questions because these things, these questions all overlap. So they've already asked the child at least three or four times by this point whether or not they have suicidal ideation and then they focus in on it. Here they say, in the past few weeks, have you wished you were dead? In the past few weeks, have you felt that you or your family would be better off if you were dead? In the past week, have you had thoughts about killing yourself? Have you ever tried to kill yourself? If yes, how and when, and, and keep in mind they, these, the therapists that are asking this stuff have not built and built any kind of rapport with the child because they've gone into it with a non affirming approach. A lot of them, as we'll hear a bit later from Cal Horton in a qualitative study that they did, a lot of the, the parents and the young people get the impression when they go into these clinics that the psychiatrist that's assessing them doesn't even believe that a trans child is a real thing. So they haven't earned the trust of the child. And then they're asking them these incredibly invasive questions. Meanwhile, the children are sitting in a semicircle with five healthcare professionals grilling them with a bunch of these questions and taking notes. All five of these people taking notes and on clipboards. Then they're separated from, from their parent and grilled some more.

Yeah, these, these are really, these are inappropriate things to be asking children. This is like an interrogation. And, and as far as I'm concerned, this is, none of these things are relevant to any, any aspect of this young person, young person's life that's in to do with accessing puberty blockers or gender affirming care. If you are looking for some mental health support, you can contact Q Life 1 800-18-4527. You can also contact beyondblue 1300-22-4636. Please look after yourselves. We are touching on some really heavy topics today and we obviously want to make sure that everyone's feeling like this information you're processing has a, you know, that you can talk to someone. So yeah, there's life there.

How about I wind this bit up quickly? I can summarise the last few most problematic questionnaires.

Yeah.

So after all that, you also have the Child Anxiety and Depression scale which asks all over again whether the child feels worthless or thinks about killing themselves. Worries what people think about things about so much.

Oh my gosh.

This is another point that, that they made in the Cal Horton study that the young people made is, I don't understand why they keep asking me the same questions over and, and over again. One of the young people said it seems like they're trying. They're checking for a counterfeit coin. It's like they're checking whether my transness is counterfeit. And the way they do that is just to grill me over and over and over again with the same.

Until you answer wrong and they go, huh, yeah, exactly. Well, actually someone just messaged in saying it sounds like Danny, thank you for messaging. It sounds like it's a list to determine a sociopath. It does, it does.

And then you've got the body image scale. Now this one. Sorry people, another trigger warning. How can I. I mean, if you're trans and you don't like being asked invasive questions about your body, maybe just turn the radio down for a sec. Very briefly, the body image Scale asks, how happy are you with? And then it lists 33 body parts. So you're supposed to say whether you're happy or not with these body parts. And the body parts include penis, clitoris, testes, ovaries, scrotum, vagina.

Right.

Again, you're asking children this. Then you've got the Parent Parental Attitudes of Gender Expansiveness Scale for Youth. So it asks parents if they're ashamed of their child, do they advocate for their child? Do they encourage their child to wear clothing and accessories consistent with their birth assigned gender? Do they use toys, treats or other rewards to pressure my child not to gender transition? Do they think their child is trans because of something they, the parents did wrong? Etc. Etc.

Goodness.

And then at the end of it all, you have 15 minutes questioning on medical history. And this can include family context, developmental history, physical health, mental health, adverse child experiences. I imagine there'd be an excessive focus on that. Gender development and experiences, sexual development, knowledge, sexual orientation, peer relationships, social context. And in. In total, you've got something like 320 questions there that are asked of these young people. And as I understand it, they get asked them periodically. So I think. I'm not sure what I think.

Maybe that's a way of measuring.

Exactly.

Part of the study.

Yeah. So how we doing? Shall we go to a break?

Yes, let's have. Let's have some music. How many genders are there? I don't know. I just got here. You're listening to transmission on 4 triple Z. My name is EZ. He. Him.

Bet she. They.

And we're chatting. Pathways. Oh, yeah, Pathways. You're probably like, what Pathways?

The Pathways Programme.

Pathways Programme by the. UK Pathways Trial. Is this. Is this uk, like. Like Ozpath uk? Is this by the same group of people? No, no. It's the nhs, isn't it?

Yes, it's the nhs in conjunction with King's College London.

Yes, There you go. Which is the study that Queensland Health Minister Tim Nichols is relying on to determine whether he would like to allow puberty blockers to be accessed through the public health system again in 2020, 32. Yeah, yeah, supposedly.

But really he's just using it as. As an excuse to delay that decision. And ultimately, surely, I would imagine that the people in his party, who I presume are putting pressure on him about this because of their idea, don't want this care ever to be made available in the public system again. So I think they're just playing for time. I still think it's worth talking about it so that we can call Them out on, on this manoeuvre.

Yeah, definitely.

I wanted to talk about. So as I said earlier, that the, the way that young people get included in this study and this trial, so the, the broader study that asks, just basically questions them endlessly for no reason. And then the trial where they have the chance to get on puberty blockers. Now, obviously, as we've said before, so that once they get on puberty blockers, half of them go on straight away and half of them wait for a year. And given that the. Who waits for a year is chose randomly, chosen randomly by a computer, and given that the age range is 12 to 15 and 11 months or something like that, there's going to be some young people who are going to not get blockers and they're going to be super annoyed, very sad, physically upset. Yeah, they're going to be. Right. I mean, they could be anywhere in the, in within puberty, within that range. Like if we were focusing on Tanner Stage two, then some of them might still have some time, a little bit of time before all of the changes of puberty occur, but some of these young people, people are going to get there. Right. When waiting a year is going to be the difference between no good outcomes and some good outcomes. Right.

Yeah.

So, yeah, I, I would imagine there's going to be a high dropout rate, which would make the, the trial, again, useless. It would introduce a high risk of bias into the trial and then they would say that, oh, we're sorry, that the trial was inconclusive, but as we've said already, there are tonnes of other reasons why the trial might be this entire conclusive.

Anyway, this entire trial is like the peak of medical gatekeeping.

Yeah.

That I've seen for young people, trans young people.

And it's about as confused as the Vine Review in my mind. Like, it's hard to work out what. Why have they designed it this way? Are they. One thing I've noticed is at the moment in the uk, you've got people on our side on the, on the affirmation side, the trans side, who are complaining about the trial for all the reasons that you and me are complaining about it. But then you've also got, on the complete other side of the political spectrum, you've got hardcore TERFs, you've got sex Matters and Gen Spect and all these really transphobic orgs who are also complaining about the trial, saying that it's unethical, but for a completely different reason, because the. They think that puberty blockers are hugely dangerous or they claim that they think that and therefore they don't see that there should be a trial of them at all for that reason. But then in the middle you've got these kind of gender centrists and so I'd put Hillary Cass in that, who wrote the Cass Review in that category, and some of the politicians and some of the other physicians, presumably the ones who are doing this study, some of them are in this boat where they genuinely seem to think that this study might be helpful or maybe they know it won't be helpful, but they don't want to be as blatant as the out and out transphobes and they want to give like a patina of respectability and medical credibility to this. I don't really understand, but it's like such a, it's, it's such a controversial thing, this trial and everyone seems to have a different take on it.

Oh. And yeah, it's just, this is not.

Gonna have, it's not gonna please anyone.

Basically no one wins.

I did want to go in with, with what time we had left, I wanted to go into some of the qualitative research. So qualitative research is not about statistics so much, it's about having conversations. And so Cal Horton, again, one of my heroes, one of my research heroes, they're a non binary parent of a child, trans young person, they're working in the uk, they've done a lot of qualitative research around puberty blockers and around accessing the NHS and they, they did this in 2024. So this was when Jids, the, the former clinic was, was closed and there was this new, even less affirming kind of treatment coming in in the uk. And what they managed to do was they managed to talked to young people and parents who had been both involved in an affirmative form of care and a non affirmative form of care. So apparently there was a clinic in Brighton, a gender clinic, that was still offering like an affirmative approach. And so some young people had had the experience of going between a very non affirming approach and a more affirming approach that we would recognise from, from so called Australia. So in order to get in the trial and in the study, the Pathways study in the first place, as I've said, young people have to go through the CYPGs, the new gender clinic. And that, as Cal says, talks about things like careful exploration of the link between gender incongruence and coexisting mental health, neurodevelopmental and, or personal, family or social complexity in children's. Lives. So in other. In other words, it's a non affirming approach that's looking for causes of transness, quote unquote causes the way you would if you were in seg and more therapy first it's an the way you would if you were giving a young person so called gender exploratory therapy. So the cypgs cautions about the potential harms of social transition. So this is as Cass review speak, they put conditions on when social transition can be supported and they define it as a decision that needs clinical approval and oversight. And by the way, in the UK it is still possible to have your young person taken away from you if you're seen as being too affirming, if you're a problem parent and that young. So they have safeguarding measures that come into to this. The service describes a watchful approach, quote unquote, which Cal Horton says is a synonym for delayed transition and itself is recognised as a conversive approach. So some, some parents and young people who went through this service said it was so a parent said it was very probing and dismantling of somebody's identity and, and what they believe about themselves and they feared it would be very damaging for their child. They felt their children were being scrutinised, questioned about their identity. One parent said, when you're questioning your child from a position that questions whether trans identity even exists, which is what we're seeing when they refuse to use the term trans, somebody is going to sit in a room and question my child on her own. And if they don't truly believe, believe that trans identity exists, exists, my child is not safe to be in that room.

No.

And what that parent says there, this refusal to use the term trans is happening all through UK policy at the moment where they're, they're not. If there's policy on young people in schools and they're not even using the word trans. So they're cutting the tea off of LGB in their, in their policy and they're talking about gender confusion children instead. As we know, a lot of trans people are not confused at all about their gender.

If anything, they're probably the most certain about their gender of any group of people, to be honest. Real someone's messaged in. Jason, thank you for messaging and saying seriously, what kind of evil comes up with these questions? Yeah, serious, it is evil. It is an evil thing to do.

So the non affirmative approach was contrasted strongly with the approach experience experienced by young people in affirmative care. So families reflected on how meaningful it was for their child to be in a room with a professional who accepted their transness, who did the bare minimum. One parent commented that you could see the stress draining off of their child. The experience was so validating because it, because it confirmed their identity.

Yeah, they just want to be seen.

And then the parents go into what I said about that kind of semi circular panel of professionals, five professionals, usually with one child grilling them all at once, taking notes. The parents said you had a paediatrician, a social worker, a psychologist, psychiatrist, someone else as well. All of them had notebooks and were scribbling down everything that we said.

And none of them are lived experience. So none of these people are trans people or necessarily have any experience with working with trans or gender.

Exactly. The parents said it would be traumatic for anyone. Even if it was five people that were gender affirming and fully supportive, it would be intimidating to be up against five people you didn't know asking multiple different questions of a very personal nature. Young people were typically very anxious when visiting the new gender clinics. And that was exacerbated by pressure from the service to be interviewed away from their parent or carer. Parent described that experience. They said, then they separated us. My child's like, why am I going through. Through this with these people that I don't even know? Because every time you go that, the people change and they always ask the same questions and they're really weird questions. Weird is such a polite way of saying, yeah, a young person.

Outrageous.

A young person described this as probably the worst thing. Thing I've ever experienced.

Gosh. Oh, and this, and this actually comes back. This actually wraps around nicely to the, the, the key concerns that were highlighted in the statement from E Path, W Path and US path, which was that this is ethically wrong. That this needs more lived experience in the bulb of the study that no, no single should study like this should determine access to care. So it's a huge gatekeeping mechanism and also the risk of coercion and compromised informed consent. Like these young people are in an extremely hot. They're in a hostile environment. They're in the enemy, you know, totally on the field of war.

Yeah.

And the battlefield. They're on the enemy lines.

Yeah.

Alone, unsupported and with no affirmation.

Totally. So Cal said the most positive experience that any of the people, parents that they interviewed reported was that they didn't think the experience was harmful, but it also wasn't helpful. This is the most positive.

The most positive is neutral.

And when, when asked why they were attending a surface service that wasn't helpful. The parents said that they were engaging as a defensive strategy in case their family was investigated for failure to engage.

Wow.

Several parents felt regret after going to the clinic that they had attended sessions at all that they felt had been harmful for their young person. One parent said, I feel really guilty that I went into that service. I've been really naive about the whole thing. I nai. I naively believed these people were there to help.

Wow.

Another parent. And this will be the last, I think. The young person was denied approval for endocrine care, and the parent had to completely hassle the service to try and see the case notes so that they could work out why the young person had been denied. And when they read the case notes, they said this. Well, firstly, they said that they bore no resemblance to what had actually happened. In questioning, the parents said, we read it and I was just beside myself. It was like a witch hunt on me. He was basically just saying that I've forced being trans on my daughter, I've made her trans, and that we're too influenced by the LGBT community. They were really preoccupied with the fact that I've got an adult trans friend and that my child confines, confides in her and talks to her. They asked me so many questions about this trans person, which I also found really offensive. It's like, it's okay to if she's talking to a cisgender person, but if she's talking to a trans person person, they're clearly trying to influence her.

Gosh, trans people just want to, like, go to work and go home and live their life.

Actually, one. One last one, a young person said, and this is possibly will make me cry again. They were always very like, you're not displaying enough distress or gender dysphoria. In my final session, I was screaming at the guy, I was crying and I was like, are you happy now?

Wow.

And this is what I've been saying. This is what an emphasis. Emphasis on dysphoria over incongruence, which is what we're getting in all of these healthcare services. And. And ironically, obviously, within the service, they're emphasising you have to be distressed to get help. But they're framing the study with gender incongruence, which doesn't require distress. Now, either that's idiocy or that's deliberate. I can't work it out. Do you want to hear what Cal Horton says?

Yeah, let's, let's. And then we'll wrap it up, because.

I'M just going to read out something that Cal Horton wrote. I actually edited together a couple of different statements that they had. In spite of hundreds of questions, pages of spreadsheets and millions of pounds, this research will not answer questions that would be useful for a health service to know the answer to questions like, what are the things that make life harder for a trans child? What are the things that improve. Improve things for trans children. The research isn't answering these questions because we already know most of the answers and our NHS and our government and our country does not like the answers to those questions because they don't care about whether trans kids have a tough life. They don't want to help trans kids at all. That is not the purpose of this service. It is a service to, quote, unquote, study trans kids to discuss delay trans kids and through delay, to convert trans kids, pushing them to suppress their identity, to give up their fight, to think of themselves as a problem, as broken, pushing them to give up even thinking that they matter or have rights. I will have no patience for any folks who in 2025 naively stumble into roles that provide a veneer of trans engagement to this harmful NHS trial. There is no space for trans and LGBT civil society pretending to be naive about the harm and unethical nature of this current study. We need trans leadership in trans children's healthcare, in all trans healthcare. Nothing about us, without us. And that means genuine influence and power across healthcare design and management structures, not relegation to, quote, unquote lived experience panels that have no power to change and hold to account the fundamental and intentional failings of the whole approach. We need de pathologisation as a core principle. We need affirmative health care Research should uphold children's rights. Research should not cause harm.

Yeah, we, this is not something that we. This is not a way to treat anybody. It's definitely not a way to gatekeep, to continue to gatekeep children. We have a serious problem happening around the world with a crackdown on trans people. Such a small minority group of people. We are, we're just trying to live our lives. And also, this is, you know, this isn't just an attack on trans people, it's an attack on children because it's such a vulnerable minority. And yeah, if you are looking to continue to support the trans justice movement and support trans kids, a way that you can do that is you can follow a bunch of things on social media, you can head to Transjustice Project on Instagram or Facebook, things like that. You can also head. There's a few different groups like Mangins People's Pride, which is a fantastic group to follow as well. Get involved, protest. These are things that our government are using these studies to inform what they want to do here to our kids. So, you know, we've, we've got to do something about this. It's not a joke. And it's getting worse, it's ramping up.

And if you're a parent out there, there's a new parent lobbying group. It's called Parents to Trans Kids. Speak Up. You can find us online. I'm. I'm helping out with that group, although I'm not a parent, I'm in an advisory role.

Yes.

You can also join the group Protect Trans Kids Queensland, which I administer on Facebook. You can get a lot of information there.

Yeah.

And we'll keep you updated about protests by those other groups as well, I'm sure.

Yeah, we will keep you all in the loop. And for any mental health resources and support, Please cheque out Q Life 1-800-184527. They also have a web channel chat. Yeah. Every day of the week from 3 o' clock till 9 o' clock at night. You can chat on the web chat. You can even call in and you know what?

And, and yeah, Q Life is great. But you know what, when, when I was going through a lot of dysphoria before I transitioned, I actually found Lifeline to be really incredibly helpful. Yeah, just a couple of times, like I would have called it every day for about two weeks, but. And it is a bit of a lottery. But yeah, you can find some kind people there who are affirming and will understand.

Lifeline is 13, 11, 14 if you want that number.

I wanted to say one last thing about all of that stuff.

Yeah.

And that is. So I read out from Cal's study, which was basically focused on supportive parents and their young people. I just want people to imagine that you're, you're a parent who's on the fence and you don't. And, and you know, you've taken on a lot of disinformation. You don't know who to believe and you go into that service and, and maybe you don't know. You haven't heard of Cal Horton. I mean, I mentioned not that many people in the wider public have. And you. If, if you Google the Pathways trial right now. I tried it actually. What I googled or I duck, duck, goad, sorry, was problems with the Pathways trial or, or, you know, people complaining about Pathway trial. I forget what the wording was that I used and I got a whole lot of TERFs complaining that it was dangerous because puberty blockers are dangerous. I hardly even that US path EU path statement was way down in the list. So my point is this is dangerous also because parents are going into this.

Yeah.

And even if their kids are not converted by it, the parents may well be converted to terfdom or to anti trans beliefs by going through all of that.

So we'll put all the links to the things that you should definitely take a look at, including the research that we've been discussing.

Yeah, I've got a bunch of links.

Yeah. We'll cheque that up on the Transmission socials and the podcast notes as well. And also on the Ford Triple Z page for programme pays for transmission. We're gonna head out of here. Nothing about us without us, please. Thank you so much for listening and we'll see you all next week.

Bye now.

Now, thanks for listening to Transmission. Catch us every Monday live on 4 Triple Z from 10am or listen to our podcast on the community radio plus applause.