Irish College of General Practitioners (ICGP)

In January 2021 the ICGP published its Guide for Providing Care for Transgender Patients in Primary Care [pdf] . However, a month later the guide was hastily retracted and an updated version was published.

The updated version revises statements on puberty blockers and places more emphasis on psychotherapy. Under treatment options for adolescents, the January version described puberty blockers as “reversible”. But the updated version revised this statement, removing “reversible”, and adding a sentence on side-effects:

“R̶e̶v̶e̶r̶s̶i̶b̶l̶e̶ ̶i̶n̶t̶e̶r̶v̶e̶n̶t̶i̶o̶n̶s̶:̶ ̶t̶h̶e̶s̶e̶ ̶i̶n̶v̶o̶l̶v̶e̶ ̶t̶h̶e̶ ̶u̶s̶e̶ ̶o̶f̶ GnRH analogues to suppress oestrogen or testosterone production (puberty blockers) and as a result delay the physical changes of puberty. Side effects may include hot flushes, fatigue and mood alterations.

The revised version also places greater emphasis on psychotherapy, moving psychotherapy from last to first in the treatment options. In the revised version, hormonal treatments such as puberty blockers and cross-sex hormones should only be considered for some adolescents ”under specialist review and following multidisciplinary assessment”. The updated version goes on to describe the limited evidence base for blockers, citing Chew et al (2018).

The Times reports on this change of wording, noting that one of the authors, Vanessa Lacey, is a ”health and education manager with Transgender Equality Network Ireland (Teni), a group that lobbies for transgender rights.

The lesson for New Zealand’s Ministry of Health is to not endorse medical guidelines written by activists if you wish to avoid egg-on-face.