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Impossible_PhD t1_j9vzrjt wrote

Okay, so, I'm pretty sure that Kaiser Permanente is saying that Chloe Cole is straight-up lying. Like 90+% confidence.

KP said in their statement that their treatments "meet all medical standards." Given that Chloe Cole is 18 now, that means that we're talking 5 years ago at the earliest, and that means she was treated under WPATH Standards of Care Version 7. WPATH sets worldwide treatment guidelines for trans people of all ages; unless KP is flatly lying in their statement, their treatment must have conformed to WPATH SoC7. SoC8 is up now, and its guidelines are different, but that only came out in September of 2022, long after Cole had become an anti-trans activist.

So, what does WPATH SoC7 say about when kids should be treated, and in what way?

  • "Two goals justify intervention with puberty suppressing hormones: (i) their use gives adolescents more time to explore their gender nonconformity and other developmental issues; and (ii) their use may facilitate transition by preventing the development of sex characteristics that are difficult or impossible to reverse if adolescents continue on to pursue sex reassignment. Puberty suppression may continue for a few years, at which time a decision is made to either discontinue all hormone therapy or transition to a feminizing/masculinizing hormone regimen. Pubertal suppression does not inevitably lead to social transition or to sex reassignment."
  • In other words, SoC7 emphasized puberty blockers, with the aim of stopping puberty until a teen was old enough to make long-term, abstract decisions on their own. At that point, they would be eligible for HRT. Blockers were (and still are) almost always used to delay until a teen was 15-16 before any further medical intervention.
  • "Adolescents may be eligible to begin feminizing/masculinizing hormone therapy, preferably with parental consent. In many countries, 16-year-olds are legal adults for medical decision-making and do not require parental consent. Ideally, treatment decisions should be made among the adolescent, the family, and the treatment team."
  • In other words, SoC7 emphasized making a decision on HRT between a patient, their parents, and the care team. Any one of the three could veto it.
  • "Genital surgery should not be carried out until (i) patients reach the legal age of majority in a given country, and (ii) patients have lived continuously for at least 12 months in the gender role that is congruent with their gender identity. The age threshold should be seen as a minimum criterion and not an indication in and of itself for active intervention. Chest surgery in FtM patients could be carried out earlier, preferably after ample time of living in the desired gender role and after one year of testosterone treatment. The intent of this suggested sequence is to give adolescents sufficient opportunity to experience and socially adjust in a more masculine gender role, before undergoing irreversible surgery."
  • In other words, only rarely should transmasculine top surgery occur before the age of majority, and only after "ample time" living as their gender. Moreover, this was the only surgery WPATH SoC7 said should ever happen on a minor.
  • For BOTH HRT and transmasculine top surgery, SoC7 REQUIRES the "Capacity to make a fully informed decision and to consent for treatment."
  • In other words, a care team cannot offer either treatment under SoC7 until and unless a child can make informed consent. HRT first, then top surgery.

It is not possible for Chloe Cole to have met these standards and begun testosterone at 13.

KP is bound by HIPAA. If she's lying, they can't just say "No, she started testosterone at [age]" outside of a courtroom. Either KP is lying in saying that Chloe Cole was treated under standard of care or Chloe Cole is lying. Given the press tour Cole has been on for over a year now, I know which I would suspect to be true.

Mark my words: I'll bet just about anything Cole withdraws the lawsuit a few days before it moves to discovery.

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AffectionateAd1446 t1_j9wf487 wrote

Some angry detrans people make a lot of dubious and straight up bullshit claims about their treatment. Anyone who's trans and been through the trans healthcare system knows they're full of shit but ignorant bigots eat this kind of stuff up and vote for hateful politicians that restrict the rights of one of the most vulnerable populations.

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axonxorz t1_j9wukiq wrote

We've got one in Canada in the same vein in the past few days. Oh man does the timing of people coming out of the smoke to criticize their own care seem suspect, given the political climate south of us.

And you're right about bigots, they're always completely incapable of parsing their own frequency bias. For each person like Cole, there tens of thousands of people who enjoy their gender-affirming care. But yes, let's focus on a random person's grievance.

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Jenetyk t1_j9wuvg1 wrote

Thank you. I needed this actual breakdown of treatments according to the current, or current at the time WPATH. Wish I spent money here or I would award you.

And yes, your assumption about withdrawals right before discovery definitely tracks. One of those rare instances where HIPPA really allows a lie to continue until legally it has to be disclosed.

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Impossible_PhD t1_j9wwkjl wrote

No worries! Breaking this stuff down is kinda my thing. I like to put my technical writing degree to useful work from time to time. 😉

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InTheEndEntropyWins t1_j9ywkln wrote

I'm confused.

Did she get surgery done when she was only 13? Is that allowed by the rules or not?

>transgender surgery performed on her when she was 13.

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Impossible_PhD t1_j9z06hf wrote

I have literally never heard of a substantiated case where a trans kid has gotten an operation that young. She's claiming they started testosterone at 13 and operated at 15, which would still be the youngest ages I've ever heard of. Only rarely are transmasculine kids able to get top surgery before they're 18, and usually only then when they're 17 or older. I've heard of like two cases, personally, of surgery at 16, so what we're talking about here is rare as hen's teeth.

The odds against things happening as Cole claims are kind of astronomical, and there should be a whole series of rails in place to keep hesitant patients from getting these sorts of surgeries. Cis people have this absurd idea that we can just pop in on any doctor for an operation whenever we want, and the reality is just absurdly far from that.

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DazedinDenver t1_ja0643f wrote

Betting that "surgery" was a just a time-release hormone suppressor implant. "GnRH analogue treatments for children are prescribed, administered and monitored by a pediatric endocrinologist. The medication is typically given as injections, either monthly or every three months, or through an implant placed under the skin of the upper arm. The implant typically needs to be replaced every 12 months." From https://www.mayoclinic.org/diseases-conditions/gender-dysphoria/in-depth/pubertal-blockers/art-20459075

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tehzayay t1_j9yughm wrote

Explain how anything you said supports the bolded statement? It seems perfectly reasonable based on those guidelines that a misguided 13 year old could start HRT, they just say it's an edge case.

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Impossible_PhD t1_j9yvq8x wrote

Visible confusion

The... The last two bullet points? Did you not read them? Kids can't give independent informed consent, and SoC7 requires it. Generally speaking, and every person is different, it's not until around 16 that a person develops that ability, though occasionally they'll twig it at 15.

It's a question of brain development. This stuff is really well-settled in psychology, medicine, and law.

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[deleted] t1_j9yx3xk wrote

[removed]

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Impossible_PhD t1_j9yzdtg wrote

Okay, first of all, I did no such thing. I am just stunned at your audacity.

Second of all, WPATH Standards of Care don't exist in a vacuum. They have to conform and respond to all pediatric standards of care as well, and if a person was treated as you suggest, they would not have been treated under standard of care, and KP would be lying.

I will not be responding to you further, given your behavior.

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Shooeytv t1_j9yhp2m wrote

WPATH SoC7 is a disgusting set of standards

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Impossible_PhD t1_j9yj084 wrote

I mean, I agree, but I'm pretty sure not in the direction you meant.

Find someone else to troll, or go spread your pro-Russian propaganda somewhere else. It's pretty easy to see what kind of person you are from your profile.

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chetchaka t1_j9yivk6 wrote

? Why so? They seem relatively reasonable from what I'm seeing.

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