Alex Ashman @AlexAshman Twitter profile | Pikagi

Pikagi

Alex Ashman

@AlexAshman

1,999

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1,299

Following

351

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7,721

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ENT surgery | @rcsnews Emerging Leader '23 | @UKWENTs social media | @PRiSM_Surgery | @theBMA EDI Advisory Group | they/them 🏳️‍🌈🏳️‍⚧️ | own views

England, United Kingdom

https://t.co/G7Zzc6l0aj

Joined May 2008

Don't wanna be here? Send us removal request.

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@AlexAshman

Alex Ashman

4 months

Great news: our critical appraisal of the Cass Review is now available as a pre-print. In it, we demonstrate that the Cass Report's application of evidence-based medicine to gender affirming care for children and young people is deeply flawed. Read here:

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@AlexAshman

Alex Ashman

6 years

"Who runs a hospital at 2am in the morning?" asks the Health Secretary, trying to win over nurses with a polemic against doctors. All of us, Hancock. We all work together in an interdisciplinary team. The only person not there at 2am is our lame arse Health Secretary.

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@AlexAshman

Alex Ashman

4 years

Worked 19 hours straight yesterday. Saw so many NHS staff working so hard and risking their own health to save lives. Heartening to hear they're getting *checks notes* real terms pay cuts this year so we can afford Serco, Hancock's pub mate, and some management consultants.

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@AlexAshman

Alex Ashman

7 years

As a junior doctor, I have a #publicduty to inform you that the Tories are gradually killing our NHS. Please don't enable them. #voteNHS .

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@AlexAshman

Alex Ashman

2 years

First year doctor salaries: 🇬🇧 UK £29,384 (FY1) 🇳🇿 NZ £37,460 (HO) 🇨🇦 Canada £37,774 (PGY-1) 🇫🇷 France £43,909 (L1) 🇦🇺 Australia £47,215 (L1) 🇺🇸 USA £63,988 (PGY-1)

@DrJulia_Simons

Julia Simons

@DrJulia_Simons

2 years

Junior doctors in the UK face having to take strike action after 26% pay erosion over 14 years. Meanwhile in australia the standard work week is 37.5 hours, no strikes and a WHAT IS THIS a retrospective pay rise £23.76 vs £14.12 for a first year doctor

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@AlexAshman

Alex Ashman

4 years

Just to clarify, I'm not worried about my pay, I'm worried about the pay of those staff at the bottom of the pay scales, who usually work the hardest and are the most marginalised and vulnerable.

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@AlexAshman

Alex Ashman

2 months

Dr Davie has added clarification about the call he had with Cass in 2020. He recalls: - Cass was sceptical about affirming care and recommended he read a 'gender critical' polemic. - Dr Davie, who felt affirming care was appropriate, was not invited to join the Cass Review.

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@AlexAshman

Alex Ashman

2 months

This footnote alone is enough to harpoon any credibility that the Cass Review might still have. The only conclusion I can make is that Hilary Cass, when entrusted with a review of trans kids' healthcare, already held 'gender critical' views. Source:

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@AlexAshman

Alex Ashman

7 years

BBC News says cuts to NHS are going ahead because there's no money. Meanwhile, after a £130m election, May is busy bribing the DUP.

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@AlexAshman

Alex Ashman

2 months

I've seen a letter is being pushed by BMJ and others who don't want @theBMA to critique the Cass Review. The letter's main argument is that the Cass Review was sound and "got it right". But if that's the case, what do they have to worry about? Why are they afraid of the BMA?

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@AlexAshman

Alex Ashman

4 years

A Tory MP thought he'd get a photo op at a cafe donating free lunches to starving kids. One week after he voted to starve them.

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Cafe rejects MP who voted against free meals to help them pack kids' lunches

'It's a no from us!'

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@AlexAshman

Alex Ashman

3 months

Another multidisciplinary group critiqued the Cass Report. They confirmed our working group's findings re: poor methodology and unsupported assertions. This is damning stuff, folks.

@jack_turban

Jack Turban MD

3 months

An interdisciplinary group of scholars (including myself) worked with The Integrity Project @YaleLawSch to contextualize, and where appropriate critique, the UK’s “Cass Report” on medical treatments for adolescent gender dysphoria.

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@AlexAshman

Alex Ashman

2 months

This footnote alone is enough to harpoon any credibility that the Cass Review might still have. The only conclusion I can make is that Hilary Cass, when entrusted with a review of trans kids' healthcare, already held 'gender critical' views. Source:

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@AlexAshman

Alex Ashman

2 months

This expert opinion from a paediatrician and psychologist, who have actual experience working with GIDS, is a useful addition to the growing evidence critiquing the Cass Review. 🧵

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@AlexAshman

Alex Ashman

4 years

Govt minister says contract tracing is difficult as it's "an entirely new infrastructure which there's no precedent for". Smallpox was eradicated by exhaustive contact tracing, a technique that has been around for decades. The govt need to find a better excuse!

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@AlexAshman

Alex Ashman

2 months

Hi @doctor_oxford , I'd like to give you some context as to why our democratic professional body, @theBMA , would decide to undertake an evaluation of the recently published Cass Review, with a view to recommending improvements to trans healthcare in the UK. 🧵

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@AlexAshman

Alex Ashman

2 months

The BMJ have released a piece criticising @TheBMA for daring to critique the controversial Cass Review. This is hardly surprising, when you realise how much of Cass is driven by the BMJ. 🧵

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@AlexAshman

Alex Ashman

1 year

A 96-hour #JuniorDoctorsStrike is due to start on Tuesday, but Health Secretary @SteveBarclay has yet to offer junior docs anything. We've lost 26% of our real terms pay, thousands are leaving for Australia & NZ/Aotearoa. This isn't going to fix itself, Steve. #PayRestoration

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@AlexAshman

Alex Ashman

4 years

Our Prime Minister is a disgrace, putting one man's job before the safety of millions. Johnson should consider his position. #dominiccummimgs

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@AlexAshman

Alex Ashman

3 years

The government: the data doesn't support any additional public health measures to control COVID. Also the government: let's build 800 extra hospital beds in car parks and get the coroners ready to work extra shifts.

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@AlexAshman

Alex Ashman

4 years

How it started. How it’s going.

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@AlexAshman

Alex Ashman

2 months

I think this is sensible from @TheBMA : - BMA will evaluate and critique the Cass Review 🧐 - Their task and finish group will also make recommendations to improve trans healthcare 📝 - BMA calls for pause in Cass implementation while work is done 🛑

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@AlexAshman

Alex Ashman

7 years

Wow, this has really taken off! It's even in HuffPost now. Keep tweeting, maybe we can make a real difference to this election #publicduty

@AlexAshman

Alex Ashman

7 years

As a junior doctor, I have a #publicduty to inform you that the Tories are gradually killing our NHS. Please don't enable them. #voteNHS .

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@AlexAshman

Alex Ashman

1 year

I doubt the government will sort things out quickly enough for me to benefit before I CCT. But this is for the next generation of doctors in training, for recruitment and retention, and ultimately for patient safety. So it's a yes from me. #PayRestoration #JuniorDoctorsStrike

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@AlexAshman

Alex Ashman

4 months

Unlike the Cass team which intentionally excluded transgender individuals and organisations, as well as experts in transgender health, from its assurance group, our working group is inclusive of trans professionals and appreciates their personal and professional expertise. /4

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@AlexAshman

Alex Ashman

7 years

As a junior doctor, I'm thrilled that @MxJackMonroe is standing as our @NHAparty candidate for Southend! #publicduty

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Food blogger Jack Monroe is standing for parliament

The A Girl Called Jack blogger wants to go to Parliament - and is putting the NHS at the heart of her campaign

www.mirror.co.uk

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@AlexAshman

Alex Ashman

4 months

Our working group, led by @Chris_Noone_ , consists of clinicians and academics from multiple disciplines including psychology, sociology, biology, law, bioethics, psychiatry, neuroscience, sexual health, general practice, nursing, pharmacy, and medical education. /2

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@AlexAshman

Alex Ashman

4 years

Official govt papers leaked to The Sun show that a No Deal Brexit this winter will lead to shortages of food, water, fuel, electricity, and essential medicines. It would see the army on our streets to control civil unrest. It's time they got a deal, or an extension.

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@AlexAshman

Alex Ashman

2 months

Hadley Freeman warps the Cass Report into an inquest into whether trans people should be allowed treatment, allowed to exist. In the 2020 terms of reference, Cass was meant to make recommendations for NHS services. That was it. Trans people's lives weren't meant to be on trial.

@HLeeHurley

Lee Hurley

2 months

It's all just a game to these people

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@AlexAshman

Alex Ashman

4 months

It really is a truly multidisciplinary team. Our team has expertise in evidence synthesis, evidence-based medicine, and transgender health. /3

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@AlexAshman

Alex Ashman

2 months

@cassesque Multi-year waiting lists are effectively a denial of care. Much of mental health services is like this, which is why it was doubly ridiculous that NHSE wanted trans kids to go via CAMHS/secondary care in order to reach the new GIDS.

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@AlexAshman

Alex Ashman

7 years

. @NHAparty 's @drmarielouise has been selected by locals as the progressive alliance candidate to take on @Jeremy_Hunt at #GE2017 !

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@AlexAshman

Alex Ashman

4 months

You can read our pre-print of the paper here:

CRITICALLY APPRAISING THE CASS REPORT: METHODOLOGICAL FLAWS AND UNSUPPORTED CLAIMS

The Cass Report aimed to provide recommendations for how services for gender diverse children and young people should be delivered in England. Our critical appraisal reveals significant methodologi...

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@AlexAshman

Alex Ashman

2 months

This expert opinion from a paediatrician and psychologist, who have actual experience working with GIDS, is a useful addition to the growing evidence critiquing the Cass Review. 🧵

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@AlexAshman

Alex Ashman

2 months

That's the thing, there is no one measure that defines all women. Trying to define anyone by just their gametes, genitals, genes, chromosomes, physicality, ability, ethnicity... it's all dehumanising nonsense that belongs in the 20th Century, along with patriarchy and eugenics.

@JessOThomson

Jess O'Thomson

2 months

If everyone with XY chromosomes is a man, which is suddenly what GCs are saying, then by their own definition some men can give birth. This is the opposite to what GCs have been claiming for years - having a mardy whenever someone suggests not only women need reproductive care.

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@AlexAshman

Alex Ashman

3 months

Vote responsibly tomorrow, folks. #PublicDuty

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@AlexAshman

Alex Ashman

25 days

The Observer is shouting loudly about how the BMA will ruin its reputation by ensuring there is proper scrutiny of the controversial Cass Review. But once again it's all just the opinion of BMJ stalwart Jacky Davis, who has already made her views clear on the matter.

@HLeeHurley

Lee Hurley

26 days

2 anti-trans articles in The Observer today and neither involve Sonia Sodha. The 2nd article here is based on the first article. Jacky Davis is a radiologist whose opinion is as relevant to this discussion as mine is on radiology.

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@AlexAshman

Alex Ashman

2 months

This led to @TheBMA distancing itself from the BMJ's output, which has editorial independence:

@TheBMA

The BMA

2 years

@AlexAshman @PRiSM_Surgery @bmj_latest @bmj_company @GLADDUK @stonewalluk @Mermaids_Gender @TransActualUK @TransNHS @transgapproject @ScottishTrans BMJ coverage does not reflect BMA policy positions. The BMJ is editorially independent from the BMA. We acknowledge that by association and by receiving the BMJ as part of BMA membership this separation may appear indistinct.

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@AlexAshman

Alex Ashman

2 months

Our thoughts go to Dr Davie, who has experienced a backlash for revealing this important context about Hilary Cass. Dr Davie's account suggests that Cass' 2024 interview with Hannah Barnes, in which Cass claims she had no fixed views before the review, was not entirely accurate.

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@AlexAshman

Alex Ashman

7 years

Jeremy Hunt doesn't realise he just described his own party's manifesto. #UnseatHunt #ElectDrLouise

@Jeremy_Hunt

Jeremy Hunt

7 years

The coalition of chaos congratulating each other for sharing regressive and uncosted policies #BBCdebate

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@AlexAshman

Alex Ashman

4 years

The UK. 0.87% of the global population 10% of the global COVID-19 deaths This is not a "good outcome". We need widespread testing, contact tracing, case quarantine, border screening, and effective procurement of equipment including PPE. #Covid_19

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@AlexAshman

Alex Ashman

2 months

BMJ editor Kamran Abbasi has denied holding gender critical views, but has repeatedly criticised affirming care for trans kids and supports "holistic care" (which in my view is a euphemism for conversion practices and for the denial of affirming care).

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@AlexAshman

Alex Ashman

2 months

The BMJ have been churning out pieces undermining affirming care for trans children, stoking the concerns of readers not familiar with trans healthcare. Notably, there was this piece in April last year:

@PRiSM_Surgery

Pride in Surgery Forum

2 years

What were you thinking when you funded this piece, @bmj_latest ? We will be writing to you in due course, but we need to call this out now. This 'investigation' reflects current prejudices and alarmism about trans people, treating their treatment and survival as a mere debate.

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@AlexAshman

Alex Ashman

4 years

Can't believe Boris Johnson is running late for an announcement he's delayed twice, to announce a lockdown that he's delayed for so long. Wait actually I can completely believe it.

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@AlexAshman

Alex Ashman

5 years

Hey UK folks. Hope you're ok. You need to start social distancing *right now*. Work from home if you can. Avoid public spaces and meetings. Postpone social and business events. Avoid hospitals and the GP's if at all possible. Use 111. Please.

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@AlexAshman

Alex Ashman

1 year

@SteveBarclay @BMA_JuniorDocs @Telegraph Hey @SteveBarclay , You need to make an offer. You don't have to start at what @BMA_JuniorDocs are asking, it's a negotiation. But you have to offer something if you want them to call off the #JuniorDoctorsStrike . None of us want to strike, but you have to give some ground here.

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@AlexAshman

Alex Ashman

2 months

And led to @GLADDUK and @PRiSM_Surgery writing to the BMJ, criticising the poor quality and inflammatory nature of the piece.

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@AlexAshman

Alex Ashman

2 months

Ultimately, the BMA wrote to the BMJ about the piece to express concerns "that alongside criticisms made by LGBTQ+ organisations such as GLADD and neurodivergent doctors, in our view, it lacks equality, diversity and inclusion awareness and patient voice."

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Take Pride in progress

The fight for LGBTQ+ rights continues in the midst of a backlash. It is as important as ever to protect the legacy of the steps forward that have been made

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@AlexAshman

Alex Ashman

4 months

@NetworkGender @WhatTheTrans @FierceMum @MeeshSnowDoes @ErinInTheMorn @AriDrennen @HLeeHurley @notCursedE @michaeljswalker @novaramedia @transscribe @Esqueer_ @David_Leavitt @IndiaWilloughby @Chican3ry @stephenwhittle And paging @JolyonMaugham @Raphaelk0hn @Devon_OnEarth @PhilosopyTube @LGBwiththeT @mimmymum @Ranting_Trans @SloaneFragment @SpillerOfTea @boymoderology @GLADDUK @cassesque @ConduitTrans , please read and share 🙏

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@AlexAshman

Alex Ashman

4 months

Paging @NetworkGender @whatthetrans @FierceMum @MeeshSnowDoes @ErinInTheMorn @AriDrennen @HLeeHurley @notCursedE @michaeljswalker @novaramedia @transscribe @Esqueer_ @David_Leavitt @IndiaWilloughby @Chican3ry @stephenwhittle , please read and share 🙏

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@AlexAshman

Alex Ashman

2 months

So we have the Cass Review, cheer led by the BMJ editor, supported by consensus articles in the BMJ, its review papers reviewed and published by a BMJ journal, with a BMJ Group editor quoted to give legitimacy, and BMJ columnists criticising those who express valid concerns.

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@AlexAshman

Alex Ashman

2 months

That Abbasi uses the Cass Review to support his views against affirming trans care is somewhat circular, as the BMJ Group are not just a key vocal opponent of care... they also have ownership of the journal that peer reviewed and published the review papers that support Cass.

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@AlexAshman

Alex Ashman

2 months

Surely the Cass Review did all this? Well, actually, no. Cass is not an expert on trans healthcare. Subject matter experts were intentionally not included on the team, except for one who was (in my opinion) biased against affirming care. Experts who were trans were excluded.

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@AlexAshman

Alex Ashman

7 years

Please stop blaming individuals for systems failures. It's not elderly who are blocking beds, it's the government.

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@AlexAshman

Alex Ashman

4 months

@Chris_Noone_ has written a nice summary of the paper for those who don't have time to read ~4,500 words right now:

@Chris_Noone_

Dr Chris Noone (He/Him)

4 months

Young people seeking to transition deserve much better than the #CassReview . In this preprint, we show that Cass relied on poorly conducted systematic reviews & primary resarch, & made unsupported claims that should together undermine her recommendations.

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@AlexAshman

Alex Ashman

4 months

@NetworkGender @WhatTheTrans @FierceMum @MeeshSnowDoes @ErinInTheMorn @AriDrennen @HLeeHurley @notCursedE @michaeljswalker @novaramedia @transscribe @Esqueer_ @David_Leavitt @IndiaWilloughby @Chican3ry @stephenwhittle @JolyonMaugham @Raphaelk0hn @Devon_OnEarth @LGBwiththeT @mimmymum @Ranting_Trans @SloaneFragment @SpillerOfTea @boymoderology @GLADDUK @cassesque @ConduitTrans I meant @PhilosophyTube obvs 🤦🏻‍♀️

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@AlexAshman

Alex Ashman

2 months

Having a trans kid undergo their natal puberty is not a neutral or desirable act just because it is a natural occurrence, in the same way that continuing an unwanted pregnancy or having intrusive menopausal symptoms should not be considered the default option.

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@AlexAshman

Alex Ashman

2 months

To be clear, these are my own thoughts and do not represent those of the BMA. I am a doctor, BMA member, EDI Advisory Group member, author on a paper critically appraising the Cass Review, I have lived experience, and I have done work on trans inclusion in healthcare.

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@AlexAshman

Alex Ashman

2 months

Puberty blockers were meant to be the safe, reversible, compromise provided to stabilise things whilst trans kids worked things through. Banning them does not reduce risk, but increases it. This is analogous to bans on reproductive care.

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@AlexAshman

Alex Ashman

2 months

Yes, the journal publishing the Cass review papers is jointly owned, by both BMJ Group and the Royal College of Paediatrics and Child Health. But, guess which royal college Cass used to be president of? Yup.

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@AlexAshman

Alex Ashman

2 months

The BMA has already had to write to the BMJ about its previous output on care for trans children, which lacked EDI awareness and patient voices, and has been used by transphobic lobby groups around the world.

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Take Pride in progress

The fight for LGBTQ+ rights continues in the midst of a backlash. It is as important as ever to protect the legacy of the steps forward that have been made

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@AlexAshman

Alex Ashman

2 months

...we're talking about cís kids with central precocious puberty (CPP). As the BMJ says, "Treatment of CPP is usually straightforward with gonadotrophin-releasing hormone agonists." Yes, puberty blockers. Yes, "straightforward". Yes, the BMJ.

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@AlexAshman

Alex Ashman

2 months

Fundamentally, there are concerns that the Cass Review was methodologically flawed, did not represent the current evidence base, ignored the wider context, viewed trans people through a pathologising, patriarchal lens, and is being used inappropriately to withdraw access to care.

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@AlexAshman

Alex Ashman

2 months

And ultimately this is about political interference in a matter that is for patients, parents, and clinicians, and not for the state. All individuals have the right to make decisions regarding their own reproductive care and must have access to services that support that right.

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@AlexAshman

Alex Ashman

4 years

Nonsense, we're in the middle of a barely-controlled pandemic. This is another PR stunt.

@MattHancock

Matt Hancock

4 years

Now we’ve flattened the curve & reduced new infections, from tomorrow, the 2.2 million people who have been shielding can safely go outside I know how much those shielding have sacrificed. Thank you to everyone who has protected our NHS & saved lives

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@AlexAshman

Alex Ashman

2 months

And here's one of the biggest reasons why a thorough critique of Hillary Cass' work is needed:

@AlexAshman

Alex Ashman

2 months

This footnote alone is enough to harpoon any credibility that the Cass Review might still have. The only conclusion I can make is that Hilary Cass, when entrusted with a review of trans kids' healthcare, already held 'gender critical' views. Source:

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@AlexAshman

Alex Ashman

2 months

In their piece criticising the BMA, the BMJ quote Nick Brown, editor of that same journal. The BMJ fails to mention its ownership in the piece.

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@AlexAshman

Alex Ashman

7 years

The idea that the ruling UK party took £5 million in laundered donations from HSBC is chilling. Who controls our democracy? #ToryDirtyMoney

@RogMull

Roger Mullin

7 years

My last letter as current MP. Continuing to fight against #ToryDirtyMoney I call for an urgent inquiry. RT if you agree.

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@AlexAshman

Alex Ashman

2 years

@SteveBarclay The @BMA_JuniorDocs team already let us know how the meeting went, and that's not what happened. @SteveBarclay came to talks without any offer, presumably expecting us to accept 2%. He demanded 'media silence' from the team but briefed the papers himself immediately afterwards.

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@AlexAshman

Alex Ashman

5 years

@KarenFlemingPhD @cnlester Thank you! NHS guide to the 7 step handwash:

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@AlexAshman

Alex Ashman

2 months

There were also concerns that the Cass Review had (a) shown cisnormative biases, (b) misrepresented contributions from trans patients, (c) involved discredited and questionable input from anti-trans sources.

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@AlexAshman

Alex Ashman

7 years

We're seeing overwhelming support for @drmarielouise in her campaign to #UnseatHunt ! This is genuinely exciting.

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@AlexAshman

Alex Ashman

2 months

So, that's some brief thoughts from me. There is so much to say, and it's not for me to say it all. For one thing, please read our paper:

CRITICALLY APPRAISING THE CASS REPORT: METHODOLOGICAL FLAWS AND UNSUPPORTED CLAIMS

The Cass Report aimed to provide recommendations for how services for gender diverse children and young people should be delivered in England. Our critical appraisal reveals significant methodologi...

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@AlexAshman

Alex Ashman

2 months

(An aside: strictly speaking, trans kids could also, in theory, go straight onto cross sex hormones, as this would avoid them experiencing a puberty contrary to their gender. Puberty blockers are a compromise that allows "time to think" first.)

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@AlexAshman

Alex Ashman

5 years

The NHS staff who have lost their lives during this pandemic have given so much to their communities and will be sorely missed by friends, families and colleagues. For their sake, please stay at home. Help us avoid more deaths. #COVID2019

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@AlexAshman

Alex Ashman

2 months

This happens elsewhere in the article: Jacky Davis is quoted as a BMA Council member, without also mentioning that she is a long time columnist for the BMJ.

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@AlexAshman

Alex Ashman

2 months

Why not keep banning puberty blockers for trans kids until things are cleared up by a trial, several years from now? Seriously? Ok. Because the harm this will cause these children is excessive. Few children get to receive blockers, but the evidence shows that they need them.

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@AlexAshman

Alex Ashman

1 month

The Labour govt has renewed the ban on new scripts for puberty blockers for trans kids, and extended the ban to Northern Ireland. Non-trans kids still have access to these medications, which are not considered dangerous and are still in use in kids.

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Puberty blockers temporary ban extended

Temporary ban on prescription and supply of puberty blockers extended.

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@AlexAshman

Alex Ashman

3 months

I just spoke for the first time at @TheBMA ARM, in support of the motion calling for the govt to reinstate @RainbowNHSBadge funding. I had to counter a member of the RB who opposed the motion, claiming the scheme was too expensive. 1/ #ARM2024

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@AlexAshman

Alex Ashman

2 months

And yes, the description of the evidence as "wholly inadequate" that Abbasi quotes is from the BMJ Group, too.

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@AlexAshman

Alex Ashman

2 months

Well, kids *are* still receiving puberty blockers to reduce the psychological distress caused by puberty, allowing them time until they can start a puberty that is appropriate for them. The evidence says this is safe, and it isn't banned. Oh, but wait...

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@AlexAshman

Alex Ashman

6 years

Here's the rest of it:

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Health secretary claims some nurses are expected to stand for doctors when they enter a room

Matt Hancock accused of being divisive and out of touch

www.independent.co.uk

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@AlexAshman

Alex Ashman

2 months

It is telling that the ban on all new puberty blocker scripts (at least outside of a trial that Cass proposed but doesn't yet exist) is only for trans kids; the safety and efficacy of these same drugs, for essentially the same treatment aim, is not in question for cís kids.

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@AlexAshman

Alex Ashman

2 months

Given concerns about Cass, political overreach, the risk of harm to trans kids, and the specific limiting of trans people's rights to access care (whilst cís kids continue to have access to blockers), it is entirely reasonable to call for care to continue whilst this is sorted.

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@AlexAshman

Alex Ashman

1 year

Hey @SteveBarclay , we're still waiting for you to come to the table and sort things out. Folks on the street get that we're not worth less than we were in 2008. We're professionals, not students as you said, and we will keep telling you until you listen. #FullPayRestoration

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@AlexAshman

Alex Ashman

2 months

We know from data on trans kids on waiting lists that 45% report attempting suicide and 84% report self harm (Stonewall, 2017). Affirming care is associated with a 73% reduction in odds of suicidality and 60% reduction in odds of moderate or severe depression (Tordoff, 2022).

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@AlexAshman

Alex Ashman

7 years

NHS funding is falling as a % of GDP, and we're miles behind the EU average. #voteNHS

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@AlexAshman

Alex Ashman

4 years

Clapping is great, but have you tried at least paying NHS staff the salary they had ten years ago?

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@AlexAshman

Alex Ashman

2 months

Here's my detailed thread on why the BMA is critiquing the Cass Review:

@AlexAshman

Alex Ashman

2 months

Hi @doctor_oxford , I'd like to give you some context as to why our democratic professional body, @theBMA , would decide to undertake an evaluation of the recently published Cass Review, with a view to recommending improvements to trans healthcare in the UK. 🧵

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@AlexAshman

Alex Ashman

2 months

Not to mention there is also data on the use of puberty blockers in trans kids too, including qualitative data that was excluded from the Cass Review. Cass deemed this evidence insufficient, but it exists and is bolstered by all the data on cís kids.

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@AlexAshman

Alex Ashman

2 months

First, you were critical of the BMA Council for making a strategic decision to evaluate the Cass Review. Surely, you thought, it is for the BMA's Representative Body (RB) to decide policy at ARM and for the Council to act strategically based on this policy.

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@AlexAshman

Alex Ashman

2 months

So it is entirely reasonable that the BMA evaluates the Cass Review, as empowered to do so by policy set by the Representative Body in 2020, and that it does so in an evidence-based manner including trans expertise which Cass excluded.

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@AlexAshman

Alex Ashman

2 months

Fellow BMJ columnist Margaret McCartney has also weighed in on the side of those opposing gender affirming care.

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@AlexAshman

Alex Ashman

2 months

The 2020 ARM, the RB passed a resolution including a call to govt to "ensure that under 18s are able to access healthcare in line with existing principles of consent established by UK Case Law and guidelines published by the public bodies which set the standards for healthcare;"

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@AlexAshman

Alex Ashman

4 years

UK govt votes to break international law. UK govt votes to keep starving children hungry. UK govt votes to keep migrant children from their parents. UK govt votes to authorise undercover police to commit murder, torture and rape. Folks I think we need a better government.

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@AlexAshman

Alex Ashman

2 months

It is also appropriate as there has been international, multi-disciplinary criticism of the Cass Review. This included criticism of the Cass systematic review papers, published in a journal of the BMJ Group, which is wholly owned by the BMA but which has editorial independence.

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@AlexAshman

Alex Ashman

1 year

We have an old copy of the Australian @WomensWeeklyMag birthday cake book in the cupboard, so of course the "duck cake from Bluey" has been requested this year 🤯 wish me luck!

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@AlexAshman

Alex Ashman

2 months

So, will the BMA be able to bring sufficient expertise in its evaluation of the Cass Review? Certainly, as per the press release, the BMA is already aware of two international multi-disciplinary papers providing critical appraisal of the Cass Review and its scientific programme.

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@AlexAshman

Alex Ashman

2 months

So we already have policy from the RB. But why not vote on this specific matter at the 2024 BMA ARM? Well, the Cass Review final report was published on 10th April, a week after the deadline to submit motions to ARM. Colleagues therefore submitted an emergency motion to ARM.

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@AlexAshman

Alex Ashman

2 months

The press release also states that the BMA Board of Science, Medical Ethics Committee, Equality and Inclusion Advisory Group, and Patient Liaison Group will be involved. Appropriate expertise should be drawn upon from multiple angles.

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@AlexAshman

Alex Ashman

2 months

Here's how the BMJ are closely linked to the Cass Review:

@AlexAshman

Alex Ashman

2 months

The BMJ have released a piece criticising @TheBMA for daring to critique the controversial Cass Review. This is hardly surprising, when you realise how much of Cass is driven by the BMJ. 🧵

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@AlexAshman

Alex Ashman

7 years

Only Theresa May's team have what it takes to create a dystopia in which the internet is censored and our public services slashed. #GE2017

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