Latest news with #hormonetherapy
Wall Street Journal
3 days ago
- Health
- Wall Street Journal
Good Supreme Court Sense on Trans Hormones
It shouldn't be news that the 14th Amendment doesn't give adolescents an effective right to access transgender hormone treatments, but it's still reassuring to see the Supreme Court say so. In a 6-3 decision Wednesday, the Justices upheld a Tennessee statute, called SB1, that bans giving such prescriptions to minors. Many other states have done the same. The 14th Amendment guarantees 'equal protection of the laws,' and the Biden Administration claimed that SB1 discriminates by sex and transgender status. 'A teenager whose sex assigned at birth is male can be prescribed testosterone to conform to a male gender identity,' it argued, 'but a teenager assigned female at birth cannot.' Yet the Supreme Court now holds that the law turns on age and diagnosis, neither of which demands heightened judicial scrutiny.
The Guardian
5 days ago
- Health
- The Guardian
Sweaty and flustered, my breast cancer patient was experiencing hot flushes. The lack of good treatment is frustrating
'Doctor, stop!' she abruptly commands me. 'I can't process a thing.' I halt mid-sentence, and in the pause that follows, watch the evolution of a hot flush (also called a hot flash) in real time. First her face flushes pink, then her neck and the part of her chest visible over the tank top she is wearing on a blistering winter morning. Beads of sweat form over her forehead. Her burning ears might warm my still-cold fingers. But most notable is her expression, changing from composed to flustered in a split second. She is like a defeated firefighter, battling to bring the conflagration under control before resorting to simply biding her time. 'Sorry about that,' she grimaces. Going by the clock at the bottom of my screen, the 'event' takes two minutes from start to finish. In that time I have had a front seat to a dramatic version of the adverse effect that oncologists often mention in passing to breast cancer patients using anti-oestrogen therapy. 'How often do you experience this?' 'A dozen times on a good day,' she shrugs. Roughly three-quarters of breast cancers are oestrogen-receptor positive, which means the cancer cells are stimulated by oestrogen. Women with this type of cancer benefit from oestrogen suppression, achieved via different methods including a pill, an injection and removal of the ovaries. This induces menopause in younger women and more complete oestrogen suppression in the already menopausal. With more than 20,000 Australian women and 2 million women worldwide diagnosed with breast cancer every year, anti-oestrogen medication is akin to the penicillin of oncology. Each week, I write, renew and replace multiple scripts. But while every prescriber mentions the anticipated side-effect of hot flushes, it strikes me that no one (including me) quite explains the living horror that many patients go on to experience. Why is that? Women who have concluded an arduous trek of chemotherapy and radiation for early breast cancer express the hope of 'never having to go through this again'. Women with metastatic breast cancer harbour the hope that their cancer, while not curable, may remain at bay for years. Every woman's risk profile warrants a tailored conversation but, broadly speaking, imagine giving this advice: 'There is an effective medication to reduce recurrence risk and improve survival. Over the many years you will be on it, you could experience hot flushes, stiff joints, disturbed sleep, low mood, weight gain and sexual dysfunction.' If it sounds like punishment served at the end of a punishing diagnosis, it is. However, when a drug works, oncologists want to encourage adherence and hope that the side-effects either don't occur or can be managed. 'Vasomotor symptoms', the medical term for hot flushes, affect up to 90% of women with breast cancer and are often severe. Up to half of all women prescribed anti-oestrogen medication stop taking the drug – and they are just the ones who tell us. Every oncologist knows the heart-sink moment when a high-risk patient declines treatment. But we also know all too well the toll that led them to do so. Given the ubiquitous nature of hot flushes, the lack of good treatments is frustrating. Of the panoply of advertised options such as cognitive behavioural therapy, acupuncture, hypnosis, diet, exercise and off-label use of antidepressants and anticonvulsants, none has been shown to help in a meaningful way. Then there is the irony of taking one medication to counter the side-effect of another and gaining weight and its associated complications in the process. As a result, most women just put up with the trailing cost of having breast cancer. Now, there is hope. In a randomised controlled trial of drug versus placebo, a once-daily pill meaningfully reduced hot flushes in women taking anti-oestrogen therapy for breast cancer. Elinzanetant works by affecting the brain signals involved in temperature regulation. At baseline, women experienced a mean of a dozen daily episodes. By one month, 61% of women on active treatment reported a reduction of at least 50% in the daily frequency of moderate-to-severe hot flushes compared with 27% on placebo. Sleep quality improved, as did overall quality of life. Crossover from placebo to the active drug resulted in similar findings. No drug is without side-effects. More than 60% of women in each group reported at least one mild adverse event but severe ones were rare. Somnolence, fatigue and diarrhoea were reported more frequently in the active therapy group but they can also be caused by cancer therapy. More than 90% of women who completed one year of treatment chose to continue for an optional two years, suggesting a high rate of acceptability. The drug is yet unapproved and oncologists will seek more details before widespread prescribing. Breast cancer outcomes are poorer in non-white women but 88% of the participants were white. Will this drug be effective in, and tolerable for, all eligible patients. Does taking the 'remedy' drug improve adherence to the primary one that reduces cancer risk? This would be the point of prescribing it. Finally, patients on clinical trials are strictly selected and heavily monitored. Will the real-world experience match the clinical trial experience? We know that it rarely does. On the way out, I commend my patient's determination to persevere with difficult treatment, and she smiles gratefully at the acknowledgement. She is only two years into treatment. I allow myself to envision a day when there will be room for reprieve. Ranjana Srivastava is an Australian oncologist, award-winning author and Fulbright scholar. Her latest book is called A Better Death
BBC News
07-06-2025
- Health
- BBC News
Gender treatment at Brighton GP practice under investigation
A GP practice is under investigation over concerns it may have prescribed gender-related medication to under-18s outside national clinical Sussex and NHS England is reviewing WellBN, which operates in Brighton and Hove, to assess the care of children and young people who were prescribed or supplied medication for gender Sussex said on Thursday it had launched "a rapid investigation into this activity".WellBN said it had paused all new hormone prescriptions for under-18s but it would "do our best to turn this decision around". The practice added in its statement, issued on its website in May, that it would continue to prescribe to young patients already under its care and the restriction only applies to "the initiation of new prescriptions".It said the NHS was "threatening to close us down altogether if we did not comply" and it "had to consider all 25,000 patients" registered at WellBN. NHS Sussex said the investigation followed "concerns raised about some prescribing for children and young people by WellBN in Brighton and Hove, that may fall outside of national clinical policy and guidance".It said it was working with NHS England "to determine the most appropriate care and treatment for these patients".It said: "The practice is no longer initiating prescribing of hormone medications for children and young people under 18 years for gender dysphoria."The practice will continue to provide general medical care to its patients while the investigation is carried out, and it will continue to provide gender care to adult patients who are aged 18 years and above." The NHS added it had established a helpline for under-18s receiving gender care from WellBN. Process to 'review' notes The cohort of patients whose cases are being reviewed are all aged under 18, and for whom WellBN is prescribing or arranging the supply of medication for gender dysphoria. It is thought that most of these children and young people, but not all of them, live in NHS said there would be a process to "review their notes, and consider next steps in their treatment, in line with national guidance and clinical advice".It said: "As a result of this process, there will likely be different outcomes for different patients."Some children and young people may be recommended for a transfer into specialist NHS commissioned gender services. "Some will be reviewed and supported by local Children and Young People Mental Health Services, and some will need an endocrinology (hormone) review."What happens following that review will differ for each individual and will depend on the outcome of the case note review, the person's age and medication profile." If you are affected by any of these issues, help and support is available via the BBC Action Line here. The BBC has contacted WellBN for May, the practice said: "We are sorry to be passing on this news, but rest assured we will continue to battle against this injustice."We have a strong case to present considering that bodily autonomy is one of the four pillars of modern medical ethics."
Daily Mail
03-06-2025
- Health
- Daily Mail
Judge OVERRULES Trump and tells prisons to keep giving trans inmates their meds in blockbuster decision
A judge has ruled the federal Bureau of Prisons must provide hormone therapy to transgender inmates after Donald Trump signed an executive order halting all treatments. Trump issued the order within hours of his inauguration in January forcing the federal government to only recognize two genders - male and female - as well as, house transgender women in men's prisons and not fund gender-affirming care. Several transgender prisoners sued the administration to have their treatments resumed. US District Judge Royce Lamberth ruled on Tuesday that federal law prohibits prison officials from arbitrarily depriving inmates of medications and other lifestyle accommodations that the bureau's medical staff has deemed appropriate. The judge said the transgender inmates who sued to block Trump's executive order are trying to lessen the personal anguish caused by their gender dysphoria, the distress that a person feels because their assigned gender and gender identity don´t match. 'In light of the plaintiffs' largely personal motives for undergoing gender-affirming care, neither the BOP nor the Executive Order provides any serious explanation as to why the treatment modalities covered by the Executive Order or implementing memoranda should be handled differently than any other mental health intervention,' Lamberth said. Trump's order required the bureau to revise its medical care policies so that federal funds aren't spent 'for the purpose of conforming an inmate's appearance to that of the opposite sex.' There are approximately 1,500 federal prisoners who are transgender women and 750 transgender men, The New York Times reported. One of the plaintiffs, Alishea Kingdom, is a transgender woman who was prescribed hormone therapy injections and approved to receive social accommodations, including women's undergarments and cosmetics. Kingdom was denied her hormone shot three times after Trump signed his order, but she had it restored roughly a week after she sued. Her access to feminine undergarments hasn't been restored, according to the judge's ruling. 'In Ms. Kingdom's case, there is no indication at all that the BOP means to leave her hormone therapy in place long-term; indeed, as noted above, she was informed by BOP personnel that the decision to resume her treatment was a consequence of this litigation itself, raising the specter that her treatments might be discontinued as soon as the litigation has concluded,' Lamberth said. Trump's order also directed the Bureau of Prisons to ensure that 'males are not detained in women's prisons,' but Lamberth blocked prison officials from transferring three incarcerated transgender women to men's facilities in February. The judge said there's no evidence Trump or prison officials considered the harm the new policies could do to transgender inmates. 'The defendants argue that the plaintiffs have not alleged irreparable harm because they are all currently receiving hormone medications. But it suffices to say that all three plaintiffs' access to hormone therapy is, as best the Court can tell, tenuous,' Lamberth said. Trump signed several orders rolling back protections for transgender people, ruling that the two 'immutable sexes' are 'not changeable.' The orders directed federal prisons along with shelters for migrants and rape victims to be segregated by sex. He also directed federal money to be no longer be used to fund 'transition services.' Transgender inmates were federally protected under the Barack Obama Administration, before Trump appealed the policy during his first term. Obama's policy was later reenacted under the Joe Biden Administration and Trump once again appealing it. The president also demanded officials use the term 'sex' rather than 'gender.' Federal agencies were urged to end funding to promote 'gender ideology' and protect against 'gender extremism.' contacted the Justice Department for comment. The Bureau of Prisons declined to comment.
Washington Post
03-06-2025
- General
- Washington Post
U.S. judge halts Trump ban on treatment for 1,000 transgender prisoners
A federal judge on Tuesday barred the Trump administration from withholding hormone treatment from more than 1,000 transgender inmates under an executive order signed by President Donald Trump, after the U.S. Bureau of Prisons acknowledged it had continued providing such treatment to roughly 628 of the inmates. In a 36-page-opinion, U.S. District Judge Royce C. Lamberth of Washington, D.C., granted class-action status to a lawsuit brought on behalf of an estimated 1,028 BOP inmates who are diagnosed with gender dysphoria, distress caused by a mismatch between their assigned gender and gender identity.
