Two amendments

I’ve changed my mind on a couple of things since yesterday.

  1. Based on the impression I got from the play Copenhagen, I said that Heisenberg was head of the German nuclear program in WWII. I was wrong. A reader wrote in with the details:

    A lot of documents regarding the WWII German nuclear program have only been declassified and rediscovered in archives in recent years (much more recently than the well-known Farm Hall transcripts and the main Alsos reports). Based on these documents, Heisenberg was not the head of the program. The chief theoretical physicist in the program appears to have been Siegfried Flügge, who was brought to the United States after the war to help Edward Teller with a certain classified project. The chief administrative official for the program in its final years was SS General Hans Kammler, who was also taken in by the United States after the war, according to several declassified documents. However, the documents do show that Heisenberg was involved in more weapons-related wartime nuclear work than he was willing to publicly admit after the war.

    I certainly understand if this is too far beyond your range of interests, but if you are curious, please see:

    Revolutionary Innovation

    I still don’t care for the character of Heisenberg in the play — just working with the Nazis makes him distasteful to me — but he wasn’t quite as bad as I thought.

  2. I was far too generous to the Cass Report. Reading the comments and digging deeper into the report, it’s clear that this was the neo-liberal version of trans care — that is, say just enough that you won’t be accused of hiding the obvious facts, but not enough to actually disturb the status quo. It’s appealing to the reactionary anti-trans crowd because they can pretend to be judicious, while not actually doing anything and allowing the bad people to continue their bad policies and bad behavior.


  1. Snarki, child of Loki says

    So, Heisenberg was successful at producing uncertainty about his wartime activities?

    Not sure how anyone could have not seen that coming.

  2. raven says

    It’s appealing to the reactionary anti-trans crowd because they can pretend to be judicious, while not actually doing anything and allowing the bad people to continue their bad policies and bad behavior.

    It is a lot worse than that.
    It’s an anti-trans document written by trans haters and full of lies.
    The more you look at that document, the worse it gets

    .1. Some of the groups involved in producing the Cass report are known anti-Trans hate groups. No Trans people or Trans organizations were involved.

    .2. The methodology of the report is completely Fake and wrong.
    What Hilary Cass did was throw out most of the research studies done on Trans medicine in the last 30 years and then pretends that there isn’t any research or data to support what Trans medicine does today.
    It’s basically highly dishonest and a form a lying.

    .3. She also calls all the research “low quality” and demands that all the research on Trans medicine be Double blinded, Randomized Controlled Clinical trials.
    This is a high standard that a lot of medicine can’t meet.
    75% of all drugs used on children don’t meet this standard. They were never even formally tested on children.

    These blinded, randomized clinical trials can’t even mostly be done in Trans medicine. They are impossible to blind because the drugs work and soon enough anyone knows which group they are in.
    There are also ethical considerations about randomizing children who are seeking medical care into control groups. Children aren’t mice or lab rats and they can’t give informed consent.

    This doesn’t mean you can’t do research on Trans health care.
    You can and it is being done.
    The data you get from surveys, longitudinal observations, surveys, before and after outcomes, case matched controls and so on is still data, still commonly gathered in all of medicine, and still useful.

    .4. Hilary Cass flat out lies about a lot of important topics including puberty blockers.

    .5. This could go on for pages.
    Already there are analysis of the report out by professionals that in fact, do go on for pages and pages.

    The Cass report is an anti-Trans document written by anti-Trans people, highly dishonest, and completely worthless.

  3. raven says

    Here is an article detailing why Randomized controlled trials aren’t possible for much of Trans health care.
    “Randomized-controlled trials are methodologically inappropriate in adolescent transgender healthcare”

    .1. You can’t blind them.
    “Gender-affirming interventions have physiologically evident effects and are highly desired by participants, giving rise to concerns over adherence, drop-out, response bias, and generalizability.”
    These people are there for health care that will affect them for the entire lives. Not to be lab rats.
    As soon as they discover they are in the control group, they will drop out and go elsewhere.

    .2. You can’t randomize them into no treatment or placebo groups either when the control group will obviously be harmed.
    The control group has to be the current Standard of Care.

    .3. You can still do medical research though and it is still valuable. We can always use more and better data especially since Trans medicine is relatively new.

    “Given the methodological limitations of RCTs, complementary and well-designed observational studies offer more reliable scientific evidence than RCTs and should be considered of sufficient quality to guide clinical practice and policymaking.”

    This is discussed in the paper below so read it yourself.
    It’s not a complicated subject unless you are Hilary Cass writing an anti-Trans report.
    She just demands Randomized trials without caring about the fact that they are most of the time impossible.

    Randomized-controlled trials are methodologically inappropriate in adolescent transgender healthcare

    Florence Ashley,Diana M. Tordoff,Johanna Olson-Kennedy &Arjee J. Restar
    Published online: 24 Jun 2023
    Cite this article CrossMark LogoCrossMark
    In this article
    Why and when RCTs are valued
    The limitations of RCTs in adolescent transgender healthcare
    The value of complementary observational studies

    Despite multiple rigorous observational studies documenting the association between positive mental health outcomes and access to puberty blockers, hormone therapy, and transition-related surgeries among adolescents, some jurisdictions have banned or are attempting to ban gender-affirming medical interventions for minors due to an absence of randomized-controlled trials (RCTs) proving their mental health benefits.

    This article critically reviews whether RCTs are methodologically appropriate for studying the association between adolescent gender-affirming care and mental health outcomes.

    The scientific value of RCTs is severely impeded when studying the impact of gender-affirming care on the mental health of trans adolescent. Gender-affirming interventions have physiologically evident effects and are highly desired by participants, giving rise to concerns over adherence, drop-out, response bias, and generalizability. Complementary and well-designed observational studies can instead be used to ground reliable recommendations for clinical practice and policymaking in adolescent trans healthcare, without the need for RCTs.

    The lack of RCTs on the mental health impacts of gender-affirming care for trans adolescents does not entail that gender-affirming interventions are based on insufficient evidence. Given the methodological limitations of RCTs, complementary and well-designed observational studies offer more reliable scientific evidence than RCTs and should be considered of sufficient quality to guide clinical practice and policymaking.

  4. chrislawson says

    @3– Yep. And sorry to repeat myself from the earlier thread, but the Cass Report draws conclusions from many non-RCT sources. Only papers that support affirming care are held to this impossible standard.

  5. chrislawson says

    Heisenberg may not have been head of the Uranveiren program, but he seems to have been treated as its chief scientist. It was his miscalculation that led to the conclusion that a nuclear bomb was impractical, and it was he who reported this in person to Albert Speer. (Ironically, the Allied scientists also miscalculated early, although in the opposite direction, which probably helped get the Manhattan Project rolling as they thought they would only need one pound of uranium.)

  6. billseymour says

    I’m currently participating in a study of the effectiveness of prophylactic radiation to keep small cell lung cancer out of the brain.  I was randomized into the group that gets everything except the actual radiation.

    It couldn’t be blind:  I’d hardly fail to notice whether I was lying in the machine; and the radiation oncologist was emphatic that there would be no “sham radiation”.  (I had originally guessed that there might be some ethical reason for that; but commenters on my own blog suggested that it might just be about cost, which also makes sense.)

  7. outis says

    About Heisenberg and the rest: he did say after the war (so maybe he was whitewashing a bit) that none of the nuclear scientist on Germany were much keen on military research. Not out of humanitarian spirit mind you, simply out of self-preservation, because: you tell Adolf and the rest of the rancid bunch that a new weapon may be possible. And then you get six months to produce it, else it’s the Eastern front, first line: not really an exctiting prospect, so they kept hemming and hawing til the end.
    Further: the nuclear effort was, un-stereotipically, pretty disorganized. The SS had their program, the army another, and so on. Many grasping little bastards, all intent in carving out a slice of turf only for themselves: hardly a recipe for success.
    Lastly, consider that German industrial capacity was not even a shadow of what the US had available, so forget about any kind of success. It’s a miracle they managed to come up with the V2, and that had a horrible cost in human lives for no strategic advantage whatsoever.

  8. nomdeplume says

    “Heisenberg in the play — just working with the Nazis makes him distasteful to me”. Hmmm. But as you also note America was happy, indeed demanded to, import any German scientists that could help the US build nuclear weapons,

  9. says

    The more you look at [the Cass Report], the worse it gets

    True — I’m reading some quite laborious debunkings now. “The devil” really is in the details.

    Oh, and can we please stop calling this sort of bigoted reactionary anti-rational nonsense “neo-liberal?” It’s almost as bad as rebranding nazism as “neo-Judaism.”

  10. fergl says

    The only gender identity clinic in Scotland is no longer prescribing puberty blockers to 16 and 17 year olds after the “findings” of the Cass report.

  11. raven says

    This Cass Review isn’t really a review.
    It’s a Trans hate document written by Trans haters.
    I’m not the only one that has noticed it is full of lies and already there are analyses that say exactly that.

    The overall goal is just vicious.

    .1. The Review assumes that being Trans is a pathology or illness and should be treated as such.

    .2. The goals of her nonsensical treatment recommendations are to keep the actual number of Trans people as low as possible.
    If you look at her recommendations, it is clear she intends to identify Trans children as soon as possible and then somehow convince them that they aren’t Trans and don’t want to transition.

    She actually said that in her recent BBC interview.
    These Trans haters aren’t even trying to hide their hate any more.

    This is going to end up as an experiment in how far you can persecute and discriminate against Trans people until the wreckage of human beings being mistreated starts piling up and people notice.

  12. raven says

    This is from the earlier thread on the Cass Review.
    You can see what her plans are for Trans people by reading it.

    This is from a BBC interview with Hilary Cass.

    In essence, Dr Cass says children have been “let down” by a failure to base gender care on evidence-based research.

    “The reality is we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” she writes.

    This is just wrong and she is lying.
    We have hundreds of studies and decades of experience with treating Trans people.
    We don’t know everything but we know a lot.
    She is making the mistake that because we don’t know everything, we should do nothing.
    It’s not a mistake though, she is discarding 30 years worth of research and just ignoring it.

    Hilary Cass:
    Dr Cass repeats previous warnings there was no clear evidence on whether social transitioning had positive or negative mental health outcomes.

    Another lie.
    There are published studies on exactly this point. Here is one:

    Pediatrics. 2016 Mar; 137(3):

    Mental Health of Transgender Children Who Are Supported in Their Identities
    Kristina R. Olson, PhD,corresponding author Lily Durwood, BA, Madeleine DeMeules, BA, and Katie A. McLaughlin, PhD

    These findings suggest that familial support in general, or specifically via the decision to allow their children to socially transition, may be associated with better mental health outcomes among transgender children. In particular, allowing children to present in everyday life as their gender identity rather than their natal sex is associated with developmentally normative levels of depression and anxiety.

  13. raven says

    Here is Hilary Cass’s plan for Trans children.
    It is to minimize the number of Trans children and keep them from Transitioning to their identified gender.

    She says those who have done so at an earlier age, or before being seen by a clinic, were more likely to go down a medical pathway and that for most, such a path “will not be the best way to manage their gender-related distress”.

    She doesn’t know that.
    She has no data on these points whatsoever.
    It is simply as assertion without proof or data and may be dismissed without proof or data.

    You can see what her plan is here.
    .1. Identify young children who are Trans.
    .2. Prevent them from socially transitioning.
    .3. Keep children from going down the medical pathway, whatever that means.

    .4. Hilary Cass “….“will not be the best way to manage their gender-related distress”.
    So how will Hilary Cass manage childrens “gender-related distress” if it isn’t socially transitioning or medically?

    It’s not too clear here.
    My best guess is that they want or already have set up clinics to simply try and talk these children out of being Trans and Transitioning to their identified gender.
    It’s basically a form of conversion therapy.

    Will it work?
    Are they going to set up her demanded Randomized Clinical Trials and look at the outcomes? (No, of course not. These are hypocrites as well as hater.)
    I don’t know. I’m not in the UK.
    I suspect if her Children’s Trans Prevention Clinics cost money, the UK NHS might not bother with them. It’s not like the NHS has a lot of extra money lying around.

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