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batakali.bsky.social

@batakali.bsky.social
139 followers 37 following 7.1K posts
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batakali.bsky.social @batakali.bsky.social · 07/10/2026
Jolyon is the Grinch
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batakali.bsky.social @batakali.bsky.social · 04/10/2026
Can anyone name any novel that has given rise to a great truth?
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batakali.bsky.social @batakali.bsky.social · 28/09/2026
maybe you know each other?
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batakali.bsky.social @batakali.bsky.social · 25/09/2026
The counter to this made by many professionals is that it is rather ordinary that in a busy ward notes may be made some time later, such as at the end of a shift. And that asking a nurse to remember events of eight years ago is bound to lead to discrepancies, not dishonesties.
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batakali.bsky.social @batakali.bsky.social · 23/09/2026
There are certain people who dream of dying on Mars and they are more than welcome to.
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batakali.bsky.social @batakali.bsky.social · 23/09/2026
What was the most damning evidence againt Letby in your opinion?
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
You really are struggling.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
... resulting in low confidence in the outcomes. The studies in this review were not high quality studies meaning we cannot have confidence in what they tell us. Any questions?
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
Let me answer for you as you only have a masters degree. A high quality study is one where the design and execution can result in reliable results that we can have confidence in. A low quality study is likely to have design limitations and execution weaknesses that introduce biases, ...
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
You do not know what "quality" means in a study. Can you say?
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
That cat looks in desperate need of some Dreamies.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
You have no idea what you are talking about. You have never appraised a clinical study in your life and learned how to, and yet you have such strong opinions. What do we call people who do not know what they are talking abotu but have strong opinions nonetheless?
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
We do not let children make decisions that will harm them. We worry about the ethics of young adults making similarly bad decisions.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
I am sure bad example exist. But we try not to repeat them again. Or at least psychiatrist should not be repeating them again.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
You are totally wrong and clearly have no idea about appraising clinical trials. A pile of shit will never be anything other than a pile of shit. Collecting more shit does not transform it into gold.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
As such, a collection of low quality studies that show a positive effect... *** CANNOT BE TRUSTED ***. Read that again and again.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
The idea that "Multiple studies with moderate to low confidence that point to the same conclusions is very good evidence" is utter nonsense. Low quality medical studies almost always tend to showing a positive treatment effect when none exists or exagerating it when it does.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
Moderate to very low evidence is "very good evience". Really?
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
Well, if they cannot get a beauty upgrade, then they should try for a truth upgrade.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
Well there may be saspects of the syetmatic review that are done well - but that does not mean affirmative care is a good idea. FFS. The review correctly noted the evidence base was a dung heap.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
bsky.app/profile/bata...
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
You will never understand. Anything.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
And whether you can guess things like Andy or Andrew.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
Oh good grief.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
Claim 3 - Gender-affirming care has no important long-term harms: Not established at all. Claim 4 - Benefits outweigh harms for all/most adults seeking care: Not demonstrated by this review. As such, how can you make a clinical recommendation?
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
Let's break down the types of claim you might need to make to move to clinical policy from this study... Claim 1 - People who receive gender-affirming care often report improvement : Fairly reasonable support Claim 2 - Gender-affirming care causes those improvements: Much, much weaker support
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
The authors do what the ideologically motivated do by moving from evidence synthesis to clinical policy conclusion. That is a big no-no in this type of research.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
... where transgender individuals often display characteristics more aligned with their experienced gender identity than their natal sex. This is what scientists call "bullshit". There are no such good studies. That makes this review very suspect.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
I can see an AI summary and it is laughable. It claims: Neuroanatomical Studies have identified structural and functional differences in specific brain regions (such as the bed nucleus of the stria terminalis and white matter microstructures) ...
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
I'm afraid I cant access the paper. I suspect no-one here has read it. Can you?
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
Low quality means exacly "treat with a pinch of salt". You are pelading for us to accept total bollocks studies as definitive.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
You are at risk of failing your course in Evidence Based Medicine here.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
There are many other problems, such as the language of the paper differing from the language of the conclusions etc. Clear ideological spin is apparent. But you woudl never detect that because the conclusions are telling you what you want to hear.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
There are other serious concerns. The outcome selection is not necessarily neutral. Certain types of outcome were just not mesured, such as, - cardiovascular outcomes - bone health - metabolic effects - fertility - sexual function - long-term morbidity etc
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
- loss to follow-up - studies being designed primarily to detect benefits - rare adverse events being statistically difficult to detect. And the authors themselves identify these major evidence gaps. Claiming we think such treatments are safe is seriously irresponsbibel.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
The absence of detected harms can result from: - insufficient sample size - inadequate follow-up - inadequate measurement - selective outcome reporting
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
As for harms, saying "No studies identified significant negative outcomes or harms" is much weaker than it sounds. The studies may not have looked for types of harms. There is not positive evidence that no harms occur.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
So it would be misleading to say, "28 studies including four RCTs" as though there were four robust trials testing the effectiveness of medical transition. There weren't. That is bullshit. There was one RCT of hormone therapy within this evidence base. And that had its own problems.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
Of the higher quality RCTs, three evaluated psychosocial interventions; only one evaluated hormone therapy. And the authors judged the RCTs themselves to have some concerns or high risk of bias overall.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
4) A biggie: Attrition People who discontinue treatment or disappear from follow-up may differ systematically from those who remain. The review notes attrition as one of the problems affecting included studies. I expect this is a very big factor. People harmed do not go through follow up.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
3) Expectation/placebo effects Participants know what intervention they have received. This is especially relevant when outcomes are: wellbeing quality of life dysphoria body image mental health satisfaction. Subject give the expected answer rather than their true experiences.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
2) Selection effects People who obtain treatment may differ systematically from people who don't. They might have: better social support greater financial resources greater stability better access to healthcare different psychiatric profiles greater confidence about their decision.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
1) Regression to the mean People may seek treatment when distress is particularly high. If you measure them at that point and then measure them later, some improvement might occur naturally even without treatment.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
There may be better explanations of the outcomes seen other than "gender affirming care works".
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
The 24 uncontrolled before/after studies are a major weakness Of the 28 outcome studies: 4 were RCTs. 24 were uncontrolled before/after studies. And the authors explicitly judged those uncontrolled studies to have "serious to critical risk of bias." Devastating for making strong conclusions,
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
The authors do separate interventions in parts of the analysis, but the headline conclusion is about gender-affirming care as a whole. That's problematic from an evidence-synthesis perspective. We have no idea which interventions to apply safely and effectively.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
The many interventions such as - testosterone - oestrogen/anti-androgens - mastectomy - vaginoplasty - phalloplasty - breast augmentation - facial surgery - voice therapy - psychotherapy are all categorised as gender-affirming care. Some of these might be low or high risk. Some may give benefits
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
The biggest problem: "gender-affirming care" is not one intervention. The paper treats an enormous variety of interventions under a single conceptual umbrella. However, each may have benefits and harms. This paper tells us nothing about this.
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
There were no high quality studies from which you could pull confident clinical recommendations. There are so many problems with this review? Woudl you like a free university class?
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batakali.bsky.social @batakali.bsky.social · 22/09/2026
You are making the common mistake of thinking that if the available evidence suggests a successful treatment then we should use it **even if the quality of that evidence is total junk**. That is what activists do, not scientists.
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