Can a child legally take puberty blockers? What if their parents disagree?
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Young people’s access to gender-affirming medical care has been making headlines this week.
Today, federal Health Minister Mark Butler announced a review into health care for trans and gender-diverse children and adolescents. The National Health and Medical Research Council will conduct the review.
Yesterday, The Australian published an open letter to Prime Minister Anthony Albanese calling for a federal inquiry, and a nationwide pause on puberty blockers and hormone therapy for minors.
This followed Queensland Health Minister Tim Nicholls earlier this week announcing an immediate pause on access to puberty blockers and hormone therapies for new patients under 18 in the state’s public health system, pending a review.
In the United States, President Donald Trump signed an executive order this week directing federal agencies to restrict access to gender-affirming care for anyone under 19.
This recent wave of political attention might imply gender-affirming care for young people is risky, controversial, perhaps even new.
But Australian courts have already extensively tested questions about its legitimacy, the conditions under which it can be provided, and the scope and limits of parental powers to authorise it.
What are puberty blockers?
Puberty blockers suppress the release of oestrogen and testosterone, which are primarily responsible for the physical changes associated with puberty. They are generally safe and used in paediatric medicine for various conditions, including precocious (early) puberty, hormone disorders and some hormone-sensitive cancers.
International and domestic standards of care state that puberty blockers are reversible, non-harmful, and can prevent young people from experiencing the distress of undergoing a puberty that does not align with their gender identity. They also give young people time to develop the maturity needed to make informed decisions about more permanent medical interventions further down the line.
Puberty blockers are one type of gender-affirming care. This care includes medical, psychological and social interventions to support transgender, gender-diverse and, in some cases, intersex people.
Young people in Australia need a medical diagnosis of gender dysphoria to receive this care. Gender dysphoria is defined as the psychological distress that can arise when a person’s gender identity does not align with their sex assigned at birth. This diagnosis is only granted after an exhaustive and often onerous medical assessment.
After a diagnosis, treatment may involve hormones such as oestrogen or testosterone and/or puberty-blocking medications.
Hormone therapies involving oestrogen and testosterone are only prescribed in Australia once a young person has been deemed capable of giving informed consent, usually around the age of 16. For puberty blockers, parents can consent at a younger age.
Can a child legally access puberty blockers?
Gender-affirming care has been the subject of extensive debate in the Family Court of Australia (now the Federal Circuit and Family Court).
Between 2004 and 2017, every minor who wanted to access gender-affirming care had to apply for a judge to approve it. However, medical professionals, human rights organisations and some judges condemned this process.
In research for my forthcoming book, I found the Family Court has heard at least 99 cases about a young person’s gender-affirming care since 2004. Across these cases, the court examined the potential risks of gender-affirming treatment and considered whether parents should have the authority to consent on their child’s behalf.
When determining whether parents can consent to a particular medical procedure for their child, the court must consider whether the treatment is “therapeutic” and whether there is a significant risk of a wrong decision being made.
However, in a landmark 2017 case, the court ruled that judicial oversight was not required because gender-affirming treatments meet the standards of normal medical care.
It reasoned that because these therapies address an internationally recognised medical condition, are supported by leading professional medical organisations, and are backed by robust clinical research, there is no justification for treating them differently from any other standard medical intervention. These principles still stand today.
What if parents disagree?
Sometimes parents disagree with decisions about gender-affirming care made by their child, or each other.
As with all forms of health care, under Australian law, parents and legal guardians are responsible for making medical decisions on behalf of their children. That responsibility usually shifts once those children reach a sufficient age and level of maturity to make their own decisions.
However, in another landmark case in 2020, the court ruled gender-affirming treatments cannot be given to minors without consent from both parents, even if the child is capable of providing their own consent. This means that if there is any disagreement among parents and the young person about either their capacity to consent or the legitimacy of the treatment, only a judge can authorise it.
In such instances, the court must assess whether the proposed treatment is in the child’s best interests and make a determination accordingly. Again, these principals apply today.
Have the courts ever denied care?
Across the at least 99 cases the court has heard about gender-affirming care since 2004, 17 have involved a parent opposing the treatment and one has involved neither parent supporting it.
Regardless of parental support, in every case, the court has been responsible for determining whether gender-affirming treatment was in the child’s best interests. These decisions were based on medical evidence, expert testimony, and the specific circumstances of the young person involved.
In all cases bar one, the court has found overwhelming evidence to support gender-affirming care, and approved it.
Supporting transgender young people
The history of Australia’s legal debates about gender-affirming care shows it has already been the subject of intense legal and medical scrutiny.
Gender-affirming care is already difficult for young people to access, with many lacking the parental support required or facing other barriers to care.
Gender-affirming care is potentially life-saving, or at the very least life-affirming. It almost invariably leads to better social and emotional outcomes. Further restricting access is not the “protection” its opponents claim.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. For LGBTQIA+ peer support and resources, you can also contact Switchboard, QLife (call 1800 184 527), Queerspace, Transcend Australia (support for trans, gender-diverse, and non-binary young people and their families) or Minus18 (resources and community support for LGBTQIA+ young people).
Matthew Mitchell, Lecturer in Criminology, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Beat Sugar Addiction Now! – by Dr. Jacob Teitelbaum & Chrystle Fiedler
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Sugar isn’t often thought of as an addiction in the same category as alcohol or nicotine, but it’s actually very similar in some ways…
A bold claim, but: in each case, it has to do with dopamine responses to something that has:
- an adverse effect on our health,
- a quickly developed tolerance to same,
- and unpleasant withdrawal symptoms when quitting.
However, not all sugar addictions are created equal, and Dr. Teitelbaum lays four different types of sugar addiction out for us:
- Most related to “I need to perform and I need to perform now”
- Most related to “I just need something to get me through one more stressful day, again, just like every day before it”
- Most related to “ate too much sugar because of the above, and now a gut overgrowth of C. albicans is at the wheel”
- Most related to “ate too much sugar because of the above, and now insulin resistance is a problem that perpetuates itself too”
Of course, these may overlap, and indeed, they tend to stack cumulatively as time goes by.
However, Dr. Teitelbaum notes that as readers we may recognize ourselves as being at a particular point in the above, and there are different advices for each of them.
You thought it was just going to be about going cold turkey? Nope!
Instead, a multi-vector approach is recommended, including adjustments to sleep, nutrition, immune health, hormonal health, and more.
In short: if you’ve been trying to to kick the “White Death” habit as Gloria Swanson called it (sugar, that is, not the WW2 Finnish sniper of the same name—we can’t help you with that one), then this book is really much more helpful than others that take the “well, just don’t eat it, then” approach!
Pick up your copy of Beat Sugar Addiction Now from Amazon, and start your journey!
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How To Avoid Carer Burnout (Without Dropping Care)
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How To Avoid Carer Burnout
Sometimes in life we find ourselves in a caregiving role.
Maybe we chose it. For example, by becoming a professional carer, or even just by being a parent.
Oftentimes we didn’t. Sometimes because our own parents now need care from us, or because a partner becomes disabled.
Philosophical note: an argument could be made for that latter also having been a pre-emptive choice; we probably at some point said words to the effect of “in sickness and in health”, hopefully with free will, and hopefully meant it. And of course, sometimes we enter into a relationship with someone who is already disabled.
But, we are not a philosophy publication, and will henceforth keep to the practicalities.
First: are you the right person?
Sometimes, a caregiving role might fall upon you unasked-for, and it’s worth considering whether you are really up for it. Are you in a position to be that caregiver? Do you want to be that caregiver?
It may be that you do, and would actively fight off anyone or anything that tried to stop you. If so, great, now you only need to make sure that you are actually in a position to provide the care in question.
It may be that you do want to, but your circumstances don’t allow you to do as good a job of it as you’d like, or it means you have to drop other responsibilities, or you need extra help. We’ll cover these things later.
It may be that you don’t want to, but you feel obliged, or “have to”. If that’s the case, it will be better for everyone if you acknowledge that, and find someone else to do it. Nobody wants to feel a burden, and nobody wants someone providing care to be resentful of that. The result of such is two people being miserable; that’s not good for anyone. Better to give the job to someone who actually wants to (a professional, if necessary).
So, be honest (first with yourself, then with whoever may be necessary) about your own preferences and situation, and take steps to ensure you’re only in a caregiving role that you have the means and the will to provide.
Second: are you out of your depth?
Some people have had a life that’s prepared them for being a carer. Maybe they worked in the caring profession, maybe they have always been the family caregiver for one reason or another.
Yet, even if that describes you… Sometimes someone’s care needs may be beyond your abilities. After all, not all care needs are equal, and someone’s condition can (and more often than not, will) deteriorate.
So, learn. Learn about the person’s condition(s), medications, medical equipment, etc. If you can, take courses and such. The more you invest in your own development in this regard, the more easily you will handle the care, and the less it will take out of you.
And, don’t be afraid to ask for help. Maybe the person knows their condition better than you, and certainly there’s a good chance they know their care needs best. And certainly, there are always professionals that can be contacted to ask for advice.
Sometimes, a team effort may be required, and there’s no shame in that either. Whether it means enlisting help from family/friends or professionals, sometimes “many hands make light work”.
Check out: Caregiver Action Network: Organizations Near Me
A very good resource-hub for help, advice, & community
Third: put your own oxygen mask on first
Like the advice to put on one’s own oxygen mask first before helping others (in the event of a cabin depressurization in an airplane), the rationale is the same here. You can’t help others if you are running on empty yourself.
As a carer, sometimes you may have to put someone else’s needs above yours, both in general and in the moment. But, you do have needs too, and cannot neglect them (for long).
One sleepless night looking after someone else is… a small sacrifice for a loved one, perhaps. But several in a row starts to become unsustainable.
Sometimes it will be necessary to do the best you can, and accept that you cannot do everything all the time.
There’s a saying amongst engineers that applies here too: “if you don’t schedule time for maintenance, your equipment will schedule it for you”.
In other words: if you don’t give your body rest, your body will break down and oblige you to rest. Please be aware this goes for mental effort too; your brain is just another organ.
So, plan ahead, schedule breaks, find someone to take over, set up your cared-for-person with the resources to care for themself as well as possible (do this anyway, of course—independence is generally good so far as it’s possible), and make the time/effort to get you what you need for you. Sleep, distraction, a change of scenery, whatever it may be.
Lastly: what if it’s you?
If you’re reading this and you’re the person who has the higher care needs, then firstly:all strength to you. You have the hardest job here; let’s not forget that.
About that independence: well-intentioned people may forget that, so don’t be afraid to remind them when “I would prefer to do that myself”. Maintaining independence is generally good for the health, even if sometimes it is more work for all concerned than someone else doing it for you. The goal, after all, is your wellbeing, so this shouldn’t be cast aside lightly.
On the flipside: you don’t have to be strong all the time; nobody should.
Being disabled can also be quite isolating (this is probably not a revelation to you), so if you can find community with other people with the same or similar condition(s), even if it’s just online, that can go a very, very long way to making things easier. Both practically, in terms of sharing tips, and psychologically, in terms of just not feeling alone.
See also: How To Beat Loneliness & Isolation
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Hashimoto’s Food Pharmacology – by Dr. Izabella Wentz
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The author is a doctor of pharmacology, and we’ve featured her before as an expert on Hashimoto’s, which she has. She has recommendations about specific blood tests and medications, but in this book she’s mainly focussing on what she calls the “three Rs” of managing hypothyroidism:
- Remove the causes and triggers of your hypothyroidism, so far as possible
- Repair the damage caused to your body, especially your gut
- Replace the thyroid hormones and related things in which your body has become deficient
To this end, she provides recipes that avoid processed meats and unfermented dairy, and include plenty of nutrient-dense whole foods specifically tailored to meet the nutritional needs of someone with hypothyroidism.
A nice bonus of the presentation of recipes (of which there are 125, if we include things like “mint tea” and “tomato sauce” and “hot lemon water” as recipes) is explaining the thyroid-supporting elements of each recipe.
A downside for some will be that if you are vegetarian/vegan, this book is very much not, and since many recipes are paleo-style meat dishes, substitutions will change the nutritional profile completely.
Bottom line: if you have hypothyroidism (especially if: Hashimoto’s) and like meat, this will be a great recipe book for you.
Click here to check out Hashimoto’s Food Pharmacology, and get cooking!
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No, beetroot isn’t vegetable Viagra. But here’s what else it can do
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Beetroot has been in the news for all the wrong reasons. Supply issues in recent months have seen a shortage of tinned beetroot on Australian supermarket shelves. At one point, a tin was reportedly selling on eBay for more than A$65.
But as supplies increase, we turn our attention to beetroot’s apparent health benefits.
Is beetroot really vegetable Viagra, as UK TV doctor Michael Mosley suggests? What about beetroot’s other apparent health benefits – from reducing your blood pressure to improving your daily workout? Here’s what the science says.
What’s so special about beetroot?
Beetroot – alongside foods such as berries, nuts and leafy greens – is a “superfood”. It contains above-average levels per gram of certain vitamins and minerals.
Beetroot is particularly rich in vitamin B and C, minerals, fibre and antioxidants.
Most cooking methods don’t significantly alter its antioxidant levels. Pressure cooking does, however, lower levels of carotenoid (a type of antioxidant) compared to raw beetroot.
Processing into capsules, powders, chips or juice may affect beetroot’s ability to act as an antioxidant. However, this can vary between products, including between different brands of beetroot juice.
Is beetroot really vegetable Viagra?
The Romans are said to have used beetroot and its juice as an aphrodisiac.
But there’s limited scientific evidence to say beetroot improves your sex life. This does not mean it doesn’t. Rather, the vast number of scientific studies looking at the effect of beetroot have not measured libido or other aspects of sexual health.
How could it work?
When we eat beetroot, chemical reactions involving bacteria and enzymes transform the nitrate in beetroot into nitrite, then to nitric oxide. Nitric oxide helps dilate (widen) blood vessels, potentially improving circulation.
The richest sources of dietary nitric oxide that have been tested in clinical studies are beetroot, rocket and spinach.
Nitric oxide is also thought to support testosterone in its role in controlling blood flow before and during sex in men.
Beetroot’s ability to improve blood flow can benefit the circulatory system of the heart and blood vessels. This may positively impact sexual function, theoretically in men and women.
Therefore, it is reasonable to suggest there could be a modest link between beetroot and preparedness for sex, but don’t expect it to transform your sex life.
What else could it do?
Beetroot has received increasing attention over recent years due to its antioxidant and anti-tumour effect in humans.
Clinical trials have not verified all beetroot’s active ingredients and their effects. However, beetroot may be a potentially helpful treatment for various health issues related to oxidative stress and inflammation, such as cancer and diabetes. The idea is that you can take beetroot supplements or eat extra beetroot alongside your regular medicines (rather than replace them).
There is evidence beetroot juice can help lower systolic blood pressure (the first number in your blood pressure reading) by 2.73-4.81 mmHg (millimetres of mercury, the standard unit of measuring blood pressure) in people with high blood pressure. Some researchers say this reduction is comparable to the effects seen with certain medications and dietary interventions.
Other research finds even people without high blood pressure (but at risk of it) could benefit.
Beetroot may also improve athletic performance. Some studies show small benefits for endurance athletes (who run, swim or cycle long distances). These studies looked at various forms of the food, such as beetroot juice as well as beetroot-based supplements.
How to get more beetroot in your diet
There is scientific evidence to support positive impacts of consuming beetroot in whole, juice and supplement forms. So even if you can’t get hold of tinned beetroot, there are plenty of other ways you can get more beetroot into your diet. You can try:
- raw beetroot – grate raw beetroot and add it to salads or coleslaw, or slice beetroot to use as a crunchy topping for sandwiches or wraps
- cooked beetroot – roast beetroot with olive oil, salt and pepper for a flavour packed side dish. Alternatively, steam beetroot and serve it as a standalone dish or mixed into other dishes
- beetroot juice – make fresh beetroot juice using a juicer. You can combine it with other fruits and vegetables for added flavour. You can also blend raw or cooked beetroot with water and strain to make a juice
- smoothies – add beetroot to your favourite smoothie. It pairs well with fruits such as berries, apples and oranges
- soups – use beetroot in soups for both flavour and colour. Borscht is a classic beetroot soup, but you can also experiment with other recipes
- pickled beetroot – make pickled beetroot at home, or buy it from the supermarket. This can be a tasty addition to salads or sandwiches
- beetroot hummus – blend cooked beetroot into your homemade hummus for a vibrant and nutritious dip. You can also buy beetroot hummus from the supermarket
- grilled beetroot – slice beetroot and grill it for a smoky flavour
- beetroot chips – slice raw beetroot thinly, toss the slices with olive oil and your favourite seasonings, then bake or dehydrate them to make crispy beetroot chips
- cakes and baked goods – add grated beetroot to muffins, cakes, or brownies for a moist and colourful twist.
You can add beetroot to baked goods. Ekaterina Khoroshilova/Shutterstock Are there any downsides?
Compared to the large number of studies on the beneficial effects of beetroot, there is very little evidence of negative side effects.
If you eat large amounts of beetroot, your urine may turn red or purple (called beeturia). But this is generally harmless.
There have been reports in some countries of beetroot-based dietary supplements contaminated with harmful substances, yet we have not seen this reported in Australia.
What’s the take-home message?
Beetroot may give some modest boost to sex for men and women, likely by helping your circulation. But it’s unlikely to transform your sex life or act as vegetable Viagra. We know there are many contributing factors to sexual wellbeing. Diet is only one.
For individually tailored support talk to your GP or an accredited practising dietitian.
Lauren Ball, Professor of Community Health and Wellbeing, The University of Queensland and Emily Burch, Lecturer, Southern Cross University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Walnuts vs Brazil Nuts – Which is Healthier?
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Our Verdict
When comparing walnuts to Brazil nuts, we picked the walnuts.
Why?
Talking macros first, they are about equal in protein, carbs, fats, and fiber; their composition is almost identical in this regard. However, looking a little more closely at the fats, Brazil nuts have more than 2x the saturated fat, while walnuts have nearly 2x the polyunsaturated fat. So, we’ll declare the macros category a moderate win for walnuts.
The category of vitamins is not balanced; walnuts have more of vitamins A, B2, B3, B5, B6, B9, C, and choline, while Brazil nuts have more of vitamins B1 and E. A clear and easy win for walnuts.
The category of minerals is interesting, because of one mineral in particular. First let’s mention: walnuts have more iron and manganese, while Brazil nuts have more calcium, copper, magnesium, phosphorus, potassium, and selenium. Taken at face value, this is a clear win for Brazil nuts. However…
About that selenium… Specifically, it’s more than 391x higher, and a cup of Brazil nuts would give nearly 10,000x the recommended daily amount of selenium. Now, selenium is an essential mineral (needed for thyroid hormone production, for example), and at the RDA it’s good for good health. Your hair will be luscious and shiny. However, go much above that, and selenium toxicity becomes a thing, you may get sick, and it can cause your (luscious and shiny) hair to fall out. For this reason, it’s recommended to eat no more than 3–4 Brazil nuts per day.
There is one last consideration, and this is oxalates; walnuts are moderately high in oxalates (>50mg/100g) while Brazil nuts are very high in oxalates (>500mg/100g). This won’t affect most people at all, but if you have pre-existing kidney problems (including a history of kidney stones), you might want to go easy on oxalate-containing foods.
For most people, however, walnuts are a very healthy choice, and outshine Brazil nuts in most ways.
Want to learn more?
You might like to read:
Why You Should Diversify Your Nuts
Take care!
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How To Rebuild Your Neurons’ Myelin Sheaths
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PS: We Love You
Phosphatidylserine, or “PS” for short, is a phospholipid found in the brain. In other words, a kind of fatty compound that is such stuff as our brains are made of.
In particular, it’s required for healthy nerve cell membranes and myelin (the protective sheath that neurons live in—basically, myelin sheaths do for neurons what telomere caps do for DNA).
For an overview that’s more comprehensive than we have room for here, check out:
Phosphatidylserine and the human brain
Many people take it as a supplement.
Does taking it as a supplement work?
This is a valid question, as a lot of supplements can’t be absorbed well, and/or can’t pass the blood-brain barrier. But, as the above-linked study notes:
❝Exogenous PS (300-800 mg/d) is absorbed efficiently in humans, crosses the blood-brain barrier, and safely slows, halts, or reverses biochemical alterations and structural deterioration in nerve cells. It supports human cognitive functions, including the formation of short-term memory, the consolidation of long-term memory, the ability to create new memories, the ability to retrieve memories, the ability to learn and recall information, the ability to focus attention and concentrate, the ability to reason and solve problems, language skills, and the ability to communicate. It also supports locomotor functions, especially rapid reactions and reflexes.❞
(“Exogenous” means “coming from outside of the body”, as opposed to “endogenous”, meaning “made inside the body”. Effectively, in this context “exogenous” means “taken as a supplement”.)
Why do people take it?
The health claims for phosphatidylserine fall into two main categories:
- Neuroprotection (helping your brain to avoid age-related decline in the long term)
- Cognitive enhancement (helping your brain work better in the short term)
What does the science say?
There’s a lot of science that’s been done on the neuroprotective properties of PS, and there are thousands of studies we could draw from here. The upshot is that regular phosphatidylserine supplementation (most often 300mg/day, but studies are also found for 100–500mg/day) is strongly associated with a reduction in cognitive decline over the course of 12 weeks (a common study duration). Here are a some spotlight studies showing this:
- Effects of phosphatidylserine in Alzheimer’s disease
- Double-blind cross-over study of phosphatidylserine vs. placebo in patients with early dementia of the Alzheimer type
- Effect of Phosphatidylserine on Cerebral Glucose Metabolism in Alzheimer’s Disease
- The effect of soybean-derived phosphatidylserine on cognitive performance in elderly with subjective memory complaints
Note: PS can be derived from various sources, with the two most common forms being bovine (i.e., from cow brains) or soy-derived.
There is no established difference in the efficacy of these.
There have been some concerns raised about the risk of CJD (the human form of BSE, as in “mad cow disease”) from consuming brain matter from cows, but studies have not found any evidence of this actually happening.
There is also some evidence that phosphatidyserine significantly boosts cognitive performance, even in young people with no extant cognitive decline, for example:
(as the title suggests, they did also test for its effect on mood and endocrine response, but found it made no difference to those, just the cognitive function—which enjoyed a boost before exercise, as well as after it, meaning that the boost wasn’t dependent on the exercise)
PS for cognitive enhancement in the young and healthy is not nearly so well-explored as its use as a later-life guard against age-related cognitive decline. However, just because the studies in younger people are dwarfed in number by the studies in older people, doesn’t detract from the validity of the studies in younger people.
Basically: its use in older people has been studied the most, but all available evidence points to it being beneficial to brain health at all ages.
Where can we get it?
We don’t sell it (or anything else), but for your convenience, here’s an example product on Amazon.
Enjoy!
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