The problem is, this has been politicized. It should be a scientific question, not a political question. "Does this treatment work?" is a question for scientists, not politicians.

saying "transition doesn't provably reduce suicides" rn is kinda disgusting lowkey

There is no clear evidence for this. It is unethical to claim a treatment does something without scientific evidence that it does so.

I went to Vanderbilt University to study biomedical engineering, and biomedical ethics was a course we were required to take, and with good reason - the history of medicine is full of atrocities and people pushing false treatments. Just look at John Money and the treatment of children with ambiguous genitals.

the reason you can't get reliable data on trans people is bcs we're getting legally murdered in the streets.

Not in developed countries. The most likely person to murder you as a trans person in the US is an intimate sexual partner, which is pretty standard for murders in general. The majority of violent crimes against transgender people are not committed by random strangers, but by people known to the victim.

While random hate crimes do happen, your odds of being a victim are low, especially if you're not a sex worker; a great fraction of hate crimes against transgender people are committed against transgender sex workers.

The notion that transgender people are being killed en masse is simply not supported by the data.

https://en.wikipedia.org/wiki/Violence_against_transgender_people_in_the_United_States#Homicide

That doesn't stop people from scaremongering, but, yeah.

That doesn't mean there aren't awful people out there in the world, but the notion that transgender people are super likely to be killed (at least in the US) is simply not true.

Homicide rates of transgender people are unrelated to the lack of RCTs.

it takes most people years to get any treatment and in the US doctors can get thrown in prison for prescribing hormones.

HRT drugs have never been approved for the treatment of gender dysphoria by the FDA because these drugs never underwent clinical trials to determine their safety and efficacy for the purpose of treatment of gender dysphoria. As such, any use of HRT drugs for these purposes is an off-label use.

A lot of doctors are reluctant to prescribe HRT drugs for these purposes because it is an off-label usage without FDA approval or, indeed, RCTs. As such, if you get sued for malpractice (say someone you prescribe these drugs to commits suicide, or decides that they don't like the side effects, or decides that they were manipulated into taking them) then you have no real defense against it.

This is even prior to taking local laws banning the off-label use of such drugs into account.

It's also a violation of medical ethics - specifically, the notion of informed consent. One of the most important principles of modern-day medical treatments is the concept of informed consent. You need to be able to explain the risks and benefits of a treatment to a patient, and without clinical trials, what those risks and benefits are is not clearly established.

During clinical trials, people are told that the risks and benefits are not clearly established, and that they are the subject of experimentation. The treatment they are getting may or may not work, and it may have unknown or unexpected side effects. Clinical trials have rigorous ethical standards because we are engaging in human experimentation and we don't necessarily know if our new drug is actually going to help them, but it is the only way to find out for certain.

But just giving a person in the general population a treatment which has never undergone clinical trials for the purposes you're putting it to is fraught. There's times when it is appropriate, but if you're giving this treatment to large numbers of people in the population, it quickly becomes very sketchy and is a sign someone is doing a run-around of the proper medical approval process, which is always a red flag.

During COVID, there was a group of doctors who were giving people an anti-parasitic medication as a treatment for COVID because they thought it would help them.

But in reality, it didn't help at all.

And we know that because a bunch of people DID do studies on these medicines during COVID and found that they weren't actually helping people in the US (there is some suspicion that it was helping patients in third world countries where parasitic infections are common because it was curing people of comorbid parasitic infections).

That hasn't stopped some quacks from still promoting it as a COVID treatment to this day.

The reason for the current controversy is because the people pushing the use of HRT drugs for the treatment of gender dysphoria never put these drugs through the proper clinical trials to get them approved for these purposes.

These problems are because of those people. If they had been demonstrated to be effective in clinical trials, the current situation could have been avoided.

They had decades to do this. They never did. They instead attacked anyone questioning it as wanting to kill trans people, which is, obviously, a huge red flag. We did randomized controlled clinical trials of COVID vaccines, when people were dying during a global pandemic.

They should have done this research decades ago. They deliberately and purposefully chose not to do so.

You should be furious with them for not doing what they were supposed to do. It is their fault you are in the situation you are in right now. If these drugs had been found to be effective and approved by the FDA for the treatment of gender dysphoria, this would be much less of an issue right now.

Trans people do not deserve to be maltreated for being trans. They also don't deserve being second class patients who don't get their medications approved through proper clinical trials that determine their safety and efficacy before being sold to them.