One of a number of things around gender identity ideology unravelling in the UK at the moment. I’ll preface this post with stating clearly that the problem here is not trans people, but the gender identity activism which has forced so many changes on society without adequate examination. In this case, it’s the surgical and hormonal treatment of children. From the Times on Friday,
The health secretary thinks the system is “failing children” and is planning an overhaul of how health service staff deal with under-18s who question their gender identity.
Javid is understood to have likened political sensitivities over gender dysphoria to the fears of racism in Rotherham over grooming gangs.
(The Rotherham reference is to a child sexual abuse scandal in the UK that ran for years because of sexism, and the fears of people in positions of power too afraid to talk about the perpetrators who were from an ethnic minority).
The context for Javid’s announcement,
- the number of children presenting at gender clinics in the UK has increased exponentially in the past decade.
- this includes a substantial increase in gender non-conforming girls being referred.
- the clinics, and wider NHS, GP, and psychology/psychiatric services have used, or been forced to use, the ‘affirmation only’ approach advocated by gender identity lobbyists and activists. This is the practice of affirming a child’s verbal expression of their gender identity. If a boy says the are a girl, or a girl says they are boy, then they are to be believed and treated as if this is real and permanent.
- Affirmation only has meant that other issues the child may be dealing with have been ignored or inadequately addressed eg sexual or physical abuse, eating disorders, depression, mental illness, the physical and emotional distress of puberty, and the increasing societal pressures to be gender conforming (including sexism and misogyny leading to girls believing their lives would be better if they were boys). A significant number of the children are autistic.
- Instead of looking at the whole child and their environment, affirmation only narrows treatment options to the single path of transition. Social transition, hormonal treatments (puberty blockers, and later cross sex hormones), and eventual surgery.
Whistleblower Sue Evans, a nurse at Gender Identity Development Service at the Tavistock and Portman NHS Trust in London, first raised concerns in 2004 about the fast tracking of GNC children into medical and surgical treatment. She was ignored and left the service.
When Evans started at the Tavistock in 2003, she was “proud to be working in a tiny team at a pioneering organisation”. But on hearing a colleague describe how, after only a few assessments, they had referred a distressed 16-year-old boy who thought of himself as female for hormone treatment, her “jaw dropped”. She recalls feeling “something was very, very wrong with the GIDS approach”.
In her early years as a psychiatric nurse, she had witnessed treatments, such as electroconvulsive therapy, that are now widely condemned: “I know enough of the history of psychiatry to always be cautious about intervention.”
Evans had assumed she would be able to use her psychotherapeutic skills to support the scores of children referred each year. When she raised the possibility of alternatives to medication, Evans was advised the service would not have any patients without the offer of puberty blockers. Last year, GIDS had 2,590 children referred for them, compared with 77 patients a decade ago.
(it’s generally accepted that a small number of children may need medical intervention, but that most need other kinds of support until they mature enough to make decisions about medical pathway treatments. There’s a lot of debate about the research, and we probably don’t have enough yet, but there are studies that show that most children/teens who say they are the opposite sex later desist and continue life as their biological sex).
In the intervening years mostly women, often grass roots, have been working hard to get the issue looked at. Many women who do this work publicly face abuse, threats, and doxing, and risk job and career loss.
Detrans women (who transitioned as girls, but later regretted this or realised their gender dysphoria was still the same) have been organising and lobbying. Often under intense social pressure to stfu from trans activists and allies, their cause has been marginalised by rhetoric of them being very small in number, or that they weren’t really trans in the first place, or they were trans and didn’t have enough support so they’re not really detrans. GIDS don’t provide services for detrans children/teens.
Keira Bell was referred to GIDS at 15 and put on puberty blockers when she was 16. The following year she was given the cross sex hormone testosterone, and when she was 20 she had a double mastectomy,
But the further my transition went, the more I realized that I wasn’t a man, and never would be. We are told these days that when someone presents with gender dysphoria, this reflects a person’s “real” or “true” self, that the desire to change genders is set. But this was not the case for me. As I matured, I recognized that gender dysphoria was a symptom of my overall misery, not its cause.
Five years after beginning my medical transition to becoming male, I began the process of detransitioning. A lot of trans men talk about how you can’t cry with a high dose of testosterone in your body, and this affected me too: I couldn’t release my emotions. One of the first signs that I was becoming Keira again was that—thankfully, at last—I was able to cry. And I had a lot to cry about.
The consequences of what happened to me have been profound: possible infertility, loss of my breasts and inability to breastfeed, atrophied genitals, a permanently changed voice, facial hair. When I was seen at the Tavistock clinic, I had so many issues that it was comforting to think I really had only one that needed solving: I was a male in a female body. But it was the job of the professionals to consider all my co-morbidities, not just to affirm my naïve hope that everything could be solved with hormones and surgery.
Bell took Tavistock and Portman NHS Foundation Trust(who run GIDS) to Judicial Review in front of three high court judges in 2020, arguing that the Trust had failed to protect children and teens and that its practice was essentially and experiment. The judges found in Bell’s favour unanimously. (PDF of judgement). Bell gives an explanation of this and the wider culture here.
Of particular note is that GIDS weren’t keeping records of what they were doing and weren’t doing adequate follow up.
Another group that has been working to get this issue addressed is parents. Seven years ago Stephanie Davies-Arai set up Transgender Trend, an organisation of parents, professionals and academics looking at issues of self-ID, ROGD (rapid onset gender dysphoria often associated with social contagion on social media), legislative and social changes affecting girls and young women in regards to sex and gender. The website is a clearing house for the various and interlocking issues, and it’s been instrumental in presenting information and analysis that most of the mainstream media ignored for many years.
One of the consequences of the Bell case, and gender critical activism, has been the Cass Review, an independent review commissioned by the NHS which released its interim report in February. From the Observer’s editorial statement on on gender identity services for children,
The Cass review’s interim report finds children with gender identity issues are ill served by adults who shut down debate
The report highlights a profound lack of evidence and medical consensus about the best approach to treating gender dysphoria in children.
This report has led to the UK government to launch the urgent inquiry, which is to be integrated into the ongoing Cass Review. From Transgender Trend’s response to the announcement,
The Times reports that Javid is also preparing legal changes that would give Hilary Cass access to an NHS database of children treated by the service to see how many later regretted taking puberty-blockers and cross-sex hormones.
The politicisation of a childhood condition and adolescent identity development has led to catastrophic failings in the health system’s duty of care to children. An ideological system based on faith rather than facts and evidence has led to numerous children and young people being harmed irreversibly by the medical profession. The independent Cass Review has shone a light on a medical experiment on children that was previously obscured by dogma and an adult political agenda.
The consequences of giving one group of diverse children the simplistic political label ‘transgender’ has led to an unquestioning acceptance of a child’s self-diagnosis by the health profession and a complete abdication of duty to provide normal standards of paediatric care. We are grateful that Sajid Javid has listened to Cass and we hope that the days of listening to activist groups on the subject of healthcare for children are well and truly over.
The question here is why GIDS has such complete ideological capture. This is another whole post, which rests largely on why progressives have uncritically adopted gender identity ideology and the degree to which well funded lobbyists have been successful (especially Stonewall UK and Mermaids).
Of particular concern here is the No Debate position taken by gender identity activists. This has been phenomenally successful at shutting down debate, in large part by attacking people who speak up, calling them bigots and using social media and other social pressures to marginalise and deter them. This includes within many institutions in the UK, where academics and medical professionals are afraid to say anything other than the gender ideology lines. The people that have broken that have faced extreme pressure, abuse, “shocking levels of vilification and attempts to undermine their professional integrity” and sometimes lost their jobs. The left has largely sat by and let this happen, where it wasn’t been actively endorsing and supporting it.
If women in particular had been free to raise concerns and we had had the debates on the left, then the problems with organisations like GIDS would have been addressed in the first years. It’s taken nearly 20 years to blow this open enough for appropriate institutions to begin to mend what has happened, and I expect it will take a number of more years due to the ideological capture and the less powerful but still functional No Debate.
I don’t know the state of play in New Zealand with affirmation only (no doubt there will be comments and links below on this). I do know that No Debate functions here as well, that the left is largely complicit in this, and that we still don’t have the freedom to debate without censure or risk. The government has at least twice done major legislative and policy changes where it explicitly didn’t consult women’s groups, and no platforming has attempted to shut down public meetings. The government appears intent on replacing sex with gender identity as the default within policy and legislation. People are afraid to speak out, and the Greens and Labour have inhibited debate within their parties.
These are complex issues. Obviously transgender people need protection and their human rights upheld just like everyone else. I trust gender critical feminists and detrans women as the groups that will work for the rights and wellbeing of both trans and women, while large parts of the left hold to the idea that women are bigots if they talk about a conflict of rights. I also at this point trust the UK tory government more than I do UK Labour/Greens or NZ Labour/Greens on issues of overmedicalisation. I hope NZ proves me wrong.