Kathleen Stock
October 19, 2023 23 mins
Since its closure was announced last July, Gids — the Gender Identity Development Service at the world-renowned Tavistock and Portman Trust — has become synonymous with mismanagement and medical scandal.
It was supposed to be a haven for young people experiencing gender-related distress. Instead, following a string of complaints by whistle-blowers, an “inadequate” rating by the Care Quality Commission, a high-profile judicial review and, finally, a damning independent review, it was deemed unsafe.
In its place, two new regional hubs were set to open, with several more centres to follow. For Gids’s long-standing critics, concerned about the distress its tumult was having on children, this came as a huge relief.
The story, however, does not end here.
Kathleen Stock has spent the past month speaking to a range of clinicians, NHS professionals and parents of dysphoric children — to find out whether Gids’s new service will be an improvement.
The portrait she paints is stark: her findings suggest that the NHS gender services are yet to become a clinically safe space for children and teens, with senior figures still pushing an activist ideology. Only last week, NHS bosses internally announced that they are significantly delaying the launch of one of the hubs. And as she reveals in the below investigation, it is unlikely to be the final twist in Gids’s new chapter…
Read on to learn about:
What happened to Gids?
The ideology in the new hubs
A new Wild West for patients
***
In 2014, the head of the NHS Gender Identity Development Service, Dr Polly Carmichael, appeared on a BBC children’s television programme billed as the story of “an extraordinary boy… born with a girl’s body”. Soothingly addressing the tomboyish young protagonist sitting across from her, Carmichael was filmed saying that a “puberty blocker” — or to give it its proper name, a gonadotropin-releasing hormone (GnRH) analogue — “pauses the body and stops it from carrying on to grow up into a man or a woman”.
She continued: “The idea of the blocker is that if we can take away that worry about your body doing something that you don’t want it to, then it gives you and us more time and space to be really thinking about what’s going to be best for you now, but also in the future.” As she spoke, a cartoonish pause button symbol was projected onto the child sitting opposite her, whose moving image was then frozen to a still, to reinforce the point.
Back in 2014, Carmichael’s service — known as Gids, and based at the Tavistock and Portman NHS Foundation Trust in London, with a satellite clinic in Leeds — was still riding relatively high in public opinion. The clinical psychologist was often in the media, describing the challenges of treating a highly mysterious new being — the “transgender child” — to fascinated and relatively uncritical audiences. Indeed, the children’s television programme in question, My Life: I Am Leo, went on to win a Bafta.
But times change. These days — thanks to a string of whistleblowers, a high-profile judicial review involving a former patient, a rating of “inadequate” by the Care Quality Commission (CQC), and a cumulatively devastating book by investigative journalist Hannah Barnes — the name of Carmichael’s service is now synonymous with mismanagement and medical scandal. The closure of Gids was announced by NHS England in July last year, and an independent review is now well under way, also known as “the Cass Review” after its chair, the distinguished paediatrician Dr Hilary Cass.
Since its closure was announced last July, Gids — the Gender Identity Development Service at the world-renowned Tavistock and Portman Trust — has become synonymous with mismanagement and medical scandal.
It was supposed to be a haven for young people experiencing gender-related distress. Instead, following a string of complaints by whistle-blowers, an “inadequate” rating by the Care Quality Commission, a high-profile judicial review and, finally, a damning independent review, it was deemed unsafe.
In its place, two new regional hubs were set to open, with several more centres to follow. For Gids’s long-standing critics, concerned about the distress its tumult was having on children, this came as a huge relief.
The story, however, does not end here.
Kathleen Stock has spent the past month speaking to a range of clinicians, NHS professionals and parents of dysphoric children — to find out whether Gids’s new service will be an improvement.
The portrait she paints is stark: her findings suggest that the NHS gender services are yet to become a clinically safe space for children and teens, with senior figures still pushing an activist ideology. Only last week, NHS bosses internally announced that they are significantly delaying the launch of one of the hubs. And as she reveals in the below investigation, it is unlikely to be the final twist in Gids’s new chapter…
Read on to learn about:
What happened to Gids?
The ideology in the new hubs
A new Wild West for patients
***
In 2014, the head of the NHS Gender Identity Development Service, Dr Polly Carmichael, appeared on a BBC children’s television programme billed as the story of “an extraordinary boy… born with a girl’s body”. Soothingly addressing the tomboyish young protagonist sitting across from her, Carmichael was filmed saying that a “puberty blocker” — or to give it its proper name, a gonadotropin-releasing hormone (GnRH) analogue — “pauses the body and stops it from carrying on to grow up into a man or a woman”.
She continued: “The idea of the blocker is that if we can take away that worry about your body doing something that you don’t want it to, then it gives you and us more time and space to be really thinking about what’s going to be best for you now, but also in the future.” As she spoke, a cartoonish pause button symbol was projected onto the child sitting opposite her, whose moving image was then frozen to a still, to reinforce the point.
Back in 2014, Carmichael’s service — known as Gids, and based at the Tavistock and Portman NHS Foundation Trust in London, with a satellite clinic in Leeds — was still riding relatively high in public opinion. The clinical psychologist was often in the media, describing the challenges of treating a highly mysterious new being — the “transgender child” — to fascinated and relatively uncritical audiences. Indeed, the children’s television programme in question, My Life: I Am Leo, went on to win a Bafta.
But times change. These days — thanks to a string of whistleblowers, a high-profile judicial review involving a former patient, a rating of “inadequate” by the Care Quality Commission (CQC), and a cumulatively devastating book by investigative journalist Hannah Barnes — the name of Carmichael’s service is now synonymous with mismanagement and medical scandal. The closure of Gids was announced by NHS England in July last year, and an independent review is now well under way, also known as “the Cass Review” after its chair, the distinguished paediatrician Dr Hilary Cass.
Following Cass’s interim recommendations, published in February last year, two new regional services are being formed to treat “gender incongruence and gender-related distress” in children under 17, with several more centres planned for launch afterwards. Slated to open next month, the “Southern hub” involves teams from Great Ormond Street Hospital, the Evelina Children’s Hospital, and the South London and Maudsley NHS Foundation Trust. The “Northern hub” partners Alder Hey Children’s NHS Foundation Trust with the Royal Manchester Children’s Hospital.
Many long-standing critics of Gids have been reassured by these developments, and by the principled and cautious approach apparently taken by Cass so far. It seems she aims to examine trans-identification in children and adolescents systemically, applying what is known about wider paediatric health rather than sacralising her patients as exotic anomalies. One parent of a Gids patient, seeking anonymity for the sake of protecting the privacy of his child, as so many parents of trans-identified children do, told me with enthusiasm: “Gender has been exceptionalised as a clinical speciality, but Cass wants to weave it back into paediatric practice.”
But the story does not end there. Over the past month, I have spoken to a range of clinicians, other NHS professionals, and parents of dysphoric young people to understand how Cass’s guidance is being enacted on the ground. I have discovered that there are deep ideological tensions and conflicts within the very institutions — clinics, hospitals, trusts, commissioning boards, adjacent adult services — whose responsibility it is to implement Cass’s new vision. Moreover, it seems NHS systems are still influenced by activist thinking; in particular, by the idea that a sex-incongruent gender identity is something to be “affirmed”, either as a matter of social justice or as personal liberation.
Considered together, my findings suggest that the NHS gender services are yet to become a clinically safe space for children and teens. Last week, NHS bosses suddenly internally announced that they are significantly delaying the launch of the Southern hub — after months of preparing training materials for clinicians recruited into the new service, and only a few days before the materials were due to be used for the first time. In line with I Am Leo’s original metaphor, it seems that senior managers too are pressing the pause button, in order to have more time and space to think. In the meantime, thousands of distressed children and their worried parents wait anxiously for a resolution.
***
What happened to Gids?
Despite the common belief that Gids closed following the announcement last year, it is still open, providing what it describes as “continuity of care” for around 1,000 existing young patients, including some on puberty blockers. (Cass recommended that in this interim period, any referrals to endocrine services by Gids staff should be reviewed by a multidisciplinary external panel).
It is unclear to outsiders exactly how patient care is now being managed at Gids, but what does seem true is that attempts have been made to improve existing processes since at least 2021. Published in February, an open letter from Gids staff concerned about Cass’s plans for the new services reveals that, after the CQC rating of “inadequate”, something called the “Gids Transformation Programme” was developed — separately from the Cass review, according to them — in order to make “wide-reaching changes to the running of the service”. The letter claims that external consultants were paid over £1.5 million to advise on the Transformation Programme, with some changes yet to be implemented.
At the heart of the controversy about the original service was its increasingly positive attitude to “gender affirmation”: roughly, the idea that a clinician should “believe” a girl who declares she is a boy (or vice versa), and so accede to her way of describing herself in clinical encounters. Though advocates deny it, critics insist that this practice precludes genuinely critical exploration of what may well be a passing phase. Without the capacity to gently challenge such a child in a therapeutic setting, an outcome involving lifelong medication is thought to become much more likely.
Even under the most scrupulous of arrangements, treating psychological distress in a physically healthy child or teen by administering experimental, powerful hormone-blockers carries risk. At Gids, that risk was increased severalfold by the organisational chaos of the service. During Keira Bell’s judicial review in 2020, High Court judges expressed surprise that clinicians did not seem to know how many young people had been referred there for blockers since 2011, nor of what age distribution. Only in 2022 — when Gids clinicians got round to publishing an analysis of outcomes for medicalised patients for the first time — was it announced that 1,151 children had been referred to the endocrine clinics in London and Leeds for puberty blockers and/or cross-sex hormones between 2008-21. According to Barnes, what proportion of them received puberty blockers still remains unknown.
There were other failures too, made clear in the course of Keira Bell’s judicial review and appeal, and in Barnes’s book. They include a startling absence of curiosity about certain recurring characteristics of patients — for instance, why so many of them were female, same-sex-attracted, and/or autistic. And there was also the close working relationship with the transactivist lobby groups Mermaids and Gendered Intelligence; inadequate preliminary assessments, both in quantity and quality; and a shocking lack of post-discharge follow ups.
In the past year or so, this impression of institutional disarray has been reinforced by Cass. In her interim report, she criticised management for having no standardised approach to patient assessment; no routine contact between psychologist and endocrinologist; no consistent safeguarding processes; poor record-keeping; and too-infrequent monitoring of medicated patients. She also seemed critical of affirmative approaches, noting with apparent disapproval: “From the point of entry to Gids there appears to be predominantly an affirmative, non-exploratory approach, often driven by child and parent expectations.”
In June, guided by Cass’s analysis, the NHS published an “Interim specialist service specification for children and young people with gender incongruence”, laying out the broad features of a new clinical pathway for this cohort — including standardised, genuinely exploratory assessment by multidisciplinary teams. Separate service specifications for puberty blockers and hormones are to follow. Cass has also insisted that, in future, puberty blockers should be administered in the NHS only as part of a properly managed clinical trial.
Despite the many criticisms of her management career to date, Carmichael remains in post as director of Gids. One of the main whistleblowers at the Tavistock, former staff governor Dr David Bell, told me: “Gids was found in the judicial review to be profoundly deficient in terms of clinical governance and record keeping. It is thus extraordinary that Polly Carmichael has been allowed to remain in position as director.” He described this as “a shocking message to parents and families who have been so damaged by this level of neglect”.
It is hard to find out which other clinicians still work at Gids, but many are assumed to be affirmative in their approach. In a second open letter from late last year — written from an affirmative perspective, in order to criticise the relatively positive response from the Association of Clinical Psychologists to the Cass Review — 13 signatories named their current workplace as Gids, including Carmichael herself.
One of the Gids-affiliated signatories was non-binary author and therapist Dr Jos Twist. Twist has edited an anthology, Non-Binary Lives: An Anthology of Intersecting Identities, which includes “stories of… how it feels to be non-binary and neurodiverse, the challenges of being a non-binary pregnant person, what it means to be non-binary within the Quaker community, the joy of reaching gender euphoria”. Another Gids signatory was clinical psychologist Dr Lorna Hobbs, who told The Guardian in January that, “for me, affirmative is starting from a stance that says gender diversity isn’t a disorder but has existed across cultures through history. It is saying ‘I believe you’ when you tell me about your experience.” Along with Twist, two other signatories who also claim to work at Gids — Dr Claudia Zitz and Dr Josh Goulding-Talbot — are now also listed as working at GenderPlus, a recently registered private provider with ambitions to prescribe hormones to teens (more on this below).
Such evidence suggests that the remaining patient cohort at Gids are not receiving the sort of care of which Hilary Cass would thoroughly approve. However, when it comes to the new services being built at the moment, it is not entirely clear that things will be much better…
***
The ideology in the new hubs:
Certainly, the presence of Professor Gary Butler in the new Southern hub does not instil great confidence that things have changed. For much of the service’s history, Butler was the endocrinology lead for Gids. In 2017, apparently with all the zeal of a true believer, he told The Daily Mail that, under his supervision, his clinic at University College London Hospitals NHS Foundation Trust “routinely” prescribed puberty blockers to children with “life-long” gender dysphoria: “When the team feels the young person is genuinely transgender they welcome [the use of] puberty-blocking drugs right from the early stages.”
Butler has also co-authored articles with Carmichael and others at the clinic. In one from 2018, he observes that “around 35% of referred young people [to the clinic] present with moderate to severe autistic traits” — apparently untroubled by the thought that he might be contributing to the premature sterilisation of autistic youth. For it is now recognised that, when combined with cross-sex hormones later, giving blockers to dysphoric young patients early on in puberty can inhibit the development of adult sexual function permanently — a fact occasionally openly mentioned by clinicians supportive of medical intervention but most of the time glossed over.
Yet Butler has now been recruited onto the team based at Great Ormond Street Hospital (GOSH) charged with developing training materials for clinicians in the new hubs. (Insiders I have spoken to believe that Polly Carmichael was initially on the recruitment panel, though the BBC reported that the decision to have her there was later “reversed”.)
Butler advertised his new role at a conference for gender medics in April, during a speech in which he also accused Cass of “nepotism” and said that the hospitals he was working with had no relevant experience with gender incongruence. He said he had “fought back” to “continue to be able to provide endocrine services for trans young people”. He has since rowed back on his comments and expressed support for Cass. But for David Bell, Butler’s presence in the new service still rings alarm bells: “Butler was responsible for being part of a service penetrated by trans ideology and neglecting the safeguarding of children; he is part of the Gids debacle and shouldn’t be involved in the new service.”
And Butler is not the only Gids clinician involved in the new hubs. I’m told that Dr Lorna Hobbs — the Gids psychologist who extolled the virtues of “believing” a trans-identified child to The Guardian in January — has advertised online that she is involved in the new service. Hobbs often reposts material from trans activist lobby groups on her public LinkedIn profile, and declares, on the website of a private therapy provider she also works for, that she applies a “social justice and equalities framework” to all the work she does.
One person working in the Southern hub told me that some clinicians recruited into the service “only believe in an innate notion of identity rather than one developing over time”. They added that involving such different voices on a single team was causing dysfunction. “The official position is that diversity of opinion in a team is a good thing, in order to mirror the fact that people don’t all agree in real life. But it doesn’t work. You can’t say yes and no at the same time.”
In the Northern hub, meanwhile, there is also a risk of repeating old mistakes. Buried within the July 2023 meeting minutes of the Alder Hey Board of Directors is the news that Leeds Children’s Hospital has now entered into the Northern hub partnership “as the existing providers of endocrinology services for children and young people under the care of the current Gender Identity Development Service”. In other words, endocrinology appointments for patients in the new service will apparently be managed by the very same hospital department involved with Gids Leeds, the satellite clinic of the Tavistock. On the current website for the hospital team, staff all list their pronouns.
Why were affirmative clinicians who were already tarnished by an association with Gids recruited into the new hubs, even after Cass’s recommendations? According to NHS sources close to both hubs, the most common explanation is cock-up rather than conspiracy. Managers at the relevant trusts don’t know much about the area, I was told, and when recruiting and setting up new structures, were likely to be impressed by a lot of mentions of “gender” on a CV. From this uninformed perspective, having already worked at the main NHS gender identity service for children presumably looks like an unimpeachable background.
Whatever the explanation, what does seem clear is that transactivist lobby groups and networks are strongly vocal in all of the trusts involved in the new hubs. Across the NHS, activist clinicians and support staff are pushing the idea that gender identity affirmation is a minority rights issue, and a way of furthering Equality, Diversity and Inclusion (EDI) goals. With “inclusive” policies about pronouns, changing rooms, and hospital wards already in place in a trust, the job of any clinician who wishes to resist affirmative narratives for dysphoric young people becomes that much harder. For fellow staff naively unaware of the potential clinical repercussions, it can easily seem that “respecting identities” is a simple matter of courtesy.
So, for instance, GOSH’s existing “Privacy and Dignity policy” instructs clinicians that “Trans and gender variant young people should be addressed and accommodated according to their self-defined gender or presentation e.g. the way they dress, and the name and pronouns that they currently use”. Guy’s and St Thomas’ NHS Foundation Trust’s trans policy says: “Asking and correctly using someone’s pronouns is one of the most basic ways to show your respect for their gender identity.” In other words — wider hospital policy in both trusts instructs clinicians and support staff to “affirm” any non-standard gender identity automatically, wherever it is encountered. It is unclear how such policies could possibly be maintained in the sort of genuinely exploratory clinical setting Cass apparently envisages.
Over at South London and Maudsley NHS Foundation Trust, meanwhile, all job adverts have Stonewall Diversity Champion branding. Freedom of Information requests also reveal that Mermaids provided EDI training to Childhood and Adolescent Mental Health Services (CAMHS) staff at the Maudsley Hospital last year. (The training this year was cancelled after adverse press attention.) Moreover, the hospital also has a vocal LGBTQ+ Staff Network, which seems to have some influence with management. I’ve been shown a copy of an email written by their leadership team in September this year, warning members of a visit to the Women’s Staff Network from Lynn Alderson, a lesbian feminist speaker with gender-critical and sex-realist views. After complaining that the speaker’s views were “divisive and hurtful, and in contradiction of our network’s gender identity statement”, the authors continue: “We have been assured that strict protocols have been put in place to prevent the speaker stating her views on gender, and that she will be ejected from the meeting if she does so.”
South London and Maudsley Trust also participates in the NHS Rainbow Badge scheme, described as “an assessment and accreditation model for NHS Trusts” and a “partnership between the LGBT Foundation, Stonewall, LGBT Consortium, Brighton & Hove LGBT Switchboard and GLADD”. (The Rainbow Badge scheme was actually founded by a medic working at the Evelina Children’s Hospital — the third hospital involved in the Southern hub partnership.) In a recent assessment, the Trust was given a Bronze Award, with particular commendation for its trans policies and for having “awareness posters across the site that reference microaggressions relating to homophobia, biphobia and transphobia” — though it was also marked down for a maternity policy that “uses gendered language throughout”.
A similarly ideological picture emerges in the North. Manchester University NHS Foundation Trust — which includes the Royal Manchester Children’s Hospital, one of the two children’s hospitals in the hub — also advertises its membership of the NHS Rainbow Badge Scheme, and in the recent past has used another scheme from the explicitly transactivist charity LGBT Foundation for training. The other one, Alder Hey Children’s Hospital Trust, is a member of the “Navajo Charter Mark” scheme — the North West’s equivalent of the Stonewall scheme, founded in 2010 to assess organisations in terms of “LGBTIQA+ friendliness” with a remit that includes “practices and policies” and “training”. Alder Hey was reportedly accredited by Navajo this month.
The content of Navajo training for organisations is unavailable to outsiders, but a 2019 Navajo newsletter perhaps gives us a sense of the organisation’s sympathies. It carries posts about banner-making workshops for Trans Pride, and regurgitates the persistent falsehood that “Almost half the trans kids of school age in the UK have attempted suicide”.
When it comes to implementing the recommendations of Cass, then, it is not inconceivable that local LGBT+ networks and transactivist groups within hospitals and trusts will put up resistance, whether active or passive. In April 2023, a NHS-sponsored analysis of responses to the public consultation on Cass’s interim service specification was published. Of the 411 clinicians who responded, 49% of them (the largest group) fell into “Group A”, described as “largely opposed to the proposals outlined in the interim service specification”, for reasons that included the perceived “transphobia” of some clinicians and the equation of “mental health treatments” for trans-identified youth with “conversion therapy”. Though obviously there was self-selection bias here, nonetheless the findings suggest there is a problem.
This sense is reinforced by the contents of a series of FOI requests made earlier this year to every NHS Trust in England and Wales that provides CAMHS, asking: “What if any training in gender, gender identity and equality your Clinical staff and practitioners have received in the last 4 years?” Some trusts replied that they paid explicitly trans activist organisations such as Mermaids and Gendered Intelligence to give them training; but even where trusts used less obviously partisan sources, it was clear from responses that the majority of them are employing a minority rights and inequality lens to look at gender identity, and not a psychological one.
And there is also evidence of at least partial capture in other powerful NHS bodies. NHS England was placed 68th in the Stonewall Top 100 Employers this year — an intensely fought competition with hundreds of entrants, in which a high placing indicates close policy compliance with Stonewall’s transactivist goals. The Care Quality Commission, in charge of regulation, proudly advertises on its website that it is a Stonewall Diversity Champion — as does the National Institute for Health and Care Excellence (Nice), Health Education England, and the NHS Confederation.
Elsewhere, the British Medical Association has come out in favour of affirmation, and published a response to Cass that criticises the new service specification for failing “to recognise the highly individual nature of children and young people’s experiences or their own developing autonomy in relation to exploring their identity”. The Chair of the Sexualities Section at the British Psychological Society, Dr Rob Agnew, frequently writes or endorses transactivist content on his public LinkedIn profile, including one post claiming that “[k]ids receive cis gender ‘grooming’ from the moment they are born” and that “[s]upposedly ‘experimental’ blockers are fully approved by the medical establishment and readily prescribed to cis kids for a variety of reasons”.
But this is not so. Some analyses suggest that blockers can negatively affect the bone density levels of young patients, and perhaps their renal and cognitive functions too. A 2020 Nice evidence review — later acknowledged by Agnew after pushback — has concluded that the quality of evidence for the positive impact of blockers on “gender dysphoria, mental health and quality of life” is of “very low certainty”. There is also increasing doubt about whether blockers are beneficial or even just neutral for mental health.
Indeed, one NHS research trial manager I talked to expressed strong scepticism that a properly described clinical trial for puberty blockers — as mandated by Cass — could ever meet statutory regulations for what is known as “Good Clinical Practice”. She told me: “The Tavistock’s original application for their Early Intervention Study wasn’t regulated as a Clinical Trial of an Investigative Medical Product (CTIMP) but this one would have to be.” She added: “Children get classed as a vulnerable group. They need to have very special protections, and the rationale is just not there. The possible impacts [of blockers] on a child are so high that the moment that this was recognised, the study would be shut down. If you had a healthy child, and you recognised that medication could confirm sterility issues, or fertility issues, or bone density issues, the trial would be stopped at that point.” It would be “completely insane” to run such a trial, she concluded.
Meanwhile, even within the National Programme Board for Gender Services, the body ultimately in charge of service specifications for both adults and children with gender dysphoria, there are worrying signs for those seeking a clinical approach that situates dysphoria in the realm of paediatrics and psychology.
The Chair of the Board is Dr James Palmer, Medical Director for Specialised Services, a consultant neurosurgeon who has overseen all gender services in England and Wales in the past decade, both for children and adults. In 2018, he told a conference that the NHS needed to design “a healthcare service that will allow somewhere around 1-3% of the population at some point in their lives to have a discussion about their gender”. Talking about the drop in average age of Gids patients, he added: “It’s got to be a good thing that there are people out there that want to explore their gender. The fact that it’s in the younger age group has got to be a good thing. For a young adult, to be able to come forward, to seek that expertise, earlier [rather] than much much later in life, that’s got to be a good thing.” The lack of curiosity about why so many younger people were suddenly arriving in his services is marked. And in fact, there is evidence that early social and medical transition for a child experiencing gender dysphoria — carried out, of course, by adults — tends to solidify a sex-incongruent gender identity in the child that otherwise might well have passed.
Meanwhile, on the Clinical Reference Group for Adult Gender Dysphoria Services, described as providing “independent expert advice to the National Programme Board for Gender Dysphoria Services on the various aspects of the Board’s work”, two out of five of the members are openly affirmatory of children. Dr Laura Charlton, a clinical psychologist, works at Gids Leeds and was the first author of the open letter signed by Carmichael last year, defending affirmation. At one point, the letter complains of the use of “male” and “female” for trans-identified children because it “undermines the lived experiences of the people being referenced”.
The second affirming clinician on the board, Dr Christine Mimnagh, is clinical lead at the Merseyside adult gender service CMAGIC, and also a GP and private practitioner. In an interview last year, worth quoting at length, Mimnagh said about trans-identified children: “The first thing you get taught in safeguarding for children is, if a child comes up to you and says, you know… ‘I don’t like the way they touch me’, or whatever, what you do is go ‘OK, yeah, tell me more, I’m listening’… what you don’t do, is say, ‘Oh no they didn’t, that’s Mr Jones the gamesmaster, he would never do that!’ There’s a difference between affirmation and dismissal and with everyone whose trans, affirmation is kind of the name of the game; you can’t deny people’s reality just because their reality is different from yours.”
In other words: just as we should believe a child who says she or he is being sexually abused, we should also believe a female child who says she is a boy.
***
A new Wild West:
It appears, then, that despite the apparent good sense of Cass’s interventions so far, contemporary gender medicine in England and Wales remains somewhat chaotic. Within relevant services and wider NHS institutions, there are clinicians with directly clashing views about what sex-incongruent gender identity is, what it means, and what clinical decisions should be made as a result. And it seems that the cracks are starting to show.
I have seen evidence that, only last week, clinicians in the Southern hub — getting ready to launch in a month’s time, and to trial the new training materials with clinicians that very week — received a wholly unexpected internal announcement: the November launch had been postponed. Rising clinical, legal, and communication costs were cited, as was the insufficient time for senior clinicians to sign off the training materials in line with the proposed delivery schedule. I’m told that a manager of the team in charge of producing training materials resigned. Though teams within the Southern hub continue to be employed, their work is now paused, with no revised schedule yet in place.
What will this delay mean? With Gids closed to new referrals and the hubs not yet established, waiting lists will inevitably grow longer by the day. Now taken out of Gids’s hands and managed separately by a NHS Commissioning Support Unit, as of July 2023 7,902 children and young people were on the national waiting list. It is widely acknowledged that any child who is 16 is unlikely to be seen by a children’s service before she turns 17 (the cut-off point for care under childhood and adolescent services).
In desperation, some parents with enough means are turning to private providers to buy puberty blockers and hormones for their child. GenderGP is the most well-known of these, notorious for its close links with Mermaids — even to the extent of employing former CEO Susie Green for a few months this year — and for its historical run-ins with the General Medical Council.
But there are others who also see waiting lists as a business opportunity. The “Yorkshire Gender Endocrinology Services clinic” offers blockers on its website, though it’s unclear whether its clinicians would dispense these to under-17s. And last month, a new private clinic — GenderPlus — arrived on the scene, overseen by former Gids clinician Dr Aidan Kelly, with stated ambitions to start prescribing hormones to teens in the next couple of months. Several other former and current Gids clinicians are involved in this venture, most notably Paul Carruthers — lead nurse at the NHS Gids clinic still based at Leeds Children Hospital, and described as the person who will be “leading the hormone clinic” at GenderPlus.
For some parents, this is an attractive option. One told me: “I know there are parents who want to do it by the book and feel that GenderGP is not doing it properly. They want to go to a Harley Street clinic, get a diagnosis, and feel reassured by having a clinician registered with the NHS.”
Yet while GenderPlus is presented by Kelly as a new project, focused on hormones not blockers, it seems he might already have experience in prescribing blockers to children under the auspices of another of his businesses, Kelly Psychology. As an anonymous comment on the TransgenderUK Reddit put it a year or so ago: “There is another provider to GenderGP but it’s probably more expensive. I use Kelly Psychology and have a private endocrinologist who prescribes puberty blockers to my 13-year-old child. The process is the same as Gids but private.” (Kelly Psychology did not respond to a request for comment.)
Whatever the truth here, it is clear that Kelly is aiming GenderPlus at the parents of dysphoric children and adolescents, and that he anticipates big business. The company already lists 17 staff members on its website, including a research manager.
Given the acknowledged lack of a solid evidence base, to prescribe such poorly-understood drugs privately could be seen to be incautious. Cass’s new interim service specification is very explicit, with added red lettering for extra emphasis: “Children, young people and their families are strongly discouraged from sourcing puberty suppressing or gender affirming hormones from unregulated sources or from on-line providers that are not regulated by UK regulatory bodies.” Though GenderPlus has told The Times it is seeking registration with the Care Quality Commission regulator, its website currently says that it has “clarified” with the CQC that its service “does not fall under their remit and as such is not eligible for CQC registration. If in the future we do provide services which will require CQC registration then we will seek registration.”
Another major worry for many parents of children currently on the national children’s waiting list is the increasing proximity to adult services as their child gets older. In August this year, letters were sent directly to all 17-year-olds on the list, encouraging them to opt for referral onto the adult list instead. They were told that the original date on which they were placed on the children’s list could be transferred to the adult one, so that they could be seen more quickly. The letters were signed by James Palmer.
Since adult services tend to be uncritically affirmative, the letters have profoundly alarmed some parents desperately holding out for a non-medicalised resolution to their child’s dysphoria. In practice, it seems that a 17-year-old might self-refer to an adult clinic and be put on hormones on the day of her second appointment, without any psychological intervention; indeed, one clinic proudly advertises the possibility of prescription at this speed.
What makes this possible is the existing NHS adult service specification, written in 2019. It is a document that governs standards of care in all adult services, and is a world away from Cass’s careful formulations. Gender dysphoria, it states, is “not, in itself, a mental health condition” — making it somewhat obscure why the NHS should pay for treatment. Equally, “psychological interventions will not be offered routinely or considered mandatory”; and “the majority of individuals will have two core assessment consultations” (and no more). Individuals can also self-refer to a clinic without any intermediate referral from a GP. For breast removal, a patient will need the sign-off of one clinician within the service. For genital surgery, she will need two.
There are eight NHS gender clinics for adults in England and Wales, plus four new “pilot” services, brought in more recently to bring down adult waiting lists in local areas (one of these was mentioned earlier: C-Magic in Liverpool, run by Dr Christine Mimnagh — the clinician who made an equation between believing a child’s disclosure about sexual abuse, and affirming a child’s incongruent gender identity). The new pilot services tend to be embedded within sexual health services, are run by predominantly LGBTQ+ clinicians, and appear to be even more affirming than the already fairly ideological norm.
For instance, the website of Indigo, the pilot service in Manchester, says: “We know that trans and non-binary people are the experts of their own experience… Our services are trans and non-binary-led, with trans and non-binary people guiding and feeding into them at all levels.” An NHS commissioning document for the pilots says that Indigo is “testing the role of Care Navigators, a non-clinical role typically staffed by individuals with lived experience, to support patients before their first appointment with the specialist team”. Somewhat unusually for a primary care provider, Indigo also has a “Leave this site quickly” button on its website, taking browsers to Google if necessary.
I talked to Anna, the mother of a trans-identified daughter currently on the Gids waiting list who is nearly 17 and is seeking medical transition. Her daughter formerly identified as a lesbian. Over lockdown, she began to identify as a boy, having discovered transactivist websites. The teenager, who also has ADHD, is now living with an affirming father who supports her transition.
Anna told me: “I’m frightened that without any evidence of benefits, and with a high rate of neuroconditions and traits — bearing in mind that girls will be more undiagnosed than boys — without consideration for all of that, and with only one pathway in the adult services, our kids have no hope. I don’t want to say mutilated but that’s what is happening. There is so much regret, I don’t want our kids to have regret. They are only on one path, without any mental health considerations. I don’t understand how they can do it.” Along with another mother in a similar position, she is now seeking permission to pursue a judicial review against the NHS, “for providing unsafe treatment advice for young people from 17 years old and vulnerable adults”.
For David Bell, what is happening to dysphoric 17-year-olds is the “biggest area of concern”. He told me that, in light of their incomplete cognitive and emotional development, there is plenty of precedent already for 17-25 year olds to be treated separately from adults in mental health services; pointing me to guidelines from the Royal College of Psychiatrists and elsewhere in the NHS that have established this. He described the failure of adult gender services to recognise this as the “trans-exceptionalism” already familiar from elsewhere in the NHS. Indeed, with what another former Tavistock clinician described to me as a “beautiful irony”, the Tavistock and Portman Trust itself has an adolescent and young adult service in general mental health that covers 14-25 year olds — just not in Gids.
Cass’s interim service specification states that, when a child is moved to an adult service, “a co-ordinated transfer to appropriate local adult services will be needed where complex presentations continue”. It seems that, at the moment, such a rational arrangement is some distance away. In effect — thanks to the collapse of the old service and to delays within the new ones — a void has opened up in the systems supposed to care for gender dysphoric young people. And until it is filled, a cohort of highly distressed children and their desperate parents will continue to pay the price.
***
A spokesperson for the NHS Children’s and Young People’s Gender Service (London) said:
“The NHS Children’s and Young People’s Gender Service for London — a partnership between Evelina London Children’s Hospital (part of Guy’s and St Thomas’ NHS Foundation Trust), Great Ormond Street Hospital and the South London and Maudsley NHS Foundation Trust — is working towards full mobilisation of the new service by the beginning of April 2024
“The set-up of this completely new service is complex. In advance of full mobilisation, we will be working with colleagues on the safe handover of current patients. We are also focused on recruitment, training and ensuring good data collection which supports the developing research, and progress made in these areas will determine how quickly it will be possible to start seeing new patients off the waiting list.”
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SubscribeThis is the hardest post I have ever had to write. My son, who is 13, has succumbed to rapid onset gender dysphoria. Like me, he has Aspergers, unlike me he is part of a labyrinthine online world, dominated by US-influenced gender-affirmative adults, and “TransTokers” who have presented a fairytale vision of gender realignment. My son is a masculine looking child whose friends are all male, who has a masculine outlook, and a masculine sense of humour (obviously “masculine” is subjective, but as a shorthand, useful). Never once as a younger child had he said “I’m a girl.” He is neurodiverse of course, very bright, but an outlier. The trans dogma, the trans evangelism, has, in my opinion, presented itself as the most aggressively vocal route towards fitting in. I have explained my point of view to him, that in my opinion you cannot “change” sex, and you cannot “feel female” as you have no concept of what feeling female is like, because you’re not female, qed. But I love him very much, and want him to be happy. At the moment I believe transitioning, with its attendant medical interventions, social pitfalls, romantic hardships and discord with reality, offers no guarantee of easing his difficulty, and in many, many ways would make his life much harder. If he could recognise that it is his autism, his “unusualness”, coupled with the onset of puberty, that is the root cause of his discomfort, then I believe he would recognise his dysphoria as a delusion. He also has real issues with proprioception which I think has led to a disconnect with his body. But, in the hope that he will recognise his folly, we have agreed that he can grow his hair and buy some female clothes. At the moment my wife wakes in the night crying, devastated at the potential loss of the son she has raised so lovingly; my younger son cries and says “I don’t want to lose my brother,” I have cried for the first time in a long time. What the trans dogmatists fail to understand is the cruel impact their quick fix ideology has on impressionable, vulnerable, confused young people and on their families. It is an encouraged destruction of identity, and, as a gruesome climax, a clamour for mutilation.
Kathleen, if you happen to read my comment, it would be extremely helpful for me to talk to you. I have huge admiration for the work you have done, so thank you.
I am very sorry to hear this. It must be incredibly hard but you are not alone (far from it – there are so many in your situation, and the stigma around talking about it in anything other than glowing terms makes it even harder to bear). There is help out there for parents in your situation – this book is very good https://www.amazon.co.uk/When-Kids-Say-Theyre-Trans-ebook/dp/B0C5Q276C2; as are these guides https://sex-matters.org/posts/schools-and-safeguarding/practical-ideas-for-parents-of-gender-questioning-teenagers/. And the Bayswater Support Group is there for parents too https://www.bayswatersupport.org.uk/
(this is Kathleen, btw – never commented before and for some reason the system has given me a different name!).
Kathleen, i just have to say i admire and appreciate you, greatly.
Depressing and dire as it all is, women and men like you, give such hope and inspiration to so many. You remind us that we are not alone in the mire, and there maybe possibly could be, a way out!
Thank you.
Thank you Kathleen. We will follow these links. Please keep up your work. It’s been a huge help to us.
Dear Kathleen. Totally in awe of you and your sanity in this crazy business, not to mention the calm with which you seem to deal with it all. Many blessings.
And check out Miriam Grossmans website she has lots of resources and helpful advice
https://www.miriamgrossmanmd.com/
I wonder whether we might utilize the fact that autistic kids are disproportionately represented among gender-questioning kids and more thoroughly involve the autism community in fighting this.
To that end, I have sent some links from Unherd to a few autism organizations.
I also wonder whether there is some autistic thinking behind some of the the transactivism to support the gender-affirming type of care.
I have a grandson who started wearing dresses from about age five. The reason could have been that he was the only boy in some kind of after school club where the girls used their time in dressing up in various dresses, He felt left out and started wearing dresses there too and also at home. Unbelievably his mother just laughed at it and his dad was silent on the matter. I eventually had a talk with him mentioning that God had made him a boy and not a girl. I think I got through, Now at 11 years old he has never worn another dress since that talk and seems very well adjusted now.
You might want to reach out to Genspect. https://genspect.org/
Thanks vm Carl. My wife has done so, they’ve been very helpful and rational.
No, they have been affirmative of your biases born of ignorance — and to go by your statements here, it is deliberate ignorance. There is no such thing as ROGD. The only category of evidence which has ever purported that it is real is fraudulently produced by asking parents who are already biased to believe that it does exist, “do they believe it does?” — not infrequently ignoring the same parents who say that they “saw no signs” are parents who speak of disciplining their children for gender non-conformity in years prior almost in the same breathe.
One goes to Genspect because you prefer a dead or miserable child over one happy in a way you do not like.
By insultingly pretending you know that only people with a preference for a dead or miserable but socially conforming child would go to Genspect you undermine any value you could bring to the discussion.
Even if every child who claims he is in the wrong body would benefit from “gender affirming care” were true you can have no evidence to support your assertion regarding the motives of Lord Plasma and other parents that are contacting Genspect.
Most parents who are not swept along by trans propaganda have only the happiness of their child at heart in seeking alternative advices when faced with their child being hurried down a path of irreversible transition that they may come to regret by fanatics who attribute malevolent motives to people who do not conform to their way of thinking. Of course there may be a few bigots who think as you suggest but to suggest these are the only people that go to Genspect betrays your own bigotry.
“By insultingly pretending … to the discussion.” <– Other than that being justified perfectly well by known facts, sure. You don’t have any real and relevant facts.
“Even if every child who claims he is in the wrong body would benefit from “gender affirming care” were true” <– Which is a strawman argument, since I have suggested no such thing — it’s only more of you making up whaterver you feel like. It’s because you have no real argument.
“you can have no evidence to support your assertion regarding the motives of Lord Plasma and other parents that contacting Genspect.” <– I read what they wrote and I know what Genspect is about. It is not honesty, it is for their ideology and nothing else.
“Most parents who are not swept along by trans propaganda” <– there is no such thing, only facts biology and it’s real range of variance which can not for reasons of emotion immaturity, deal with other than by abusing some children, among other people. You are not different at all compared to those who insisted “science” jusitified racist laws.
“have only the happiness of their child at heart in seeking alternative advices” <– The same as those advocating a period of consuming only fruit juices as a cure for cancer, sure. At least idiots like Steve Jobs only tortuously killed themselves.
“when faced with their child being hurried” <– Another strawman argument, there is no such hurrying.
“down a path of irreversible transition” <– Any pubertal changes are equally irreversible and between transgender children forced to undergo the puberty of their birth sex, and cisgender children transitioning medically in error — equally tragic. That you think that is not true is objective evidence of your mindless bigotry — you think transgender children aren’t worth as much as cisgender children. That you think the latter outnumber the former evidence of your deliberate ignorance.
“by fanatics who attribute malevolent motives to people who do not conform to their way of thinking.” <– If any fanaticism is seen in such a broad majority, it would be the first time. Fewer than 1 in 800 doctors in the US, for example, oppose gender affirming care. If you were to say it was complacency you might have a point — of curse, you would ave to have facts backing up your opinions, and you do not.
You are in the relative position of lay people insisting to physicists that Phlogiston really does explain fire, and the the Earth really is flat. Genspect is the equivalent of a pro-Flat Earth website.
“Of course there may be a few bigots who think as you suggest but to suggest these are the only people that go to Genspect betrays your own bigotry.” <– You are exactly such a bigot.
is he gay? Talking to gay people would help too. We had so much stress and anxiety growing up in a straight society and we all bought we were the only one. Until we meet other gays. Just saying… Bon courage.
He says he thinks he is bisexual. But I’m not sure he really knows. I hope that is what has caused his confusion, it would be a big relief.
Your son is not trans. “rapid onset gender dysphoria” does not exist. He is being groomed online, I’m afraid.
I wish you all the best of luck.
Thank you Addie
…”if we can take away that worry about your body doing something that you don’t want it to“
Is there anything more ludicrous? I don’t want my middle aged body to build fat around my midriff!
Your post is truly heartbreaking. May I suggest that you give him articles about young adults who have detransitioned? Their stories of regret and incalculable loss may help change his mind.
Another thing that comes to mind is how the current form of the term ‘gender’ was coined by Dr. John Money, a scientist who performed disturbing sexual experiments on children, at least two of whom ended up committing suicide. The adults pushing sexual reassignment surgery on children are engaging in the same sick behavior and I hope that one day they are all held accountable for the lives that they have ruined.
Lastly, in a fantasy trilogy by the author Philip Pullman, His Dark Materials, a mysterious group of men and women kidnap children in order to sever them from their souls. The children end up lost, sad, pale shadows of their former selves. By severing children from normal healthy sexual development, the adults involved in transgenderism are doing almost the exact same thing.
“The Detrans Perspective – A Conversation With A Survivor (James Esses & Ritchie Herron)” by the LGB Alliance is an excellent talk (YouTube) on this subject.
Your example of the soul-snatchers in Pullman’s trilogy (I can’t recall what he calls them) is apt. Dark times indeed.
Though sadly, Pullman has joined the ranks of trans ideology celebratory celebs.
Oh no! I do wonder what makes some people, more than others, susceptible to this social contagion.
As opposed to other contagions?
I suspect he has, like quite a lot of older ‘lefties’ I know, fallen for the Stonewall line that it’s just like the fight for gay rights back when they were younger.
Even if they subsequently realise their error we all know what happens to the heretics and doubly so to the apostates (look at how the detransitioners are treated).
I think you are probably right. But I’m curious: why do you think it is different to the fight for gay rights? I see lots of parallels. Honest question.
I would guess it is because they are terrified of being cancelled and excommunicated.
You are somewhat fortunate that there are supports and resources now that may help guide you and protect your son from “capture” by this social movement. Strongly advise you to reach out to Genspect and join a parent group and listen to or watch the Gender A Wider Lens podcasts. There is still hope for the younger kids like yours with ROGD, especially in the UK. I promise you, you may be able to guide him through unharmed. Parents of older children now, and in North America in particular, are not so lucky.
Reach out!
Transition regret is a growing phenomenon. It might be worth showing some of the testimonies to your son.
Just google ‘transition regret’, or type it into YouTube and there are plenty of quite heart breaking examples of young people who went down the road of ‘gender affirming care’ and now deeply regret it.
They all report being enticed by online Trans forums, as well as showing symptoms of various syndromes including autism, eating disorders, trauma, depression, anxiety etc. All were told that gender dysphoria was the problem and that gender affirming care was the solution.
Failing that, is there any way you could persuade him to wait until he is an adult before making a decision?
Several of those with transition regret also say they they wished the adults had refused to affirm them and had left them to go through what they now realise was just a phase.
Hi there. I saw a YT video of an average black woman talking about ROGD in her daughter from California where she was at risk of having the child taken off her by the authorities. She literally had to run off in the night and hole up with a friend in secret.
She described the online trans ‘community ‘ as a cult. She had to strictly limit her child’s online time after taking her somewhere with no reception. She likened it to putting her through AA detox. All shocking but…..
She managed to completely turn it around in a few months and now her daughter is back to her old disruptive, argumentative, arsey teenage self (lol) so there is hope but it’s a long hard road, I’m afraid.
Good luck.
PS These trans-tokers are like witches and should be burned at the stake.
Was with you until I read your p.s.
To Lord Plasma,
This is truly a sad story of your son. But, I must say, where are you as a parent? You and your wife know that what is happening to your son is wrong. Why aren’t you doing what parents should do and protect your son by stop affirming his brainwashing?
You’ve already received many useful suggestions from other commenters regarding resources that might help you deal with this situation. I would also suggest an episode of the podcast Triggernometry where a female, autistic Triggernometry employee describes how she thought she was trans but eventually figured out her confusion arose from being autistic. The link is below. Best of luck.
https://www.youtube.com/watch?v=-pntLxZjsAM
That was a brilliant suggestion. I watched it and was very moved. (though I would warn that she gets a little bit preachy about going back to Christianity as a solution, albeit in a very charming way.)
Here’s another interesting video.
https://www.youtube.com/watch?v=I6MWY6wnpxk
A psychiatrist explains a meta-analysis of the link between ASD and gender dysphoria.
Among the comments:
I’m a straight cis male, and I’ve recently found out I’m autistic. What’s super interesting to me about this video is that I definitely had a “crisis of masculinity” when I was younger (17, 18, 19), in part because it felt like a lot of other neurotypical men heavily rejected parts of my personality that were considered “not masculine.” To this day, I often get people ask me if I’m gay, because it simply doesn’t make sense to me to “perform” certain aspects of masculinity (especially those that seem entirely for the benefit of other men, rather than women). It was actually quite a frustrating experience before I understood I was autistic.
I would not at all be surprised if other autistic people also feel like they don’t belong in their “assigned” gender because of similar feelings of being completely unable to relate to the socially constructed facets of gender and sexuality.
Thank you to all of you who have offered suggestions. It’s very kind and I hope we find a solution.
I think you should remove his access to all
Social media and take him away on a long holiday to somewhere where trans is not an issue. Get him out in the world adventuring and keep his mind busy with new people and activities.
Consider taking your son on a long trip somewhere where wifi does not work. Set things up so he must depend on you and you are the alpha presence, so he will re-attach to you. As it is, he is attached to on-line ideas and ‘heroes’. Please see https://macnamara.ca/ and neufeldinstitute.org/
look at pitt.substack.com for a lot of stories of parents like you. Some stories have good suggestions for handling your son.
DO NOT AFFIRM!!
I am neuroatypical, and ever since boarding school, and I believe because of it, I have been disconnected from my body. As I understand it one of the key features of us Aspies is intense focus on a particular interest or issue. So I imagine that once this bee got in his bonnet it has got a great deal of attention. And though I remember only vaguely the issues, I seem to remember that time and time again I got obsessed with some change I wanted, only to find out it did not achieve much or anything at all of what I had hoped and intended. So it seems to me all your fears are well founded. My suggestion in case you have not done it already, is to try to find some attention grabbing article, ideally perhaps scientific, that he might be obliquely encouraged / induced to analyse and study. That’s all I’ve got. Deepest sympathies. It sounds like absolute hell for the rest of the family. Good luck.
“The trans dogma, the trans evangelism, has, in my opinion, presented itself as the most aggressively vocal route towards fitting in.”
I am really grateful for this article by Kathleen Stock and for your testimony from the front line. The calculation and base wickedness of exploiting children’s insecurities – especially those such as your son who are autistic – that lies at the heart of this vile industry needs far more exposure.
My heart goes out to you and all your family and I hope and pray that you get the help and support you need.
The saddest thing about this is when the same people stoked their pet manias & hates in the past their victims could buy into their lies for as long as it took to learn or grow out of them. Bar a few cases no permanent damage was done. How many per 1000 exhorted to drop acid or smoke weed by messrs Leary & co ended up with junk habits? less than 1:500 is my guess. Same with CPGB and far left Labour: Of those exposed to their posters and xeroxed ‘zines how many joined the Red Army Faction or the INLA, or even the ever popular Che Guevara? got to be < 1:10,000 at an absolute max and probably much lower given how tiny these “fairly secret armies” were. I know the numbers mutilated by the trans lobby are small, but they are increasing and unlike foolish or firebrand ideology you can’t grow out of removing your genitals and knackering your endocrine system!
I have a granddaughter who is Asperger’s and feels like she should be male. I understand your heartbreak because it is also mine. This is the preschooler who we could not get out of her princess dress and pretty pink shoes. There was never any indication of a problem until her school encouraged her to look at her mental issues in a gender dysphoric manner.
A fine piece of investigative reporting. The trans madness won’t end, imo, until the culpable medical professionals are successfully sued for malpractice and appropriate, apolitical, standards for the diagnosis and care of trans people are implemented. Only the real prospect of hefty civil, and perhaps criminal, penalties will dissuade the ideologues. Perhaps Unherd might consider an article on avenues for legal recourse for children harmed by ideologically driven physicians.
Unfortunately the law may not provide a remedy in the sense that to establish a claim of medical malpractice or negligence the claimant has to show that the treatment they received was below the standard expected of a clinician of their field of expertise. If the predominant standard treatment involves affirmation and rapid progress to puberty blockers, hormones and surgical intervention it becomes difficult to prove that the treatment fell below the standard expected of a competent medical expert in this area. In other words medical ideologues may be able to establish a standard of care that is legally bulletproof simply by ensuring that their treatment is the standard treatment which seems to be the way that things seem to be progressing.
I recall that many of us anticipated the probable outcome following the interim Cass review and the suggestion that the Tavistock Clinic was to be closed and be replaced by regional clinics. It always seemed probable that, as Richard Craven has observed, the cancer of this ideologically driven treatment will simply have metastasised and spread to the regions and into private clinics.
A thoroughly depressing prospect for the parents of confused young children in fact requiring proper psychological treatment rather than a pathway to chemical castration and mutilation.
Thanks for the mention, although – as I’m sure you’ll appreciate – I wish it wasn’t necessary!
I do not think it would be difficult at all to mount a civil claim. All someone has to say is that they were not properly advised and were pressured to go along with a medical intervention that harmed them. You were aware that I was mentally unstable
And before you claim there is a problem with gender affirming care, you need to be able to show it can be substantially bettered — or even bettered at all. It has been in use for decades, it is the mindless Social Conservative moral panic about it which is new. And instead, gender affirming care has a 99%+ accuracy rate in predicting whom will benefit from gender affirming surgery contrary to birth sex (as opposed to gender affirming surgery consistent with birth sex, such as breast augmentation or gynecomastia removal).
You have no factual excuse to presume youth treated with medical transition per gender affirming care are confused.
A huge amount of credit must be granted to Kathleen Stock for this thorough review of the existing state of these services, alongside Unherd for its part in commissioning and publishing this review.
It’s been said before, but when she lost her tenure at the University of Sussex, we gained someone with sufficient intellect, insight and sensitivity to provide searching analyses of many of our current cultural and now medical issues. On this latter point, the world of medicine is notoriously difficult for anyone not medically qualified to gain traction within; the nature of specialist services requires considerable study to gain even enough insight to be able to write about and discuss the critical issues authoritatively. I feel that KS has achieved this, though speaking as a former long-term NHS employee, i’d expect she should be prepared for the usual arrogant pushback by medical professionals who might disagree with her findings.
It’s noteworthy that no conclusions as such have been reached, but this review should require those charged with the provision of revised services to be more accountable. One of the key failures within this process following the as yet incomplete closure of the Tavistock Clinic seems to be the lack of expertise and accountability of those managers charged with recruitment for the new clinical hubs, something that doesn’t surprise me but is actually hugely problematic and worth challenging at the highest level of the NHS and government as to why this remains the case.
I look forward to hearing from KS again, as the service redevelopment moves on – I hesitate to use the term “progresses”.
Brilliant article from Kathleen Stock as usual, but thoroughly depressing. No surprise though; it’s like trying to get rid of knotweed.
And the number of private services all waiting to make a killing from these confused kids.
We need a British Matt Walsh to hold rallies outside these places and get them to close down.
“it’s like trying to get rid of knotweed”
… or a metastasized cancer.
Part of me thinks, take it off the NHS and let them all go private! If parents want to pay to have their kids chemically castrated, that’s on them.
The lunatics are truly running the asylum!
Matt Walsh is accurate in his analysis and condemnation of transactivism, but his stance is also much too politicised as a very rightwing commentator. This does not help in an issue which should transcend politics but is too.often used and abused to political ends.
With knotweed, if you try to pull it up at the roots, it always leaves a bit behind that will eventually grow to be as invasive as the original. The only answer is powerful herbicides that go right down and kill the roots. Maybe we need to find an ideological equivalent…
Don’t forget that this is all being funded by our taxes. The whole ‘gender’ nonsense should be removed from the NHS. Selling drugs and procedures to mutilate children should be made illegal and, for adults, particularly those under 30, subject to very strict regulation.
As it is, we, the taxpayer, funding this nonsense, the NHS is then liable for class action suits, which the taxpayer foots the bill, and then the NHS is relied upon to treat the resulting mess, again funded by the taxpayer.
It’s now blindingly clear why GIDS became so overtaken by ideology; Polly Carmichael is a bloke.
Just what occurred to me when I saw the photo!
I wondered this too, but I can’t find a source to verify.
Dead naming blah blah. I’m sure you won’t find any way to confirm online but look at his Adam’s apple!
Me too ; it beggars belief that such a person is allowed within a mile of children.
It might be simple to say that Polly Carmichael is trans but I don’t think so.
There are many pictures of Polly Carmichael on-line and no evidence of an adams apple just the normal aging of the neck.
When speaking the voice is decidedly female and so are mannerisms which,even in the most passing trans person are usually a giveaway, such as constant hair touching or head tilting.
Obviously, it is possible to shave the adams apple and have voice training but on balance it seems more likely that Polly Carmichael is just a women who has been captured by the trans ideology as have so many, often because there is a trans person somewhere in their family, unlike many male supporters who simply display pure hatred of women.
Passing trans women have feminine mannerisms and voice.
Polly has facial melasma in early photos, which is a common side effect of oestrogen in men.
In the WPATH video on YouTube she strokes her face with her nails several times which is typical of trans women.
Try looking on YouTube for Dr Polly Carmichael as a speaker at the 2016 WPATH conference. Her voice is pretty clearly that of a woman.
I can remember, at the time of the interim Cass review and the subsequent Tavistock closure/regional hubs announcement, that Pink News was bullish and much derided for spinning it positively. Sadly, it looks like they were correct.
Despite Cass, and despite successful case after case in employment areas, the gender ideology juggernaut rolls on and will gather speed again under a Labour government. Children will continue to be harmed.
Thank you, Kathleen, for this excellent but very depressing, report.
Labour is slowly changing its mind about the gender ideology cult. First (after the SNP’s various embarassments on this issue) it announced that there would be no gender self-ID under a Labour government: even though its reduced requirement from two medical opinions to one, leaves this open to abuse from online outfits like Dr Helen Webberly’s “GenderGP”.
Then Starmer conceded that “women” are “adult females” — though he left out “human”: still a major advance on “some women have penises”.
And take a look on YouTube at a Labour Women’s Declaration fringe meeting at the Labour Conference, just held. Jess Phillips MP attacks our current legalised rape culture as one of the worst offences against women’s rights to be safe from predatory men. No gender nonsense here.
I have “lived experience” of gender dysphoria. Clinical psychologists start from the premise that affirmative care entails an accepting stance that says gender diversity isn’t a disorder but has existed across cultures through history. They aim to validate the testimonials coming from gender distressed children, like I once was.
However, what follows is at odds with this rhetoric. If they truly accepted the gender dysphoric child, then the logical response would be to de-bunk gender (as queers and feminists did in the pre-Trans era). Gender should not be a heteronormative straight jacket into which we all must fit. Unlike biological sex – which is real – gender is just a set of social conventions. Instead of embracing social non-conformity (the actual cause of the child’s distress), affirmative care clinicians pathologise the child because he/she does not conform. In the past, the ‘solution’ was not to change non-conformists, it was to tackle the social conventions that reinforced rigid stereotypes. Affirmative care is as regressive as lightening a black person’s skin to make them ‘less distressed’ in a racist society.
Really good post. I don’t agree that gender is just a set of social conventions – I think it likely that average differences in behaviour and personality between men and women are to some extent grounded in sex. But there is no doubt that society reinforces these norms.
The loosening up of our perception of gender was an entirely good thing so far as I’m concerned. It was a bit of a straight jacket for many of us, but especially for the gender non conforming.
Given that the gendered behaviours of men and women have changed in significant ways over the centuries and also between different cultures I cannot see how it can be argued that these are somehow inherently grounded in te bilogical sex of the individual man or woman.
They have changed to some degree, but there is much that is common across cultures. From memory Pinker covers this pretty well in the blank slate, and there is plenty in evolutionary psychology. We need to be careful that we don’t take superficial differences (like dress codes) as significant differences.
I should also add that if there really are no innate biological differences in personality between men and women – that both are simply blank slates at birth – then a good deal has been conceded to the trans side of the argument.
If there are only people with penises and people with vaginas – with gender sitting in an entirely external relation to that – then there really is no reason why a man (sex) can’t be a woman (gender) and vice versa.
This is one of the reasons some on here argue that feminism opened the door to trans. Because it unhooked gender from sex.
If by gender we mean how people present themselves to the rest of the world, that has changed over the millennia in response to the particular mores of the time. And there’s no doubt that sometimes those dress codes can reinforce specifically ‘sexed’ behaviours. But in broad evolutionary terms we’re still sexual animals and it’s always been natural for us to display ourselves in ways that are attractive to the opposite sex (if we’re that way inclined of course!) I’d say it’s easy to be outwardly gender neutral these days though. There are still social norms but most people can wear what they please & no one much cares. Many women never wear dresses…but funnily enough ‘trans’ women all do. They’re presenting stereotypes – it’s cosplay.
I’m not sure it’s cosplay – they may lean towards stereotypes because they want to look feminine not ambiguous – and for most that is not going to be easy. I suspect there may be multiple reasons for someone being trans – there is no reason to suppose the psychology is simple. And we know so little.
Good post.
The role of feminists in unanchoring gender from its moorings in sex often seems to be forgotten how. I sometimes wonder if this wasn’t too aggressive – especially as it was pushed in schools. Is this at least part of the reason for the gender uncertainty of young people?
Looked at historically, it’s impossible not to see feminism and trans as part of the same development. Ours is the age in which sex and gender became a problem. Not a secret, private one, but a very public and political one.
You nailed it Mr Murray! Thank you. And a massive thank you to Kathleen Stock for her brave, brilliant and thorough journalism, and to Unherd and Freddie Sayers for going against the hysterical / witch-hunting grain. And to Lord Plasma for sharing his son’s story.
One thing that strikes me is the very small number of young people who appear to have been patients of GIDS. Has the World been turned upside down, all children exposed to abnormality, language changed for everyone, in order to accommodate an infinitesimally tiny proportion of the World’s young people? Also why have the presentation profiles of patients (showing many similarities) not been thoroughly explored? This cannot masquerade as science when glaring coincidence of non mainstream profile amongst patients is not researched.
An excellent and timely piece. I am convinced that one of the main antidotes to excess in this and other fields suffering from radical progressive cultism is the combination of fact based investigative journalism and calm reasoned debate. The public, when well informed, tends to react strongly against lunacy. Congratulations to Kathleen and UnHerd.
I suggest the next topic for fact based investigation should be corporate DEI training. Even in its own terms, I understand research reveals it is utterly counterproductive and that, if anything, it actually increases unconscious bias and systemic racism.
Meanwhile, the sensible next step on puberty blockers for teenagers is surely to make their prescription without a prior general assessment of autism, social contagion in the peer group, etc etc illegal – or at least medically unacceptable. A few doctors struck off for irresponsible prescription would change behaviour rapidly. Prior to the assessment, instead of teenagers being automatically “affirmed” 100% in their new gender choice they should be told that it is one amongst several possible explanations for their feelings i.e. it should neither be denied nor unambiguously endorsed.
Lastly, hidden away in this excellent essay was the truly radical idea that adults are not fully psychological mature until they are twenty five. Although I believe this is relatively uncontroversial amongst psychologists, unleashing this thought in public debate may cause mayhem. After Kathleen has slain the trans activist dragon, should we expect her next campaign to be raising the voting age to twenty five? with Charles Stanhope – an obvious ally – pointing out in support that this was Roman approach? The mind boggles.
Hear hear sir!
It is logically impossible to block sexual development without blocking the psychosexual development imperative for informed consent to irreversible loss of sexual & reproductive function. The legal clock they are running out is predicated on puberty having taken place by 18. Blocking the emotional development of the ‘terrible twos’ for a year would not result in a 3 year old with the emotional development of a 3 year old.
My concern is that by closing the Tavistock clinic (quite rightly) and then encouraging the opening of many more ‘hubs’ we are spreading this appalling trend, like the hydra,
.
Good to see UnHerd venturing beyond the limits of opinion-churning columns and getting stuck into some investigative journalism. Let’s hope this is the first of many. There are a host of institutions which could do with a thorough investigative light shone on their methods, their staff and the extent of their powers. My first choice would be Ofcom.
Mine would be Ofgem, especially after the doubling of the “standing charge”.
“ For instance, the website of Indigo, the pilot service in Manchester, says: “We know that trans and non-binary people are the experts of their own experience… Our services are trans and non-binary-led, with trans and non-binary people guiding and feeding into them at all levels.”
A literal admission that rather than clinicians leading it is the lunatics who have taken over the asylum.
Sunak has just announced he intends to ban ‘trans conversion therapy’. The gender-affirming model is well and truly back on track in the UK. If this is the single issue for you, you may as well vote Labour now because the Tories – while they claim to know what a woman is – still apparently think it’s a good idea to try and change someone’s sex with hormones and a knife. If you have a gender non-conforming child who is drinking the Kool-aid, either on TikTok or at school, and you fear that the psychotherapists and the NHS are going to recommend chemical and surgical intervention to sterilise and mutilate them, think seriously about migrating to a red state in the US or to Finland, because the UK is fast becoming unsafe – whoever you vote for …
Don’t Labour believe in “gender-affirming care” tooand with bells on.
Even though it actually acts as a form of gay conversion therapy in itself.
At least Sunak doesn’t want to do it. He’s being blackmailed by a group of about 26 trans ally Tory MPs who have threatened to entirely derail his Justice Bill (from memory I think that’s what they’re going after) if he doesn’t introduce the ban.
Transgenderism rests on the notion that there is a “self” somewhere inside you, separate from the body that hosts it, which is capable of determining whether you are ‘really’ in the ‘right’ body. This is philosophical and psychological nonsense, but it is the basis of the equally ridiculous idea that gender dysphoria is a normal, healthy expression of human identity. It’s not. It’s a disorder, obviously, perhaps in the area of OCD (the doubting disease as it was called in the 19th century), dissociation and even aspects of psychosis – losing touch with reality. But the false Californian belief system of endless self reinvention in the search for hyperindividualistic libertarian-flavoured “authenticity” and imaginary “liberation” currently completely obscures the mundane truth that being human is difficult.
“Transgenderism rests on the notion that there is a “self” somewhere inside you, separate from the body that hosts it,” <– There is no such thing as transgenderism, it is not an ideology or philosophy. It is a physical condition produced by anatomy — you will be unable to find any evidentiary support for you ludicrous claims.
The whole basis of gender affirming care is that by mischance of genetics and or natal environment, the anatomy producing one’s gender and that producing one’s sex have developed at odds with each other — and the examples of people attempting to raise children randomly or purposefully contrary their probable gender, such as David Reimer, bear out that theory . . .
. . . as does the drastic reduction is depression and suicidality seen in those who are diagnosed with gender dysphoria per proper standards of care such as those propounded by the WPATH, while young enough to benefit from the fully. That diagnosis has an accuracy rate in excess of 99%, and you have no examples to the contrary.
“the anatomy producing one’s gender” makes absolutely no sense I’m afraid.
I already knew reality made no sense to you.
https://taliaperkinssspace.quora.com/People-are-born-transgender-they-are-not-mentally-ill-it-is-no-paraphilia-it-is-a-physical-variance-from-the-usual-at
You want it to be real, and pretend it is real, a sort of perfection per usual which in human development never is never universally seen — only usually.
I can see your blue hair from NZ
I’m completely fed up with the notion that there’s such a thing as a ‘trans’ child. Has the entire medical establishment developed Munchausen’s by Proxy? All children find puberty confusing, difficult, sometimes frightening. It’s the one major transition that all humans go through. Unless it’s way too early or otherwise a health concern, to prevent or deny a natural puberty is abuse. As for them deciding for themselves about their ‘gender’ (or to be exact, ‘sex’) we don’t let children drive or drink alcohol or carry guns or take drugs or operate heavy machinery or run the bloody country. But let them tell you they want to self-mutilate and suddenly they’ve developed a deep wisdom & understanding about sex, the universe and everything? It’s ludicrous. Those with true dysphoria need care and responsible medical health adults around to help them come to terms with the body they have.
I thank my stars that this rubbish wasn’t pushed on children when I was growing up in the 60 & 70s. A whole group of my girl friends when we were 12/13 years old used to say we wished we were boys. We’d have been instantly ‘affirmed’ and swept up into the maelstrom of drugs and surgery if we’d been growing up today. We were lucky.
An excellent response. My mother was a tomboy; so was I. She lived a heterosexual life; I’m lesbian. Straight or gay, girls or boys, these young people need natural puberty, with all its difficulties, to begin to know who they really are.
“Straight or gay, girls or boys, these young people need natural puberty, with all its difficulties, to begin to know who they really are.” <– No, they do not. What makes someone a man or woman occurs in the womb, and has solely to do with the brain between the ears and not the sex between the legs.
A brilliant article. Sorry to say that the findings of it are not in the least bit surprising, this is exactly what I expected when the closure of GIDS was announced. My first thought was it’ll just be the same people doing the same things in several places instead of one, and here it is!
1. No public funding for activists – none of them do research, they just broadcast opinions
2. Any employee of the service makes a patient decision supported by anything other than evidence based medicine is struck off
Next, the Sandyford Clinic please
An excellent article. I am reminded of the 1970s album and song ‘Crime of the Century’ by Supertramp. The lyrics are, IMO, chillingly accurate to what we see unfolding before our eyes. It appears to me that gender dysphoria, which I understand to be a mental health issue, is the perfect feeding ground for gender identity ideology, which could be termed the crime of the 21st century.
But perhaps it rather works the other way round: gender identity ideology creates, or at the very least, supports the development and existence of gender dysphoria. It is not the affected children and their parents that benefit from this development but big pharma. After all, medical transition guarantees a life-long income stream for pharmaceutical companies.
Kathleen Stock’s book ‘Material Girls: Why Reality Matters for Feminism’ arrived yesterday. I’m looking forward to reading it.
I assume KS is part of the new realism movement in philosophy or allied to it. It’s an interesting subtitle: implying, rightly in my opinion, that feminists need to be reminded that reality matters. For way too long now feminism has been all about discourses and narratives and dismissing disagreement as “patriarchy”. More mythological than scientific.
But the encounter with reality may be a difficult one. Some of the old weak minded thinking will have to go. Real issues will have to be faced as they are, not as they are imagined to be. Feminism can only gain by this, but it may be a bitter pill for some to swallow. Being free to believe whatever suits you, and your pet ideology, is a bit of a jolly. Having reality as arbiter is a lot less fun.
The same way mens rights activists believe that issues are as they imagine them to be?
Everybody needs to be challenged if they have drifted away from reality into a conceptual wonderland, or if their thinking is flawed. Do you have examples in mind?
“…NHS Gender Identity Development Service…” Sounds like something from a 1984 nightmare world.
Is this a ray of hope ?
” Long-running divisions on banning conversion therapy have seen Rishi Sunak dither on picking his side. But this morning’s Times reveals the King’s Speech will include draft legislation to ban attempts to change someone’s sexuality and gender identity in England and Wales, making it a criminal offence”
I’m assuming this is aimed at stopping “conversion therapy” – so may not be the ray you are looking for.
Therapy which tries to return someone from a trans identity back to one aligned with their actual sex is usually seen as an example of conversion therapy.
This is the opposite of a ray of hope. By banning ‘trans conversion therapy’ they force therapists to adopt a gender-affirming care model, or face being struck off or going to jail.
Or at least make it a pretty terrifying tightrope walk.
The headline should read ‘England’s’ new trans clinics. As the Scottish organisation ScotPAG noted, there are two faces to the NHS in UK. NHS England has been subjected to rigorous scrutiny by the Cass Report and Hannah Barnes, yet is still chaotic and captured. NHS Scotland has had no such scrutiny & has retreated into an impenetrable and sullen silence where ideological capture also prevails.
Trans is paedophilia remarketed.
That is a re-marketing of the failed lies told against homosexuals, it will fail again.
That’s just silly. Can’t believe you got upvoted for it
I have no idea why it surprises you.
Sue the bast**ds, close/defund the woke universities and bring back trade schools. Get the gender professors brick-laying
One of the biggest problems with running gender dysphoria clinics as a specialist service is that almost all the people who want to work in them will be ideologues with an anything but neutral approach to affirmation. These services are deeply unpopular with, for example, psychiatry trainees who might be rotated through them.
The only possible (or, at least, likely) futures for them are to continue to be run by people with ideological skin in the game, or for them to be absorbed into general medical, psychiatric, psychology services. Running them as ideologically neutral specialist services would require a very logistically challenging purge of those with a bias towards the transactivist mindset.
This is such a general issue. Even academics will be drawn to areas of study where they have a strong allegiance with one side of the debate.
How can a non-binary person be pregnant? Must have been doing something pretty binary to get in that condition.
Awkward, isn’t it? To be in the most womanly of conditions while denying you’re a woman.
“How can a non-binary person be pregnant?” <– Because some of them have working female reproductive systems, you idiot.
Women should sue for free breast enhancement surgery if men can get this and if other women can get free breast elimination surgery. Surely breast size choice is part of gender expression.
The issue of funding for ‘health’ treatment is key: why fund health treatment for something that is not a health problem? Having and eating cake…
Talia Perkins, Champagne Socialist and David Morley: two bullshit spewing advocates of child mutilation and their cowardly enabler. Where are the real men and women?
Except I’m the only one here with any facts, and you want the mutilation of a boy forced to have a period and breasts and a girl forced to have beard and a deep voice. They are real men and women — you are a permanent cowardly child.
Everything you say is solipsistic bullshit which you state is if it were irrefutable truth, which absolutely none of it is. You must be twisted and hollow inside to advocate for the things you’re advocating for. There are none more venal and craven than those who would harm children.
What I say is backed up by facts which you have not factually refuted, and since what I cite was not generated by myself it is not solipsistic. You are the venal and craven one trying to harm children.
You have no ‘facts’, it’s all made up horseshit. No point arguing with a sick mind.
These are all facts.
https://taliaperkinssspace.quora.com/People-are-born-transgender-they-are-not-mentally-ill-it-is-no-paraphilia-it-is-a-physical-variance-from-the-usual-at
You have no factual basis on which to argue.
The only thing the three of us have in common is that, deliberately or not, we rile up the dunces. Entertaining at least.
People who recognize the reality of biology are ‘dunces’? You just don’t have the spine to call out the glaringly obvious insanity and sick goals of the trans lobby, Neville.
You do not recognize all of biology to be reality. That is why you think what is between the ears is immaterial, other than as psychiatry.
Journalism at its best. Brava to Dr Stock and Unherd for such a thorough investigation into this dangerous collision between science and ideology.
In a sane world every one of these ‘clinicians’ would be standing in the dock at the Old Bailey charged with conspiracy to inflict grievous bodily harm.
This informative article points to only one conclusion: Transhumanism is here to stay and the gendered mind requires concerted research, not just psychoanalytically but in today´s production of hormonal imbalances in young people that results in this ´transgendered mind´ which may also have a strong relationship with the preponderance of autism as a distinctly modern condition.
You make an important point. Even if the tide of trans-affirmation at a very young age were to be turned away from precipitate medical intervention, there’s something going on in the collective human psyche – probably as a result of, but not exclusively, the internet – which may have been lying dormant but has now established a foothold in plain view.
Prior to now, myths and sects have arisen around the issue, not just of trans-sexuality but the merging of humans with gods; indeed, Christianity is based upon the precept of Jesus being both man and god. What lies behind this psychic phenomenon really does need to be better understood.
Excellent article and thank goodness somebody’s doing some investigative journalism – the bulk of the media & political establishment has capitulated to gender ideology, which is the biggest threat to the safeguarding of children of our times.
It’s apparently too much to hope that Hobbs et al. would act as credible psychologists and doctors — according to historical professional standards — instead of imposing a “social justice and equalities framework” on vulnerable children whose dysphoria needs to be carefully investigated, not automatically affirmed.
These people are not fit for purpose, unless that purpose is to shill for a delusional ideology that demonstrably and sometimes permanently harms young people. They should not be involved in any response to the Cass review of Gids.
Thanks to Ms. Stock for so capably demonstrating her investigative journalism skills, in addition to those already in evidence as academic and author.
Do those treated with puberty blockers remain prepubescent as adults?
Puberty blockers were initially sold as a delaying mechanism to allow for time in which to explore options. They were not initially sold as resulting in a permanent, irreversible change.
But can an 18 year old whose puberty has been blocked and who decides to stop taking them, then go through a much delayed puberty? Or has the moment passed forever, meaning they will always be prepubescent and never be a fully sexual adult?
My understanding is that it temporarily pauses puberty, and with cessation the clock starts to tick again. There must be some time limit on this though.
I’m not so sure about that, having heard various opinions, although it must depend on the age at which the puberty blockers were started and stopped.
Part of the problem is that puberty blockers are frequently followed by cross-sex hormones then actual surgery, often in quick succession.
I’m not in favour. But like you I find objective information is hard to find. As is the case with the whole area. Why we would be implementing actions like this when we seem to know so little of what is going on is beyond me.
“But like you I find objective information is hard to find.”
No, you do not. You will find it impossible to locate objective evidence which supports your inclinations — that is a different thing.
“Why we would be implementing actions like this when we seem to know so little of what is going on is beyond me.”
It is only your baseless pretense that we know little of what is going on.
I don’t know all the answers but it certainly isn’t the simple ‘pause’ it’s made out to be. When used for precocious puberty these drugs are used for as short a time as possible to avoid developmental disruption as much as possible.
We don’t know enough because data collection has been sketchy at best. But there is plenty of evidence that some important developmental milestones, once missed, can’t be retriggered. Boys who have been on blockers that have inhibited their penile growth throughout normal puberty will not ‘catch up’ that growth and will always be left with a micro p***s.
Puberty blockers actually work on the brain rather than directly on the gonads and logic would suggest to me that the brain is coordinating a lot of different things developing alongside eachother during puberty and young adulthood. It stands to reason you can’t actually just ‘pause’ one bit without lasting effect. I did see mention of a study the other day which found that those who had been on blockers followed by cross sex hormones had IQs on average 10 points lower than their unmedicated peers suggesting that the disruption goes far beyond sexual characteristics.
I don’t know all the answers but it certainly isn’t the simple ‘pause’ it’s made out to be. When used for precocious puberty these drugs are used for as short a time as possible to avoid developmental disruption as much as possible.
We don’t know enough because data collection has been sketchy at best. But there is plenty of evidence that some important developmental milestones, once missed, can’t be retriggered. Boys who have been on blockers that have inhibited their penile growth throughout normal puberty will not ‘catch up’ that growth and will always be left with very small genitals.
Puberty blockers actually work on the brain rather than directly on the gonads and logic would suggest to me that the brain is coordinating a lot of different things developing alongside eachother during puberty and young adulthood. It stands to reason you can’t actually just ‘pause’ one bit without lasting effect. I did see mention of a study the other day which found that those who had been on blockers followed by cross sex hormones had IQs on average 10 points lower than their unmedicated peers suggesting that the disruption goes far beyond sexual characteristics.
“When used for precocious puberty these drugs are used for as short a time as possible to avoid developmental disruption as much as possible.” <– And for as long as 10 years.
“We don’t know enough because data collection has been sketchy at best. But there is plenty of evidence that some important developmental milestones, once missed, can’t be retriggered. Boys who have been on blockers that have inhibited their penile growth throughout normal puberty will not ‘catch up’ that growth and will always be left with very small genitals.” <– You have not the slightest evidence for anything you have claimed.
“Puberty blockers actually … beyond sexual characteristics.” <- Fears based on nothing real, and in the 40 some years they have been in use, such problems would have been noted.
There is an ideological reason you are unable to draw a rational conclusion from that fact.
“Do those treated with puberty blockers remain prepubescent as adults?” <– No, not as a result of puberty blockers. For that matter, you can not possibly have any honest excuse for asking the question. They have been in regular use for over 40 years — do you really think any actual side effects are unnoticed?
Puberty blockers block puberty. It’s what they do. Why do you object to me raising questions about these powerful drugs?
If a 12 year old is put on puberty blockers and stays on them throughout adolescence, what happens if they then come off them?
Do they go through puberty in their late teens and early twenties? Or do they never go through puberty at all, having missed the body’s time frame?
The problem in finding an answer is that in practice, puberty blockers are regularly followed by cross-sex hormones and actual surgery, often in quick succession, so there’s a problem isolating which drug or procedure is doing what?
“Why do you object to me raising questions about these powerful drugs?” <– Because you have no factual basis for your objections, and the fact you are asking the questions you are asking means you have already decided to not look for or have decided to ignore the facts which already exist which answer them.
You have yet to express any honest question here.
If a 12 year old is put on puberty blockers and stays on them throughout adolescence, what happens if they then come off them? Do they go through puberty in their late teens and early twenties?” <– Would not happen per protocol since about the longest any child might be on blockers for gender dysphoria is 3 to 4 years, 5 at the very unlikely outside. Generally, 1 year on blockers is required for youth prior to any HRT. What happens if they stop blockers without cross-sex HRT is they undergo the puberty of their birth sex, as much as their prior anatomy allows. What happens if they stop blockers with cross-sex HRT is they undergo the puberty not that of their birth sex, as much as their prior anatomy allows. None of this is concealed in any way at any point by competent caregivers.
“Or do they never go through puberty at all, having missed the body’s time frame?” <– Within the age range involved, there is no such time frame.
“The problem in finding an answer is that in practice, puberty blockers are regularly followed by cross-sex hormones and actual surgery, often in quick succession, so there’s a problem isolating which drug or procedure is doing what?” <– No, there is not, because regret rate for such surgery is under 1%, also, the far larger number of people given puberty blockers for precocious puberty, endometriosis, and some sex related cancers show no signs of any such complications regardless of their age.
All of that is already known and publicly available. Why would you ask here unless your real purpose was to affirm your certainty that transgender children should be condemned by your preferred policy to the hell for which you think they are fit?
“Generally, 1 year on blockers is required for youth prior to any HRT. What happens if they stop blockers without cross-sex HRT is they undergo the puberty of their birth sex, as much as their prior anatomy allows. What happens if they stop blockers with cross-sex HRT is they undergo the puberty not that of their birth sex, as much as their prior anatomy allows.”
What does this mean? What is their “prior anatomy”? Are you saying that puberty blockers can change the anatomy even if only taken for a year?
Chloe Cole is the Californian detransitioner who is suing the health body responsible for prescribing her puberty blockers at 12 years old, followed by cross-sex hormones a year later, then a mastectomy at 15.
She now has a permanently deep, masculine voice because her voice box developed like a man’s would and this change is permanent.
Puberty blockers are the first stage in the process known as ‘gender affirming care’ which has left Chloe Cole, a young woman in her early twenties, without breasts, a permanently deep voice, changes to the structure of her face, and without knowing if her fertility has been affected or not.
And there are thousands like her, who have been permanently changed by the gender treatment they received, and now regret.
And it all starts with puberty blockers ……
Apparently puberty blockers prevent the bones mineralising. Have you heard about that?
“What does this mean? What is their “prior anatomy”?” <– It means the obvious, that not everyone develops identically. Does every male human look like Gigachad? No. Could every male look like Gigachad if they worked hard enough at it? No.
Chloe Cole is the victim primarily of her parent’s who shopped her around to the three most permissive caregiver’s in her area before threatening to sue the 4th if they did not endorse surgery. Having evaded the WPATH standards of care entirely, her experience has nothing to say about those standards. At that it is worth noting that of the 3 total cases in history known to me of any FtM transgender youth having mastectomy at age 13, two are very happy with the results and now in their 30’s.
“And there are thousands like her, who have been permanently changed by the gender treatment they received, and now regret.” <– So what? That is consistent with a regret rate below 1%. Why do you seek to condemn to a living hell the other 99%+?
“Apparently puberty blockers prevent the bones mineralising. Have you heard about that?” <– I have heard that lie told before. There are in fact no instances of any person who underwent puberty who have any above baseline osteoporosis afterwards. You repeat a myth told in order to deceive, and you are apparently happy to be deceived.
Puberty mineralizes bone. Delaying puberty delays that mineralization. On either the puberty of the birth sex or one under cross-sex HRT occurring, bone then mineralizes.
The lie is to claim an expected temporary effect of the puberty blockers with a permanent effect never seen.
Are you relying on dodgy data from Tavistock GIDS – data which has been queried many times?
For example – “Dr Michael Biggs (an advisor to SEGM) has been calling for the release of data from the Tavistock’s experiment since 2019. A subset of the data were finally released following the judicial review into puberty suppression at the Tavistock clinic. Biggs’ reanalysis has just been published in the Journal of Paediatric Endocrinology and Metabolism. It finds that after two years on GnRHa, the Z-scores for a significant minority of the children had declined to a level that should trigger clinical concern. For the hip, one third of Z-scores were below -2. For the spine, over a quarter of Z-scores were below the threshold of -2. Some had even fallen below ‑3; such low bone density is found in only 0.13% of the population.
(SEGM, the Society for Evidence based Gender Medicine.)
And here’s more, showing how dodgy the data from Tavistock GIDS actually is.
“The clinical consequences of the failure to accrue normal bone mass are unknown, because the Tavistock’s researchers have not collected data on fractures experienced by children undergoing puberty suppression. Biggs cites an example of one patient at the Tavistock clinic who started GnRHa at age 12 and then experienced four broken bones by the age of 16. But there is no way of knowing whether this case is exceptional.” (Schagen et al. 2020).
Four broken bones by the age of 16 …….
Are you reading this?
As for the effects of puberty blockers being reversible –
“Puberty is an important time for bone strength development,” cautions Dr. Cartaya. “Because we’re pausing it, the decrease in bone mineral density that we see is likely due to the lack of the pubertal encouragement of bone growth. Once a child goes off of a puberty blocker, the bone mineral density increases, but it does not get back to where it was before.” Cleveland Clinic.
They never make up for lost time on puberty blockers.
Who is telling lies here?
No, in fact I am not aware of any data from Tavistock particularly. I use more primary sources.
“It finds that … of the population.” <– Declined relative to whom? The usual trick as I mentioned is pretending poeple on blockers a the time can be compared to other people of their age who are not on blockers, the deceit just as I mentioned. Only if for example he is comparing people post blockers in say their 20’s to other poeple in their 20’s could there even possibly be anything of interest.
““The clinical consequences … case is exceptional.” <– What sports was the child involved with? And again, compared with whom?
“As for the effects of puberty blockers being reversible –
“Puberty is an … telling lies here?” <– You are telling the lies here, and you have provided no evidence of what you claim, that there is an irreversible decrease in mineralization of bone in puberty blocked youth after a certain age of administration of blockers.
That same Cleveland Clinic you quoted I can quote as well:
“When a child starts a puberty blocker, it doesn’t mean their body’s puberty changes are permanently suspended. A puberty blocker is more like a short-term solution. It stops the process for as long as a child is using the medication. Once usage stops, puberty will resume. “
There is a certain historical irony here.
The suggestion, made here as elsewhere, is that without the pressure of trans ideology, many of these girls would grow up to be perfectly normal lesbians. Except that it is only relatively recently that this has been considered a normal outcome. And only after a long ideological fight, on similar lines to the current one.
Mary Whitehouse, for example, saw homosexual activists as taking advantage of a natural homosexual phase in child development to convince children they were gay. Absent such pressure, gay identifying children might grow up into “perfectly normal” heterosexuals.
In a sense, by ceding the right to set a scientifically discovered or socially sanctioned standard of normality (ie one outside subjective lived experience), we are in a poor position to try and reintroduce such a standard now.
Funny then that people have been “growing up gay” well before any “mainstream activism” appeared.
It may not have been considered a “normal” outcome but happened quite often anyway despite the wall-to-wall heteosexuality displayed by the surrounding dominant culture.
Ditto trans. There have always been trans individuals, and in some cultures there is greater acceptance that there are such individuals. In our own culture there was less acceptance, but as you put it “it happened quite often”.
There was even a small amount of sanctioned trans behaviour, through drag, pantomime, and fancy dress parties etc.
That aside, you appear to have missed my point anyway.
“Mary Whitehouse, for example, saw homosexual activists as taking advantage of a natural homosexual phase in child development to convince children they were gay. Absent such pressure, gay identifying children might grow up into “perfectly normal” heterosexuals.” <– No, that is not the case. Her confabulations are only that.
I’m paraphrasing MW
A google search (is there any other kind?) quickly reveals that Dr Christine Mimnagh is herself/himself a transgendered person.
There is a fundamental psychological question in all of this. In the complexity of the human psyche, each of us have an ‘internal other’. This in an ‘Otherness’ which is ‘me’ and ‘not me’. Troubled by a sense, feeling, or disturbing dream images of this ‘other’, we seek to rationalise it. So, naively and psychologically ‘innocently’, we try and find a concrete sense of this ‘other’. We turn to the ‘other’ of a contra-sexual image. This is clearly a failure to grasp psychologically what we are dealing with. It is like someone suffering from a generalised, abstract, anxiety, who seeks to deal with it by ‘inventing’ a ‘dog phobia’. Then that person feels erroneously that they have found the answer to their otherwise inexplicable anxiety. We seek to concretise the elusiveness of the psyche. This is a grave psychological mistake with harmful consequences.
Excellent article. It’s fascinating how GIDS acted as essentially an elaborate eugenics sandbox aimed at taking autism out of the general population.
Interesting to see that a deep dive investigation like this affirms the fact of “activist clinicians”. I expect a similar trawl through schools would find “acitivist teachers” and we already know the MSM has a high % of workers identifying as “activist journalists”. Remember the Lucy Letby trial circus featured “celebrity pyschiatrists” and “celebrity paediatric surgeons”. These status signifiers obviously function as ranks in the “long march through the institutions”. After a period as “activist radiographer” for example you become a “celebrity radiographer”. They show how ineffective the march itself has become – the damaged trans kids don’t strike me as “dictatorship of the proletariat” material and their public sector mentors spend so much time off sick i doubt they’d be fit enough for a revolution. They also show how bizarre neo-communism is compared to its fairly mundane origins in Marxist Leninism. After all Lysenko was 1 single celebrity under Stalin and didn’t have an “activist” following. Try applying neo-communist language markers to real jobs and professions and it shows the paucity of their thinking but is also quite scary: “Activist safety officer” anyone? “Celebrity Railway Signalling Engineer”? The mind boggles, but equally the ability of the modern left to strike fear into civil society is much reduced by these antics. Perhaps that’s why they want to leave the heavy lifting to their pals in Hamas and Daesh etc.
The Tavistock is still open and will be replaced by two new centers run by a lot of the same sick bastards, so now the hydra has two heads. Puberty blockers shouldn’t be given to any child ever, period. There is only one thing that will stop this tide of heinous, criminal child abuse and that is to completely reject the trans ideology and its supporters. Zero tolerance for their ludicrous claims.There are no ‘trans kids’, just shit parents.
“Puberty blockers shouldn’t be given to any child ever, period.” <– Why? Do you even have the first idea why these drugs exist? No.
“There are no ‘trans kids’, just shit parents.” <– Too bad for you there is no evidence whatsoever of what you claim. All transgender people are or were trans kids, because it is a condition existing at birth.
It’s sad, isn’t it? We’re encouraged to give children life-altering drugs and surgery, but penalized for trying to talk them out of it.
No, you are penalized for decrying their making a choice known to be a very good one to the tune of more than 99 times out of 100 — where you are motivated by loathing and disgust for the child and only based on your ignorance.
There is a fundamental psychological question in this. In the complexity of the psyche, there is an ‘internal other’, which is ‘me’ and ‘not me’. Haunted by such disturbing sensations, feelings, and dream images, we try to rationalize and concretise them. So, we often turn to a contra-sexual fantasy figure. We identify with this psychic image, and erroneously seek to embody it (often literally). This fantasy of the ‘Other’ can take other forms, of course. But gender ideology pushes us towards the ‘opposite’ gender figure. Though such images come from a deeper level in the psyche, we personalise and literalize them. It is like having a generalised, abstract anxiety. We try and concretise it by ‘inventing’, say, a ‘dog phobia’. Then we can feel at least we understand why we are anxious and keep away from dogs. It keeps the anxiety contained. Thus, do we deal with the ‘internal other’, inherent in the very nature and complexity of the psyche. A naivety and simplistic psychology, psychotherapy, and psychiatry are then complicit in this literalising, concretising process.
None of our resident Transatollahs making an appearance, I see.
Keeping to the shallows. Wise strategy.
If conversion therapy is banned, it will be increasingly hard to implement any kind of approach which is not gender affirming. At the very least, any non gender affirming care will involve suspending belief in the persons claimed identity while the issue is explored.
Will it really be possible to explore other causes? And if the professional convinces the patient that they are not really a boy in a girls body but that their feelings have some other cause, isn’t that an example of conversion?
With its concept of the self-made man or the self-made woman, gender self-identification is where Thatcherism has inevitably ended up. It was an unknown concept in 2010, and has arisen entirely under a Conservative Government. Margaret Thatcher was last depicted on British television, for the first time in quite a while, in December’s Prince Andrew: The Musical, the title of which spoke for itself, and in which she was played by one Baga Chipz, a drag queen. Well, of course. A figure comparable to Thatcher, emerging in the Britain of the 2020s, would be assumed to be a transwoman, just as Thatcher herself emerged in the Britain of everything from Danny La Rue and d**k Emery to David Bowie and The Rocky Horror Show.
Hence Thatcher’s destruction of the stockades of male employment, the economic basis of paternal authority in the family and in the wider community. She created the modern Labour Party, the party of middle-class women who used the power of the State to control everyone else, but especially working-class men. Truly, as she herself said, her greatest achievement was New Labour. Leo Abse, who had had the measure of the milk-snatcher, also had the measure of Tony Blair’s androgyny.
Precisely, well said sir.
Thank you.
Absolutely indispensable. Now, remind me who has been in government, well, pretty much forever these days. And who has been defining the paradigm by setting the economic agenda of every Government for nearer 50 years than 40.
We look forward to Labour getting in (didn’t they also have 13 years , 1997-2010? Which is like, “forever”, as you say) and shutting down the harmful practices which flourished during their previous reign.
Do you really think labour are any better?
NO.
I am the last person to advocate voting Labour. Even though it is true that there was none of this in 2010.
Puberty blockers have been in use since well before 2010, but only to “children” over 16 until 2011, according to Google search.
They in fact have been used in children and adults since the ’70s, and out of the experimental stage since the early 80s. They have been in use for gender dysphoria for over 20 years. They are used for precocious puberty, gender dysphoria, some sex related cancers, and endometriosis.
Transgenderism isn’t a national political issue. It is a globalist one that seeks to a) desexualize children and young adults in order to reduce the global population and b) turn young people into the sexual playthings of the rich and powerful. What is becoming increasingly clear is that once we removed Christianity from our Western foundations, we didn’t replace it with secular enlightenment, but with a dark occultism that is gradually infiltrating our once-reliable institutions.
“Moreover, it seems NHS systems are still influenced by activist thinking; in particular, by the idea that a sex-incongruent gender identity is something to be “affirmed”, either as a matter of social justice or as personal liberation.” <– No such thing is true. Gender affirming care is based on the idea gender is a biological characteristic fixed in utero, and that it can not be changed without regard to the pressure or abuse heaped onto a child to try to make as is preferred by another.
It is the factually basis pretense of social conservatives than anything else is true and relevant.
Thanks for commenting. It’s a bit one sided on here. Can you point to the evidence that gender (gender identity?) is fixed in utero. Or is this a hypothesis, a bit like the “gay gene” idea?
There never was a “gay gene” idea. That implies something singular. The “single gay gene” was a strawman argument beaten by social conservatives to cover up for the overwhelming evidence of a biological impetus towards being gay — there are about 30 genetic alleles having more of them means someone is more likely to be gay. These papers talk about the genetic variants associated with being transgender.
https://pubmed.ncbi.nlm.nih.gov/31882810
https://pubmed.ncbi.nlm.nih.gov/17765230/
https://academic.oup.com/jcem/article/104/2/390/5104458
Thanks for that. I used “gay gene” as a kind of shorthand. I realise that for almost all aspects of human personality there are multiple genes
This is very interesting – especially the OU paper because of its size and use of a control group. The research is more advanced than I thought. It would certainly be helpful to have a way of confirming trans identity which is more objective than subjective feelings.
Thanks for making the effort. And please keep contributing to the discussion, even if you get downvotes.
“It would certainly be helpful to have a way of confirming trans identity which is more objective than subjective feelings.” <– The accuracy of diagnosis by the current gender affirming approach with consequent surgery is already higher than 99%.
Why pretend other wise? Why have a firm opinion as you do, when you know not?
I will post links in this reply, and UnHerd may show this in 24 hours. I will duplicate this post without the links, so you know to look for it.
https://pubmed.ncbi.nlm.nih.gov/35690947/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8099405/
“It would certainly be helpful to have a way of confirming trans identity which is more objective than subjective feelings.” <– The accuracy of diagnosis by the current gender affirming approach with consequent surgery is already higher than 99%.
Why pretend other wise? Why have a firm opinion as you do, when you know not?
I will post links in this reply, and UnHerd may show this in 24 hours. I will duplicate this post without the links, so you know to look for it.
Something I have wondered out loud on here (not well received) is whether certain masculine presenting lesbians are in fact trans (or better, that we are dealing with related phenomena).
Their reaction to trans could then be seen as a sort of denial. After all, there is nothing intrinsic about sexual orientation/ same sex attraction that should lead you to adopt male clothing styles. And yet many do. It would perhaps also explain the rather troubled relationship to masculinity that some of these people have.
Further genetic research may give us some answers.
So my perfectly factual reply to you has been disappeared. Do you really think the herd here is on the side of the angels?
I think some people on here seem to go on flagging campaigns against stuff they disagree with. It’s a mixed bag on here, but certain articles bring out the worst. Mainly the ones around the trans issue. Some people on here are open minded, some less so.
I’m probably not on your side in this debate (I want to be completely honest) but nonetheless I find the bigotry and lack of sympathy quite shocking. To be honest I’ve seen it all before – it usually comes from feminists of a certain age – and it seems to reflect a hatred of men rather than of trans people specifically.
It’s good to see some challenge on here.
If you think this is bad, try a Julie Bindel article.
“Given the acknowledged lack of a solid evidence base, to prescribe such poorly-understood drugs privately could be seen to be incautious.” <– What an outlandish lie! They’ve only been in use for more than 40 years and are perfectly well understood.
I love how you liars downvote the literal truth. You aren’t the “unherd” you are only a herd. Resenting reality is not itself a counterpoint.
Talia – try not to rise to the bait. I get downvoted all the time. The more so the better the point I am making. It usually means they have no counter argument.
Can you link to research?
“Can you link to research?”
No, UnHerd removes it.
EDIT: or takes 24 hours or so to unhide it.
“Resenting reality is not itself a counterpoint.”
That’s a bit rich. Seems to work well enough for trans & ideologues!
There is no part of ignoring reality to being transgender. That is why you are unable to point out what part of reality transgender people ignore.
Of the two of us, you are the ideologue.
The biological reality. The part about no woman having a p***s, or there’s no such thing as non binary, or maybe the part, where transwomen are men.
Biological reality is that some women have penises, that non-binary people exist, and transgender women are women for the same reason any woman is. That you pretend there is ever any aspect of human sexual development which is always perfect is your ignoring reality.
Healthy debate occurs when people can agree that they have differences of opinions, not differences in facts.”
— Robert J. Braathe
And I have actual facts and you do not. This debate is about how much success you have in hurting transgender people, including children — no more or less than that.
Speaking of transgender, hurting, children – just read about that 53 year old transwoman, who abducted a young girl for 27 hours of sexual assault and torment. Primary school age. The horrific reality of women and children.
You shouldn’t judge others, by your own standards.
Oh I definitely judge others by my standards — and you certainly do not want to be judged for the sins of other cisgender people by your standards, now, do you?
Exactly my point, you shouldn’t judge others, by your standards. They suck. Seems we’re all out to hurt each other, by your standards. The aim is quite the opposite, in fact.
Keeping women and children safe is the aim, that your lot cannot seem to fathom.
No, by your standards, all transgender people are out to hurt children — this means your standards are those of an imbecile.
“Keeping women and children safe is the aim,” <– Which is not your real aim, or you would be as worried about cisgender people as transgender people.
Your real aim is to hurt transgender people, on the basis of your bigoted disgust.
“Worried about cisgender people as transgender people” … Kinda like, being worried about white people as black people. Weird.
Yet again, the transgender position turns to insults and slurs. That’s a shame, just another typical trans rights activist.
Gaslight and attack. Over and over, again. Far too threatened, to accept sex based facts, and way too privileged to respect other people’s, hard earned rights.
And all because, you refuse to accept that #sexmatters.