January 17, 2024 - 4:00pm
A controversial private hormone clinic for young people with gender dysphoria has been given the go-ahead. The Gender Plus Hormone Clinic has been approved by the regulator, the Care Quality Commission, to prescribe hormones for those over the age of 16, just days after the World Health Organization made a startling admission.
The WHO, which is widely regarded as being captured by gender ideology, recently announced new guidelines on healthcare for transgender people — but these do not apply to children and adolescents. “On review, the evidence base […] is limited and variable regarding the longer-term outcomes of gender-affirming care for children and adolescents,” the WHO admits.
Adolescents, in this context, include individuals up to the age of 19. So is it safe to prescribe cross-sex hormones to patients under that age? The answer, according to the WHO, seems to be that we don’t know.
The new clinic says that hormones will be prescribed only to over-16s who have been assessed by a team of clinical psychologists after a minimum of six sessions. But the fact remains that it isn’t just the WHO which has reservations about such treatment. The NHS acknowledges that long-term use of cross-sex hormones may cause “irreversible changes” and “temporary or even permanent infertility”.
There are obvious questions about whether young people who have self-diagnosed with gender dysphoria, and who may have been influenced by material they’ve found on websites or in books promoting transition, are capable of evaluating the risks of medical intervention. You can’t get a tattoo under the age of 18, but the CQC apparently thinks it’s fine for adolescents to go to a private clinic and pay for hormone treatment with unknown outcomes.
This is exactly what critics predicted would happen when the closure of the Gender Identity Development Service (Gids) at the Tavistock Clinic was announced two years ago. It was severely criticised in an interim report by Dr Hilary Cass which highlighted the service’s “affirmative, non-exploratory approach, often driven by child and parent expectations”. The Cass review said that a diagnosis of gender dysphoria meant other health conditions, such as autism and eating disorders, were in danger of being overlooked.
Two years on, replacement NHS services have yet to open and the waiting list for children expressing anxiety about their sex now stands at five years. With Gids due to close in March, there’s an opportunity for the private sector, which is now filling the gap left by the NHS. The newly-approved clinic is part of Gender Plus, a private service whose staff include clinicians who previously worked at Gids.
The risks of privatising treatment for gender dysphoria, and creating a two-tier system based on family wealth, have been pointed out many times. Families seeking expensive private treatment are likely to have expectations quite at odds with current advice from NHS England, which is that many children who think they’re transgender are going through a “transient phase” and will grow out of it.
It’s hard to know whether the delay in setting up alternative NHS services to Gids has been caused by a shortage of resources or nervousness about abandoning the “affirmative” approach to kids with gender dysphoria. But when an organisation as in thrall to gender identity as the WHO has admitted it doesn’t know the long-term effects of medical intervention, it is surely time for clinicians and regulators to think again.
Joan Smith is a novelist and columnist. She has been Chair of the Mayor of London’s Violence Against Women and Girls Board since 2013. Her book Homegrown: How Domestic Violence Turns Men Into Terrorists was published in 2019.
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SubscribeI was shocked when I saw the news about this a few days ago. My immediate reaction was there is an obvious conflict of interest to the patient from a private service, since there is the inclination to extend and expand treatment, even if it is not the best course of action. This will end badly.
The US model has now reached the UK. Stump up the cash, get whatever treatment you like from a bunch of quacks! Sad times 🙁
The quacks are all on the gender denying side, your side, Graham.
This is a link to what is real and representative of transgender people.
(not a monetized link)
https://taliaperkinssspace.quora.com/People-are-born-transgender-they-are-not-mentally-ill-it-is-no-paraphilia-it-is-a-physical-birth-defect-no-more-a-men
From your link … “It is a physical birth defect”
Claims from the gender ideology front never cease to amaze me in their absurdity. A person’s entire, sexed body–excluding their brain– is a birth defect?
Incredible.
You have the only ideology here, it is to deny physically measured facts. As I point out,t he actual data supports exclusively the fact that transgender people have brains which have sexually dimorphised while in utero, in the pattern more or exactly corresponding to the sex not between their legs. No more, no less.
That is no “new” claim, but what has been theorized for nearly 50 years, and, supported by discovered biological, physical evidence more and more for more than 40 years.
There is no contrary evidence.
Your ideology is the only gender ideology involved, and it is to deny the evidence.
Two questions spring to mind:
If gender, unlike s 3 x, is a social construct, how can people be born ‘transgender’?Where in a new-born is transgenderism located, and by what medical means can it be detected?
Only the “soft sciences” claim anything is a social construct, none of which have any relevance to what is physically measured. Look at those links. Genetics can determine the odds of someone being gay, bi, or transgender, but epigenetics — happenstance — also have a role. In the separated identical twin study, one twin randomly has their hormone surge first and suppress the other one at least briefy, and timing is one of the things determining how these parts of the brain develop — if one such twin is transgender, the other has a 50% chance of also being transgender.
At birth being transgender has no more way of being known than being gay or bi is. So what?
There is no evidence of an inherent gender identity, and plenty of evidence against. The only thing you’re born with a body, secondary effects of
having that body, and the rudiments of a personality. Is it possible your personality fits current society’s stereotype of “what girls are like” when you were born with a p***s and testes? Sure. Does that mean you’re a girl? Hell no. It means you’re a “feminine” (a societal designation) boy. The idea that you should change your body to fit a stereotype is horrifying. Oh, and the science is overwhelmingly on the gender-critical side. Not that science is what’s driving your conviction. That’s an ideology, also with no foundation in reality. By the way, I’m a Liberal.
“There is no evidence of an inherent gender identity, and plenty of evidence against.” <– The opposite is true, and you will cite no evidence for your claimed opinion.
“The only thing you’re born with a body, secondary effects of having that body, and the rudiments of a personality.” <– And the gender of a person is a part of that, literally it is parts of the brain you can remove and put on an anatomy tray.
“Is it possible … foundation in reality.” <– None of which has anything to do with it, or anything to do with reality at all. I literally am the only one here in this thread so far citing any procedurally defensible research. Here is a link to a list of links to such, and other news citations supporting me — and refuting you.
https://taliaperkinssspace.quora.com/People-are-born-transgender-they-are-not-mentally-ill-it-is-no-paraphilia-it-is-a-physical-birth-defect-no-more-a-men
“By the way, I’m a Liberal.” <– No, you are an advocate for grotesque child abuse and functionally an uneducated deliberate imbecile.
Your adoration of politician control of medical care is sickening.
“This will end badly.” <– It likely will not, since the gender affirming standard of care developed over 50 years, and has been in general use for about 20 without any incidents of note.
Can you hear yourself?
Responsible, ethical scientific consensus that evidence of benefit is lacking reframed as “politician control of medical care”
There is no consensus that evidence for gender affirming care is lacking. The actual consensus all goes only the other way.
You’ve already ignored the actual evidence.
The only thing this is really about is a moral panic creating politcal control to prohibit evidence based medicine.
In less slippery language, you’re arguing that there is no evidence that there is no evidence, thus there must be evidence.
Science doesn’t work like that.
No, look at my links. I said exactly what I meant to which is not slippery. The evidence is overwhelming that gender affirming care is far more safe and effective than most medical protocols, and that is the consensus view and there is no evidence against it. — only politically motivated hacks claim other wise. The physicians willing to oppose gender affirming care amount to only 1 in 800 in the US, for example, exactly becaues there is no evidence on basis of which to do so. ACPeds membership is so low it can be explained better by occasional insanity than evidence.
This is the first I’ve heard of the WHO’s new guidelines on gender affirming care for children. I’m shocked and pleased.
The question is not whether Joan Smith and UnHerd are misrepresenting WHO, but how they are.
“The WHO, which is widely regarded as being captured by gender ideology”
Stopped reading here. Utter garbage.
This writer is obsessed with persecuting young trans people and anyone trying to help them. Grotesque.
What are your thoughts on gender nullification?
The good and righteous tell us to comply with the wishes of a 15 year girl when she wants to change gender with life-altering surgery. At the same time, they tell us to ignore the 15 year old girl who doesn’t want to compete in sports against a boy who has changed gender. Funny that.
Give an exact definition of ‘young trans people’?
I can’t resist. A transgender person when young, as opposed middle-aged or old.
The writer is obsessed with protecting vulnerable young children from being dosed up with drugs which have long term side effects, and preventing them undertaking unnecessary and grotesque irreversible surgeries which lead to their sterilization.
No, that is what the writer and you pretend they are about.
Because the accuracy in diagnosis with gender dysphoria is so high with respect to people who actually transition medically — what you are really doing is forcing some boys to have breasts and a period and forcing some girls to have a beard and a deep voice. There is nothing you are pretending is a “long term side effect” which is real — you are claiming the intended effects are side effects. The people who actually take them for such reasons disagree with you to the tune of 99+ to 1.
What is grotesque and unnecessary is the mutilation you want for them.
Sterility, inability to experience sexual pleasure, inability nurture offspring with breast feeding, stunted growth, weakened bones, scar tissue, infections, wound drainage, and a lifelong dependence on pharmaceuticals are the intended effects?
“Mutilation” is the natural development of a human body following its genetic blueprint — written in the absence of human hand–since the moment of conception?
You are truly living in upside down world.
Firstly much of what you said is myth, not real.
There is no such thing ever as inability to experience sexual pleasure, stunted growth, or weakened bones as a result of competently adminstered cross sex HRT. None of what you claim about it is real.
Wound drainage is temporary as with any surgery, and scar tissue not notably any problem either — if a person even chooses surgery. Not all do. When they choose surgery they regret it less than 1% of the time.
Sterility only necessarily results if someone chooses surgery and does not have successful gamete banking, and the same with “inability nurture offspring with breast feeding”. When that is chosen it is not regretted more than 1% of the time.
Up to lifelong use of HRT is not different from any other need for medication — why pretend is this special or objectionable?
It certainly can be and in this case it is.
You have no evidence at all to the contrary.
You apparently have the delusion that the body’s genetic blueprint is always flawless, and never has objectionable results.
For the sake of your delusions, you think you get to force other people to live their lives by your lights.
You are an evil imbecile.
Your last statement sums up the person you are.
No, it does not. If it did, you could find evidence to contradict my views, and also show I have no reason to believe my evidence. It’s the other way ’round though.
You fail to understand that if you throw epithets at people, you have lost all credibility. Calling someone an ‘evil imbecile’, merely because they have a different viewpoint to you, means that you have lost the argument before you have even started.
As a certain Margaret Thatcher once pointed out, “if they attack one personally, it means they have not a single political argument left.”
In usual honest debate she has a point. This is not an honest debate, you are are willful liars.
There you go again; anyone who has a different point of view to you is ‘a wilful liar’.
One of the clearest indicators of a cult mentality is the inability to accept that those outside the cult don’t actually believe the scripture.
There is no such scripture, only evidence you ignore. You are a child abuser in like circumstances to why Flat Earthers are frauds.
I am not the one who is proposing irreversible surgical interventions and life long drug treatments for confused adolescents. You are ignoring the needs of vulnerable young children in order to play out your ideology.
You are proposing they are confused. The evidence shows they are not. You ignore evidence because you love your lies more than you even want health and happiness for these youth.
Why don’t you re-read your comments and count up the ad hominum attacks you have made on people, instead of debating them as a reasonable person.
Why aren’t you able to realize accurate description is not an ad hominem attack, not ever? In any case, I am not saying they are wrong because they are”bad”, I am saying how they choose to be wrong proves they are bad.
When someone finds accurate description of them to be insulting, they should change the fact it is accurate!
It is generically UnHerd’s editorial policy to lie about what the Cass Report says, for example, so there is no doubt Joan Smith is lying as carefully as she dares to here.
Really those monsters who want to force girls to have beards and deep voices and to force boys to have breasts and periods — that’s UnHerd and other Social Conservatives, the gender deniers — should look on the bright side of this.
When there is private care for minorities of sexual dimorphism, they can claim the profit motive is distorting the science . . .
. . . and then complain about socialism at the same time, since the perception of cognitive dissonance requires a functioning mind, and they do not have one, or heart either.
” which is that many children who think they’re transgender are going through a “transient phase” and will grow out of it. ‘ <–
Which supposed conclusion is baseless horseshit — no evidence for it has ever been produced. It has from time to time as with Ken Zucker been fraudulently created. What is real is that almost no one desists, because the screening criteria are effective and social and medical transition effective at alleviating the gender dysphoria caused by being born transgender.
Medical and social transition is quite effective at relieving the misery associated associated with the problem:
https://www.sciencedirect.com/science/article/abs/pii/S1054139X23005608
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423
https://www.inverse.com/article/59830-gender-incongruence-transgender-surgey-survey#%3A~%3Atext%3DThe%20research%2C%20led%20by%20Richard%20Branstrom%2C%20Ph.D.%2C%20and%2Cdiagnosis%20of%20gender%20incongruence%20between%202005%20and%202015
https://www.hsph.harvard.edu/news/hsph-in-the-news/mental-health-benefits-associated-with-gender-affirming-surgery/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4771131/
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423
https://fenwayhealth.org/new-study-shows-transgender-people-who-receive-gender-affirming-surgery-are-significantly-less-likely-to-experience-psychological-distress-or-suicidal-ideation/
Including when tested by randomized trials:
https://pubmed.ncbi.nlm.nih.gov/37676662/
And no, they don’t “change their mind” anymore than they regret surgery.
https://www.sciencedaily.com/releases/2015/01/150129132924.htm
And it is not a Social Media created fad.
https://pubmed.ncbi.nlm.nih.gov/36935303/
All the talk about teens accessing hormones is just obfuscation around the basic question: “does any ‘natural law’ prescribe limits on what humans may consensually do with their own bodies?”
The progressives and liberals (derived from Mill and Locke) insist that human freedom is limitless, and thus any infringements are illegitimate and must fall in the name of maximal individual autonomy.
The conservatives (derived from Burke) claim that limits and hierarchy are integral parts of the human condition, and that the tearing down of all such institutions is gravely detrimental to human well-being.
Everything else on the subject of transgenderism or transhumanism or even public recognition of gay relationships largely comes down to this question. Which is why Anglo politics has become so toxic in the last few decades, since this question is essentially theological not political.
I notice that you refer throughout to ‘humans’ without distinguishing between children and adults. Even leaving the obvious consent issue to one side, do you believe that, say, a 13-year-old can consent in a meaningful sense to medical surgical intervention ‘affirming’ transgenderism? What about a 10-year-old? Or a 4-year-old?
No, I do not believe that in any of those cases. Nor do I believe that a 25 year old or a 40 year old has some kind of right to do so either.
My point is that these two are inseparable. Once you accept that humans have an innate right to use technological means to make their bodies match their minds, you have entered what Mary Harrington calls the “cyborg” world. You’re no longer arguing about whether there are natural limits to humans redesigning themselves, but only about what limits ought to bee imposed externally. That’s why it’s a losing proposition. Once you leave natural law behind, you’ve already joined the Noah Harari / transhumanist kegger even if you don’t realize it.
As appealing as the “adults can do what they want but let’s just not let teenagers slice off their private parts” position is… it’s built on sand.
Nothing you are framing as a “natural law” is. E-mc^2 is a natural law. Being forced by you to be blind or crippled, or a man or a woman for the sake of some one else’s moral vanity or delusions (yours) is only you taking license with other people.
I’ve got no idea what this comment is trying to say.
Very good point. It’s always good to go up a level of abstraction when stuck inside a large collection of trees.
In my limited understanding of things, would it make sense to possibly add a third prong of “socially functional” to “theological vs political” ?
Could you please say what ‘you’ think, rather than quoting people who I have never heard of.
To put it more clearly, Mark, I think there’s no separating the teen-trans issue from the adult-trans issue. If adults have a right to use medical and pharmaceutical means to modify themselves, there is no stopping teenagers (or parents of teenagers) from doing the same. If redesigning your body and mind to your own specifications is an innate human right, denying that right to 17 or 14 or 10 year olds is child abuse.
I’m a philosophy teacher, so I sometimes forget that not everyone has actually read people like Locke and Mill and Burke. However, they’re not hard to get to know, and are very useful.
Your modern world is derived mostly from John Stuart Mill, so you could probably skip him. I would start with Edmund Burke, who was arguing against John Locke’s new Enlightenment-era idea of a value-neutral state. Hillsdale College has a lot of free online classes, and I’m sure you could find a few lectures and readings on all 3 of those figures that would get you started.
“I’m a philosophy teacher” <– Apparently not a very good one.
Burke railed against the Endarkenment begun by Rousseau and the Montagnards, not Locke.
Liberty is a value, in fact it is the greatest public good.
Child abuse is the manipulation of a child for the purpose of sexual, emotional or physical abuse, usually by an adult. I think the ‘trans activists’ fit the bill beautifully.