November 28, 2023 - 7:00am
On the surface, last summer’s headlines about the Tavistock Gender Identity Development Service for children and adolescents sounded definitive, with the National Health Service ordering the clinic’s closure after it was found “not safe” for patients. That harsh verdict was supposed to be the end of an era and the start of a fresh approach to working with gender-distressed children and young people.
It wasn’t. This weekend, the Telegraph reported that the number of children prescribed puberty-suppressing drugs has doubled since the National Health Service promised to curb the practice last summer, with at least 100 children initiating the controversial treatment between July 2022 and October 2023.
Last summer, in the wake of a damning independent review, the NHS announced that “puberty blockers will not be made routinely available outside of research,” “except in exceptional circumstances on a case-by-case basis.” These changes would kick in when the new youth gender services opened and when researchers had developed a new clinical trial to study the effects of puberty-blocking drugs on children and adolescents with early-onset gender dysphoria.
But the launch of the new youth gender services has been repeatedly delayed and the clinical trial the NHS outlined has not yet materialised, leaving thousands of young patients in limbo.
Last month, Kathleen Stock reported on the struggle to reorganise youth gender services in England and Wales — and pointed out the difficulties of designing a clinical trial that would meet basic standards of medical ethics, given the serious risks and unknowns and dubious benefits. An NHS research trial manager Stock interviewed described the idea of such a trial as “completely insane.”
Over the past few years, the evidence supporting puberty suppression has taken one hit after another. The NHS’s website now warns that “little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria” and that effects on mental health, brain development, and bone density are also unknown.
Unpromising findings — like research that found “no changes in psychological function” for youth on blockers — turned out to be worse on closer investigation. Rather than being merely ineffective, 34% saw their mental health “deteriorate” on blockers, while 29% showed signs of improvement.
And the theory that puberty blockers bought patients “time to think” broke down, as reporter Hannah Barnes explained in an interview with WBUR: “Because… what are the chances of every single young person with their very different needs and backgrounds given time to think, and all thinking in the same way?”
As a result of these delays by the likes of the NHS, children and young people are falling into the gap between a service deemed “not safe” for patients and reforms that have yet to take shape. In the absence of meaningful change, a reckless model of care prevails.
What’s happening — or not happening — in England and Wales is a warning for other medical systems attempting to reverse course. It’s not enough to dismantle the evidence base and condemn a treatment model that has turned the lives of distressed children and adolescents into medical experiments. These are necessary but hardly sufficient steps on the long road back from a medical scandal.
Patients who have come to see themselves — their identities and their struggles — in these terms are not going away. They urgently need compassionate alternatives to transition that recognise the sources of their distress and the meanings they’ve attached to trans identities. The current path is no longer fit for purpose — and it is dangerous too.
Eliza Mondegreen is a graduate student in psychiatry and the author of Writing Behavior on Substack.
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SubscribeI had severe endometriosis (growth of the uterine lining in places other than the uterus) in my 20’s, which resulted in major abdominal surgery and the loss of an ovary – apologies to the gents reading. I was given a 6 month regimen of Lupron, an estrogen suppressor, after the surgery to clear up the rest of the endometriosis.
Fast forward to my early 40’s. I started breaking ribs from doing innocuous things like sneezing. A Dexa Scan revealed I had osteoporosis from – you guessed it – the Lupron I had been on in my 20’s.
Lupron is the drug they use as a puberty blocker for girls who wish to be boys because it blocks estrogen. I researched and these children are on it for much longer than 6 months, and at much higher doses than I was in my 20’s. Their bones, which are still forming, will be dust for life. I predict spinal fractures.
No child can consent to a lifetime of early hip fractures and fragile bones because she thinks she might want to be a boy when she’s 10 years old, not to mention forsaking her ability to have a child, or letting her brain mature from the normal course of puberty.
This is evil. Making money off of children. Using children to legitimize an adult paraphilia.
To be honest, I think both sides are using children as ammunition in this debate – because none of their real motives would look pleasant in the cold light of day. They need to be called out. As do the politicians who are using issues like this to hold onto votes.
The politicians have been absolutely spineless on these issues. Their pathetic squirming when they are asked to define what a ‘woman’ is says a lot about how little they know about the travesty that is happening on their watch. These issues are more important than trying to guess which ideology to buy into in order to secure votes. They are just as culpable for ruining the lives of children as the zealots who are pushing these catastrophic ideas. I used to admire Peter Tatchell for the work he did for gay rights. Not any more! He is pushing agendas which are untenable and actively harming vulnerable people. He should be ashamed of himself and wake up before more are harmed.
Peter Tatchell has IN PRINT sanctioned pedophilia. He deserves zero respect.
I didn’t know that. Thank you. Historic respect withdrawn forthwith!
do you have a reference to back that up?
This issue isn’t about ‘sides’!!!
I only is about “sides”. There are Social Conservatives who want to deny transgender poeple exist and abuse them in law and policy, even children. And the fact based side which opposes them.
No one is questioning the existence of people who, despite easily being able to prove what sex they are, believe they are or should have been the opposite sex. Sex is an objective biological reality, feelings about one’s sex make no difference.
“Anyone who can make you believe absurdities can make you commit atrocities.” Voltaire.
Biological sex is immutable at every level of analysis.
Thank you for bringing some empirical evidence into the discussion; it’s usually in short supply!
She did not. She literally wrote an unverifiable anecdote.
That’s pretty good coming from someone who thinks 1 in 150 children are transsexual. You are nothing short of complicit in the drugging and mutilation of confused children if you push this terrible ideology.
Mark, you are correct, of course. The person to whom you responded quotes himself all the time, and them claims his writings are objective research.
Do you need my medical records? How about the X-Rays of my broken ribs? I was on Lupron and I have osteoporosis. My rheumatologist says Lupron is the culprit.
No credibility to your story exists, and there has never been a case of osteoporosis in any adult — not in 40+ years — caused by any puberty administered to them as a youth. It is far more likely you should have had HRT after your endometriosis treatment and did not.
You are dead wrong. I was given Lupron in my 20’s for endometriosis. It damaged my bones. It’s a known side effect. And for your information, I was on HRT for years.
“In controlled clinical studies, patients with endometriosis (six months of therapy) or uterine fibroids (three months of therapy) were treated with LUPRON DEPOT 3.75 mg. In endometriosis patients, vertebral bone density as measured by dual energy x-ray absorptiometry (DEXA) decreased by an average of 3.2% at six months compared with the pretreatment value.” https://www.accessdata.fda.gov/drugsatfda_docs/label/2012/020011s040lbl.pdf
They now give women a small dose of HRT with the Lupron therapy for endometriosis. They did not when I was given it. But they would NOT for trans youth as it is the effects of female hormones they are trying to suppress. And Lupron is being used OFF-LABEL for youth. No one knows the long-term effects because it has not been approved for youth – not tested.
https://www.statnews.com/2017/02/02/lupron-puberty-children-health-problems/
“For years, Sharissa Derricott, 30, had no idea why her body seemed to be failing. At 21, a surgeon replaced her deteriorated jaw joint. She’s been diagnosed with degenerative disc disease and fibromyalgia, a chronic pain condition. Her teeth are shedding enamel and cracking.
None of it made sense to her until she discovered a community of women online who describe similar symptoms and have one thing in common: All had taken a drug called Lupron.”
I’d like to know what your medical credentials are please.
Humans are the only mammals who exhibit two growth phases. All other mammals become sexually mature at the end of their only phase of growth. This means that there is no way that the medical profession can do any meaningful tests on animals (whether you agree with that, or not) to see what effects they have on the development of the brain and body during the second growth phase; i.e. puberty.
Pre-pubescent children are, therefore, being used as human guinea pigs in what will become the biggest medical scandal of this century.
Nothing you have said follows logically, and puberty blockers have been in use for over 40 years with no negative side effects being seen to be caused by them.
I studied pharmacology as part of my degree. The opening gambit from The Professor was that any drug which is administered to the body has adverse effects as well as desirable ones. That is the nature of altering the body’s chemistry. To deny that is to deny reality; although you do seem pretty skilled in that department.
This will not do, it is time to name names.
.
I believe Sweden, Finland and the Netherlands, all previously in the vanguard of the trans cult, have moved back from the indiscriminate use of puberty blockers that follows the wildly reckless adherence to the so-called “affirmation” model. The main Swedish clinic reported itself to its own regulator. In the NHS, trans people and transgender fellow travellers within the management structures are the problem. They must be redeployed where they can do no harm.
There is no such thing in evidence as any “indiscriminate” use of puberty blockers.
“In the NHS, trans people and transgender fellow travellers within the management structures are the problem.” <– You refer to people aware of the actual evidence of the fact transgender people actually exist.
Finland for example has a lifelong transphobe in charge of it’s gender identity clinic, as exposed here.
https://www.erininthemorning.com/p/abusive-practices-and-conversion
Unherd claimed she was a pioneer of gender affirming care . . .
Unherd lies continually about this topic, it is this site’s editorial policy.
Spamming this forum with denial and ideological language is not helping your cause, whatever it may be. I am not saying that you are acting with malicious intent, but if I were to give advice, it would be to spend some more time listening to what the other side has to say, especially with regards to identity politics.
There should be a red line for everybody as soon as health issues become a matter of ideology.
Just mention the term autogynephilia in any context with individuals in your circles and you will experience what ideological narrowmindedness means.
How can ‘Unherd’ lie? It’s an online discussion forum which you, presumably, subscribe to so you can offer comments and opinions.
Serious questions to those who might know: what is the role of NICE in this? It does seem atrocious – literally- that this medication is prescribed unless there are medically compelling reasons .
Given how small the numbers are, perhaps that is the case.
Why are you thinking it is not done for a medically compelling reason?
Sorry for tardy reply. The proximate reason why medications are not prescribed for medical reasons can include patient pressure . It seems reasonable to ask this about puberty blockers as there is a suggestion that social contagion is a major factor in some vulnerable teenagers believing that they are the wrong sex. Claiming that pills prevent suicide would be another example of social prescribing .
I don’t want to defend the practice – but these are very small numbers in a population the size of the U.K. I’m not happy they are being used, but it is not the epidemic of use that is often portrayed – which often sounds more like a kid or two in every school, if not every classroom.
This not an argument. 100 children is 100 too many.
Fair enough. See you on the March to ban cars because they run over children. Not sure how many – but obviously it’s too many.
Sorry if I seem facetious, and I get your point, but numbers do matter. Many, many more children are being abused by their parents. This is not the biggest issue the country has.
It’s fine for the medical profession to join in the abuse then; just because the numbers are small? I think you need to have a rethink about what protection of vulnerable children is all about!
There is no such abuse.
That is why you can not find any evidence of it.
That’s what every narcissistic abuser also says.
The issue of confused children and Munchausens-by-proxy is a small part of a wider problem caused by the acceptance of transideology by our major institutions. I’m sure we all know about the issues in women’s prisons, women and girls toilets etc etc. It’s all connected and very very well funded by the medical-industrial complex!
Agreed. It doesn’t help that our institutions invite outside agencies with political agendas to come in and spout their ideologies as though they are facts.
Susie Green (formerly of ‘Mermaids’) had her boy castrated on foreign soil at the age of 16. She spent the subsequent years encouraging other people to do the same to their children in the name of ‘helping’ them. This constant pushing an ideology was, in my opinion, simply a way for her to justify her actions.
Prove it.
Show the 99 who will never regret such healthcare count for nothing compared to the 1 who might.
The constant repetition of the “only 1% regrets” from one study of kids who were gender dysphoric since childhood, were carefully selected as being unlikely to desist, who all received therapy prior to and during transition, and who were therefore in numerous ways NOT representative of the kids going through transition now, is dishonest and inapplicable. In more recent, better-representative studies, the regret/detransition rate is up to 30% for kids who in many cases present first as teens, and are being fast-tracked into medical transition by the “affirmative approach”. Which sounds low, given most kids who believe themselves to be the other gender and are NOT transitioned, generally desist on their own in young adulthood (and turn out to be Gay, or Lesbian). The problem is not that anyone wants to deprive trans kids of needed health care. It’s that it’s likely a large % of kids presenting as Trans actually are not. Which means all this is not a leap forward, but a medical scandal.
Very well said. The tragedy is that gay, lesbian and bisexual people who have gone down this irreversible path will never have fulfilling sex lives. Scandal is not a strong enough word.
is that the actual proportion then ?
A medical treatment that is 99% successful would be amazing. And is it right that success is judged by patient satisfaction ?
I thought 100 was shockingly high.
I’m guessing there are about 10 million school age kids in the U.K. that would make it 1 in 100,000 children. I’ll let you turn that into a %.
But there are 100 children undergoing a needless medical intervention that could compromise their health forever. That’s shocking to me. Even if you support a child’s desire to transition, blocking puberty is a dangerous solution.
Yes – I don’t agree with it. And I don’t think we know enough about the whole trans thing. We are using radical interventions in an area we don’t understand.
It is only the size of the issue that I am commenting on.
Government incompetence over Covid, a health service which is breaking down, even strikes for more pay by highly paid consultants – will all have had more damaging effects on far more children.
I think you need to concentrate on the issue in hand instead of making blanket statements which have absolutely no relevance.
I’m concentrating on the actual size of the issue as reported in the article, and asking why, politically, it is being blown out of all proportion.
“And I don’t think we know enough about the whole trans thing. We are using radical interventions in an area we don’t understand.” <– Try demonstrating any evidentiary excuse for that claim whatsoever.
Even on the pro trans side of this debate there are different theories. Those who follow Judith Butler see gender as performative, and not rooted in biology.
Others, like yourself, see gender as the expression of an innate sense of identity, which is rooted in biology.
Personally I find both implausible.
But in any case this is not a settled issue, whatever you might claim.
Theories!!! Biological sex is immutable. Why are people ‘theorising’ about what is patently true!
They do not compromise their health at all. and you have no excuse for pretending the intervention is needless.
“blocking puberty is a dangerous solution.” <– Prove it.
At all.
What you are claiming in contrast is that girls should be forced to have beards and deep voices and boys should be forced to have breasts and periods.
Keep telling yourself this. Blocking puberty is a big nothing burger – not like causing sterility or loss of bone density. Calling me ignorant just makes your case even stronger. I see the Dutch are now rethinking gender affirming care for children as well. I guess they’re all ignorant as well.
Because you are ingorant.
“I don’t want to defend the practice” <– Why not? What evidence do you have it is undertaken in conceptual or evidentiary error?
Given that the numbers are small relative to the population, and that feminists have never been that big on putting children first, we have ask why so much is being made of this.
I would say that from “Jews killing Christian children” onwards everybody knows that if you want to get support for your cause, you need some damaged children to point to.
What has this got to do with ‘Feminists’?!!!
The murder of transgender people is objectively what Unherd wants, or they would stop lying about transgender people.
https://www.erininthemorning.com/p/brianna-ghey-murder-trial-texts-show
This is representative of what is true about transgender people.
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
Unherd has yet to present any evidence of any supposed negative side effect of puberty blockers actually being measured to occur at above baseline rates in people who were given blockers as youth — either at all or for reasons of gender dysphoria.
The drugs as a class have been in use for over 40 years.
‘Unheard’ is not a single entity. It is an online forum where people are able to put their own opinions. The fact that you have grouped all these differing views into a single ‘identity’ which you can make outrageous claims against says everything about your politics.
As an individual who has worked around adolescent children for thirty years, all I want to do is try to protect the vulnerable ones from making decisions that they will regret for the rest of their lives. That is not tantamount to ‘murder’, in my view.
You must subscribe to ‘Unherd’ Talia, in order to post your comments. Does that make you ‘A murderer of transgender people’?
Why shouldn’t it rise? It’s not 1 in 30,000 who is transgender, it is 1 in 150. There is no “damning” independent review, the chief takeaway from the Cass Report is your NHS outlays to support transgender people should increase to match the actual occurrence rate — not what was thought when psychiatry wrongly still thought it was a mental illness and was still trying to convert transgender people into cisgender people.
There is no evidence that time spent on puberty blockers harms mental development, and this is proven over the 40+ years they have been in use. The lie in the report you cite compares people not then undergoing puberty with people who are undergoing puberty, and, only confirms people at any stage of development do not all development at the same rate throughout life. That is why in the small sample looked at, as many were doing better as were not.
““Because… what are the chances of every single young person with their very different needs and backgrounds given time to think, and all thinking in the same way?”” <– How might that even possibly “break” anything down, when it is not assumed in the first place that every single person is thinking in the same way?
“In the absence of meaningful change, a reckless model of care prevails. ” <– What is reckless is trying to save money at the expense of children, and what needs to be done is to drastically increase the availability of gender affirming care.
About which treatment approach, you have been unable to make any substantive criticisms, but obviously false ones.
And your evidence for these incredible assertions is…………?
Here, is a small but representative part.
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
Self-harming and anorexia are on the decrease. Why bother doing all that when you can get the attention you want from people in the medical profession who affirm your narrative about ‘being born in the wrong body’? This is nothing more than a social contagion which is resulting in the sterilization and mutilation of confused and vulnerable young people.
The ultimate irony is the that children who will most likely grow up to be gay, lesbian or bisexual are being surgically ‘converted’ into something that they can never be. Every single person who pushes for puberty blockers and/or brutal surgery is complicit in ruining the lives of vulnerable and confused young people. They should be ashamed of themselves. People in the medical profession who have bought in to this appalling ideology should be struck off and prosecuted for actual bodily harm.
No, being of any particular sexual orientation is an entirely separate thing from being transgender. There is no such thing as “conversion”. There is no ideology to it, only biology — the exact same thing that makes anyone be straight, bi,or gay.
You have no evidence at all for anything you claim.
Try reading ‘Trans-When Ideology Meets Reality’ by Helen Joyce. You will find all the empirical evidence that you need in that. I don’t suppose you will bother though.
You cannot change your biological sex. If gender is a different concept to biological sex, why are chemical and surgical interventions being used to try to do just that?
There is no more of an excuse to think this a “social contagion” than when the number of people who were admitting being gay or bi went from 1 in a few thousand to 1 in 20 or 30. The regret rate at successfully seeking medically assisted transition is less than 1 in 100. You have no excuse to pretend either vulnerability of confusion.
So what explains the sudden explosion in girls transitioning to boys? It used to be almost exclusively boys to girls, now girls outnumber boys something like 6 to 1 – in just over a decade. Or what explains some American universities where students identifying as LGBT Is over 40%.
The whistle blowers who have since left the Tavistock Clinic used to ‘joke’ that there won’t be any gay people any more.
I’m getting on a bit but that means that I have seen the progress made with regards to same sex-relationships.
There is no ‘queer-bashing’ by thugs, gay relationships have been decriminalised and same sex marriage is legal. The stigma of being gay, lesbian or bisexual has all but disappeared. This is all underwritten in law as well. To conflate these two issues is to be be ignorant of how awful things were for the gay and lesbian community. Coming out was not an option!
The ultimate irony is the that children who will most likely grow up to be gay, lesbian or bisexual are being surgically ‘converted’ into something that they can never be. Every single person who pushes for puberty blockers and/or brutal surgery is complicit in ruining the lives of vulnerable and confused young people. They should be ashamed of themselves. People in the medical profession who have bought in to this appalling ideology should be struck off and prosecuted for actual bodily harm.
There’s plenty of evidence that being able to go through a normal puberty cures gender dysphoria in 80%+ of children, most of whom emerge as gay or lesbian adults with healthy fertile bodies capable of a fulfilling sex life. Mother Nature is a wise old woman!!
I couldn’t agree more Alison. I feel so sorry for the sexually confused children who have been led down this irreversible path and won’t be able to experience the wonderful joys of a fulfilling sex life.