[I was] a mentally ill teenager who had been groomed and preyed upon and sexually exploited online to the point of authorities getting involved.
I spiralled into a hatred of myself and my body, and was told that it was just because I was a boy born in the wrong body, and that this would fix me.
I was affirmed down a path where I wasn't given any other choice as to what would help me. The very first medical intervention I ever had was a double mastectomy at 16. And then a few months later, I was put on testosterone.
I'm now 21, and I will live with the impacts of that so-called care for the rest of my life. In the past 4 or 5 months, I have watched as my body has fallen apart in front of me. My joints constantly hurting, my vocal chords aching, watching as parts of me atrophy away before my very eyes.
And yet, at 16, they looked me in the eyes and they told me this was care. They told me it would save me.
Despite the fact I was never suicidal, my parents were baited with the idea of "would you rather have a dead daughter or a living son?" Bullied into going along with it, their biggest crime being trusting those who they thought took an oath to "do no harm."
It's not about "hate," detransitioning, it never has been. It's about keeping kids whole. I've worked with children, I've seen them explore the world, and I've seen that magic that they have. And doing something like transitioning them takes that away.
How can you look me in the eyes and tell me that a child can consent to being chained to an experimental medical industry before they're even old enough to drive, or understand the impacts of what that means in the first place?
Kids deserve to be kids. They deserve to get to explore the world as a safe and loving place.
==
It's disturbing that the position "don't mutilate kids" requires bravery.
Today is a great day to think of what you'll say when you're asked why you went along with it.
When I was younger I dove into all the research about gender identity and sexual orientation devouring journal articles about various genetic factors, neurological development, socio-cultural performance, the whole kit and kaboodle. In retrospect, I wanted to know why I was the way I was. I was focused on finding a cause I could use to explain myself, because I didn't feel the world would accept me without explanation. Essentially, I needed chemistry, neurology, psychology, or sociology to defend my validity. The dilemma, of course, is that there are far too many extraneous variables to ever explain, directly, why any of us exist. Don't get me wrong, there's some excellent research out there, but the more I began to accept who and what I am, the less I cared about causation. I say knowledge is a pliable stone carved by imagination because we often have to conceptualize a hypothesis, before we set out to disprove it with the scientific method. Yet if we hold any theory as a singular answer, then we err towards arrogance. I am, I exist, and that's all that matters.
Irreversible medical treatments are causing unbelievable harm to young people.
By: Jo Bartosch
Published: May 3, 2023
Twenty years ago, after one too many beers, I met some pagans in a pub in Gloucestershire. They invited me to travel with them to Ireland the next morning on a spiritual pilgrimage. I expected a mystical experience, but I remained unmoved. On returning to Ireland last week to attend two rival conferences on how best to help people distressed about their gender, I realised that my scepticism is still intact – and that mad beliefs about magic have spread far beyond damp hippies.
The two conferences were very different. The larger, more established conference was organised by the European Professional Association for Transgender Health (EPATH), which claims to promote the ‘mental, physical and social health of transgender people in Europe’. The other conference was organised by a relative upstart called Genspect. Founded in 2021, Genspect is an international organisation that aims to ‘promote high-quality, evidence-based care for gender-nonconforming individuals all around the world’.
In a press release from March, Genspect’s director, psychotherapist Stella O’Malley, summed up the difference between the two organisations’ approaches when dealing with those experiencing gender distress: ‘The EPATH programme promotes heavy medical interventions while Genspect favours the least-invasive approach first.’ Genspect, explained O’Malley, aims to ‘crack open EPATH’s mono-focus on medicalised modes of treatment’.
The Genspect conference set out to challenge both the magical thinking of trans ideology and the medicalisation of childhood distress that this has led to. This was reflected by the presence of around a dozen ‘detransitioners’ among the delegates – that is, people who regret transitioning and want to revert to their original gender. These detransitioners, who were predominantly under 30, are now living with the consequences of taking hormones and having their healthy body parts amputated. In time, they might recover their mental health. But in many cases the harm done to their bodies will be permanent.
Michael Biggs, an associate professor in sociology at the University of Oxford, has long been investigating the effect of puberty-blocking drugs on sexual maturation. Presenting his findings at the Genspect conference, Biggs revealed that patients who have suppressed their puberty as children before surgical transition may never be able to orgasm as adults.
Speaking after the conference, Biggs told me that there is a wilful lack of published research on the long-term effects of taking puberty blockers. He said that ‘puberty blockers have been used in the Netherlands for over three decades, and yet the long-term effects are known for only one person’. By the age of 35, that ‘one person was depressed and ashamed of their genitals’.
Biggs also revealed that where research has been carried out into puberty blockers there have been attempts to suppress it. The NHS’s Gender Identity Development Service (GIDS) at London’s Tavistock clinic, which is due to be closed down later this year, began a study of 44 children aged between 12 and 15 in 2011. But GIDS director Dr Polly Carmichael effectively kept the results of this trial to herself. The findings remained unpublished until they were discovered and first analysed by Biggs in 2018. ‘It required a complaint to the Health Research Authority, questions in parliament, and a judicial review’, Biggs tells me, ‘before Dr Carmichael finally published the full results’.
Most disturbingly, Biggs told me of the awful fate of one healthy Dutch teenager. After having his puberty blocked as a child, the teenager underwent a vaginoplasty aged 18. The complicated procedure involved taking tissue from his bowel to create a replica vagina and vulva. Within 24 hours of having surgery, he had died in hospital of necrotising fasciitis.
Predictably, EPATH’s conference featured no such criticism of these surgical or medical interventions. Far from it. The conference was even spon.sored by a company offering facial-feminisation surgery, and from the off EPATH went on the offensive. In the opening address, the organisation’s outgoing president, Joz Motmans, attacked ‘anti-gender and anti-trans voices, legislation, policies and movements’. Motmans even claimed that the growing public scepticism towards trans ideology was driven by ‘far-right parties’. ‘We respect everyone’s freedom of speech’, he said, ‘but we choose not to listen to it’.
In the interests of actual free speech and debate, EPATH attendees were told that they would be permitted access to Genspect with their EPATH ticket. This gesture was not reciprocated. Indeed, EPATH has even blocked Genspect from its Twitter account.
Whether or not EPATH chooses to listen, the debate over how best to treat patients with gender distress is gaining momentum across Europe. Last year’s announcement that the Tavistock clinic would be shut down, on the grounds its model of care is ‘not safe’ for children, has sent shockwaves across the continent. Medical bodies are now sounding the alarm in Sweden, France and most recently Norway. More and more clinical professionals are coming out to ask for the evidence that mental distress can be successfully treated by ‘gender-affirming’ medical interventions.
Last week in Ireland, the authority of EPATH’s gender priests took a battering. They showed themselves to be unwilling and perhaps even incapable of engaging with those who hold opposing views. More damning still, they refused to engage with the evidence.
Trans ideology is now being exposed for the magical thinking it always was. Its adherents are doing real harm.
==
Telling people to get a facelift or a boob-job when they're depressed or anxious used to be regarded as unethical.
After becoming upset by the school's acceptance of transgender ideology, this 14-year-old female student has decided to expose the truth abo
By: Anonymous
Published: Feb 8, 2023
• An anonymous student speaks out about transgender ideology in her school
• The student, aged 14, attends a state secondary school in South-East England
• Claimed teachers say Lady Macbeth non-binary and girls wear breast binders
She’s 14 and attends a co-educational state secondary in South-East England — where she says one in ten children in her year identifies as trans or non-binary. After becoming increasingly upset by the school’s acceptance of transgender ideology, this female student has decided to expose the truth about life in an ongoing culture war.
The other day, I went to the school office to get a new copy of the timetable. The teacher I spoke to used ‘they/them’ pronouns about me, asking another member of staff, ‘they have lost their timetable, can they have a new one?’
He knows me really well and it’s clear that I’m a girl. I felt furious he didn’t just say ‘she’. But it’s not just the odd teacher here or there; I am regularly asked if I am in the process of transitioning.
There is a gender-neutral uniform policy at school and lots of the girls wear trousers. Those of us that do are often asked if we are transgender, especially if we have short hair, as I do.
The fact a girl likes playing video games, or doesn’t like feminine clothes or make-up is enough to be seen as potentially trans. When my mum complained about me being called ‘they’, the teacher apologised but explained he was being cautious in case I was transitioning. He said the teachers are treading on eggshells, scared of being labelled transphobic.
It feels like trans is all anyone talks about. The library has a section devoted to LGBTQQIA+ books and there is a display for Pride in the school entrance, with rainbow flags and words and terms such as ‘non-binary‘, ‘polysexual’, ‘demiboy’, ‘demigirl’ and ‘pansexual’. These words come up in lessons, too. I’m now in Year 10, and the other day a girl in my English class asked if the Greek god Zeus was a man or a woman and the teacher replied that Zeus could have ‘identified as non-binary’.
More recently another teacher said Lady Macbeth was ‘neither a man nor a woman’. I think most parents will have no clue this is what their kids are being taught.
So I’m glad the Education Secretary Gillian Keegan is set to tell schools they must be more open about their handling of trans issues. I would be too scared to say this at school, though. I would lose my friends if I did, as they’re completely intolerant of anything they think is transphobic.
That’s what made me decide to speak out here — without giving my real name.
When I started at my secondary school four years ago, I didn’t even know what ‘transgender’ meant. It hadn’t been talked about in primary school or at home. But within days, we were told by a teacher in our PSHE (personal, social, health and economic education) class that we would be seen as ‘transphobic’ if we used any of the ‘offensive words’ from a long list, which included ‘gender bender’ and ‘butch’.
I had no idea what transphobic meant, but I could tell it was definitely something I didn’t want to be seen as. At that age, when you are told something at school you just believe it. We trusted that what the teachers told us was true.
But I did ask my mum about it later. She is a feminist and is critical of students being dictated to. She said that often it depends how you use words — that people within queer communities have used ‘gender bender’ as a positive way to describe themselves and that ‘butch’ is used by lesbians to describe other lesbians who are quite masculine in appearance.
While still in my first year, 11-year-old girls in my class began asking to be called ‘he’ or ‘them’.
Soon afterwards a number of others were doing the same. It felt as if they joined in because it meant they were seen as cool.
You get special treatment if you say you are trans or non-binary and suddenly become the centre of attention when you ‘come out’.
As soon as a girl says she is a boy, her name is changed on the school register and students are told to use their chosen boy’s name.
Now, out of 200 students in my year, at least 20 say they’re trans — almost all are girls claiming to be boys or non-binary. Although there is one boy saying he’s a girl, this really is largely about girls saying they are boys. The kids in my year don’t say they are lesbian or gay, because those words are thought to be an insult.
There is a straight boy going out with a straight girl who says she is trans, so he now has to say that he’s bisexual. It’s often said by my schoolmates that trans girls are ‘better’ girls than ‘other girls’. I find this insulting. But the teachers don’t take any action even if they do hear conversations like this.
Recently, I was watching a news item with friends about the changes to the Gender Recognition Act in Scotland and every time a guest on the programme said, ‘this is a threat to sex-based rights’, my friends were sneering and laughing. It made me feel as though girls have no rights and are not respected in my school.
There is constant talk of transphobia and bigotry and many of the students who say they are trans constantly talk about being ‘victims’, with anyone who isn’t trans being the perpetrator.
Coming out as a lesbian or gay doesn’t have the same effect, but barely any students do, in my experience.
My friend Kelley* was ‘affirmed’ [accepted without question] as a boy in Year 7. She has serious mental health issues and is regularly off school as she self-harms.
Kelley socially transitioned without any teacher challenging her. She has a new name and can now use the boys’ changing rooms. All my friends pretty much believe in ‘gender identity’. Girls and boys are referred to by teachers and students as ‘assigned female at birth’ or ‘assigned male at birth’. This is shortened to AFAB and AMAB.
There is also confusing language such as the word for being attracted to non-binary people, ‘skoliosexual’. I find it ridiculous — but can’t say that.
There is a lot of breast-binding going on, too, but we don’t know who might be on puberty blockers because no one talks about that. One trans-identified girl wants to get a breast binder, but was complaining that her parents would not want her to.
I joined the Equalities Club because I believe in equal rights for all, then found it was impossible to talk about any group, other than trans people, that was discriminated against. There’s a rule against wearing badges in school but some students wear trans flag and pronoun badges and nobody tells them off.
Recently, a group of us were watching Prime Minister’s Questions and when MPs talked about maternity care, using the terms ‘birthing partner’ and ‘non-birthing partner’, I wondered out loud why they didn’t just say ‘mother’.
I was told off by a friend who said that not everyone with a cervix is a woman. I didn’t want to disagree because I knew what would happen — I would be publicly humiliated.
Until now, I’ve just gone along with most of it. But there are some things I can’t leave alone. For example, I really like J. K. Rowling but she was called a ‘TERF’ (Trans-Exclusionary Radical Feminist) by a friend, who said she was heartbroken to hear that J.K. was ‘anti-trans’.
I asked in what way J.K. was transphobic but this friend couldn’t give me an answer, she just said: ‘I hope all TERFS drop dead.’ I was shocked by her anger.
There have also been violent comments on social media towards ‘transphobes’ with students from the school threatening to strangle them.
That’s why I’m writing this piece anonymously, although I believe I should be able to say these things without fear of attack. I want adults to know what it’s really like in schools like mine now.
*Names have been changed.
==
This confusion, this uncertainty isn't a bug of Queer Theory, it's the explicitly stated intent. When nobody can trust anything about the world, they can't know whether to oppress you or to give you the privileges associated with being an oppressor. No more "systemic" oppression. One of the big problems is that this constantly questioning your own perceptions is a tactic of Malignant Narcissistic Personality Disorder. It's no wonder it attracts narcissists.
The new NHS guidance recognizes social transition as a form of psychosocial intervention and not a neutral act, as it may have significant effects on psychological functioning. The NHS strongly discourages social transition in children, and clarifies that social transition in adolescents should only be pursued in order to alleviate or prevent clinically-significant distress or significant impairment in social functioning, and following an explicit informed consent process.
It's Psych 101 that affirmation solidifies belief, because it wires the amygdala to accept the belief as reality. If you keep telling someone "yes, you are a victim, the world is out to get you," they'll become helpless and incapable. If a therapist actually recommended affirmation therapy for those with anorexia nervosa - "if you think you're overweight, you must be, since you're the expert on you. In fact, you could probably even stand to lose a few more lbs" - we'd know they were incompetent and dangerous.
If those who are born Black or disabled are the chosen, trans people are the converts who have voluntarily accepted Marginalization. They choose to suffer more from their involuntary embodiment. Because of this, they become virtuous. They are saved.
The impacts of this ideology are far-reaching and affect us all, not just women.
By: Pamela Garfield-Jaeger
Published: Mar 8, 2023
As a licensed therapist, I have been taken aback by the rapid spread and radicalization of gender affirmative therapy over the past half-decade. After a hiatus from my profession due to a physical disability, I was stunned by the changes that had taken place upon my return. My perspective on gender ideology is not motivated by political considerations.
The ongoing trans wave is a central issue for feminists for two key reasons. Firstly, it is impacting adolescent girls on a scale that is both startling and concerning. Secondly, transgender women (i.e., men) are encroaching upon women's spaces, causing general discomfort and unease in addition to the more serious threats to our safety.
While these facts are beyond dispute, it is important to recognize that the trans issue extends beyond the realm of women's concerns. Indeed, it is a broad and more complex issue. It affects us all.
A male detranistioner named Abel Garcia had a very poignant tweet on 11/14/22:
Unfortunately, there are a few feminists that only care about girls and women being hurt, they could care less about boys and men being hurt by this ideology. We all need to understand that this ideology targets everyone & we need to protect & help everyone hurt by it.
Another male detransitioner named Ritchie Herron, who is also known by the handle “Tulip” on Twitter, has recently sparked a contentious debate among feminists. The root of this debate stems from Herron’s appeal for assistance for young boys who may have become ensnared by trans ideology.
I see a lot of rallying calls to protect women and girls, but why not boys too? Aren’t all children worthy of protection?
The threat to young males and boys has been overshadowed for too long. Your fury for what’s happening to young women and girls should apply to them too. If no one stands for them, I will. And I’ll still be standing alongside women and girls.
Both of these men, and countless more, have told horrific stories about how they were victims of medical malpractice under the guise of “gender affirming care.” These men warrant our empathetic attention and the amplification of their voices.
While the plight of male detransitioners has been a topic of growing concern, there are others who suffer silently. Consider the parents who find themselves estranged from their children as a result of the cult-like mentality that this ideology instills. Gender activists imbue their followers with a belief system that casts even the most well-meaning family members and friends who dare to question its precepts as bigots and transphobes.
My inbox is inundated with heart-wrenching messages from parents who are grappling with an array of intense emotions—from grief to fear to anger—as they face the reality that their beloved child has shunned them. Such parents, mothers and fathers alike, are left to contend with the alienation that arises when a powerful ideology severs the close bonds of family.
Here is recent message I received from an anonymous parent:
My daughter is 20. She began injecting male hormones at 18. I do not pretend to agree. Our relationship has suffered. I can’t sleep well. I can’t do much of anything well. I don’t know how to help her. What to say. What not to say. My life is a wreck and I feel like I’m holding my breath every day. I can’t save her. I want to. I can’t find help. She’s not going to be ok.
And let’s not forget about siblings, cousins, aunts, uncles, grandparents and other family members who lost a family member because a cultish ideology told them to sever ties with their families.
Another overlooked group are the other children caught in the crossfire, the ones not on board the “trans train” but nevertheless find themselves subjected to a kind of speech policing that can upend close relationships. They may be left behind as their peers embrace “glitter families” and unconventional gender identities. Additionally, there are children who already struggle to fit in and lack the insight or confidence to stand up to uncomfortable lies. The spread of gender ideology throughout our culture can be devastating for all children (and adults too).
As someone who has led teen therapy groups, I have seen this dynamic unfold firsthand. I have seen how the so-called “pronoun game” can be just as damaging to the children who are not trans-identified as it is to those who are. Some children may enjoy the feeling of “doing the right thing,” but this can leave them feeling empty and disconnected from their peers, since their actions are often superficial. Others may not feel comfortable with these linguistic demands, but feel compelled to go along with it anyway as a result of peer pressure. In either case, all of these children face an extra obstacle when it comes to creating genuine connections with each other. (I never encouraged pronouns when I worked there, but I didn’t fight the kids who insisted on using them either.)
And what about humanity? As a society, we cannot afford to overlook the potential consequences of a generation growing up with fractured identities, shattered trust, and physical disabilities. We must recognize that the impacts of these issues are far-reaching and affect us all. The cliche “The children are our future” has been replaced with a dangerous mentality that disregards the potential harm caused to them by blindly embracing the radical trans agenda.
This is not just a women’s issue, but a humanity issue. We all have a stake in the future of our society, and we must act accordingly.
A new article in Springer’s Current Sexual Health Reports, “Current Concerns About Gender-Affirming Therapy in Adolescents,” provides an up-
By: SEGM
Published: Apr 18, 2023
The field of gender medicine must stop relying on social justice arguments and return to the time-honored principles of evidence-based medicine.
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A new article in Springer’s Current Sexual Health Reports, “Current Concerns About Gender-Affirming Therapy in Adolescents,” provides an up-to-date overview of the current state of evidence about the practice of gender transition in youth in the Western world and discusses the international debates surrounding this controversial practice.
The authors identify the key area of concern: It is unknown how gender-transitioned young patients fare in the long term. Systematic reviews of evidence of youth gender transition are naturally limited by short follow-up times, as the practice only began at scale after 2015. For this reason, it is informative to look at long-term adult outcome data. Unfortunately, the long-term studies of adult transitioners have repeatedly failed to show lasting psychological improvements, and studies with the longest follow-up suggest "the possibility of treatment-associated harms."
In fact, the disappointing long-term outcomes of adult transitioners were used to justify transitioning minors, in the hope that earlier intervention would lead to improved outcomes. However, every quality systematic review of youth gender transition to date has failed to find credible benefits even in the short-term, issuing conclusions about the risk-benefit ratio that range from highly uncertain to unfavorable.
The authors observe:
There has never been a dispute about whether medical and surgical interventions can feminize or masculinize secondary and some primary sex characteristics. For children and adolescents, the debate is not whether such transformations are possible, but “at what age can youth meaningfully consent,” “upon fulfilling which criteria,” and perhaps most importantly, “just because we can – should we?”. Such questions have provoked an intensity of divisiveness within and outside of medicine rarely seen with other clinical uncertainties. This passion reflects decidedly different prioritization of scientific evidence, medical ethics, and social values.
Ten key unproven—or disproven—assumptions underlying the practice of youth transitions
The authors note that while a “growing number of European countries recognized deficiencies in the evidence supporting the highly medicalized “gender-affirming” approach to treating gender-dysphoric youth, in North America, the narrative that “gender-affirmative care has been scientifically proven” has been remarkably resilient.”
The authors observe that the practice of “gender affirmation” of minors using hormones and surgery is based on 10 key fallacious assumptions that are misrepresented as proven facts:
The emergence of a trans identity is the result of reaching a higher level of self-awareness.
Whether the trans-identity emerges in very young children, older children, teens, or mature adults, it is authentic and will be lifelong.
All gender identity variations are biologically determined and inherently healthy.
The frequently co-occurring psychiatric symptoms are a direct result of gender incongruence (the so-called “minority stress” model).
The only way to relieve, or prevent, psychiatric problems is to alter the body at the earliest signs of puberty.
Psychological evaluations and attempts to address psychiatric comorbidities should only be used to support transition.
Attempts to resolve gender dysphoria with psychotherapy range from ineffective to harmful.
Gender-dysphoric youth must have unquestioning social, hormonal, and surgical support for their current gender identities and desired physical appearance.
All individual embodiment goals, even those that do not occur in nature, must be fulfilled to the full extent technically possible.
Science has proven the benefits of early gender transition, and low rates of regret and detransition further validate the practice.
The authors refute these assumptions, focusing on the three most critical fallacies. They recount the evidence that identity formation in adolescence is far from complete, and a trans identity for many will prove to be temporary. They note that the rationale for “gender-affirming” interventions has shifted from reducing extreme suffering, to merely fulfilling individual embodiment goals, which undermines the original premise of administering drastic, irreversible interventions off-label to young people whose identities are far from fully formed.
Finally, the authors note that the claim that gender-transition is a proven net-beneficial practice is demonstrably false. The claims by gender medicine clinicians that these interventions are “proven” collapse when scrutinized through the lens of systematic reviews, which are a fundamental requirement of evidence-based medicine. Unlike “narrative reviews” which the field has come to rely on, and which cherry-pick “favorite” studies and merely restate those studies' biased conclusions, systematic reviews require the analysis of all the available evidence, subjecting each study to a critical appraisal for risk of bias and other methodological problems, issuing an overarching conclusion which states the effects of a given treatment, and grades evidence for quality/certainty.
To date, every systematic review of evidence has concluded that the evidence of benefits is highly uncertain. The only disagreement is about the harms: some consider the harms also uncertain, while others note that the evidence of potential harms to bone and cardiovascular health, and the expected infertility and sterility, render the practice net-harmful for most youth today.
Clash of Ethical Principles and Value Systems
The authors note that most clinicians involved in the heated debate over gender-transitions of youth believe that they are practicing according to the principles of medical ethics. The disagreement comes from a clash in value systems:
Those who insist that a young person has the right to receive any medical intervention they desire now, and the right to regret that intervention later, privilege autonomy above all else. Those who advocate for sharply curbing the practice of medical interventions in gender-diverse minors because they view the practice as a major source of iatrogenic harm, privilege the principle of non-maleficence.
They also acknowledge that there is disagreement about what constitutes beneficence:
Each side claims they are pursuing beneficence, but sharply disagree on the solution: one side insists that the most benefit is derived by undergoing a transition as early in puberty as possible to achieve the best possible cosmetic outcomes, while the other asserts that achieving cognitive maturity, emotional stability, and obtaining life experiences (including sexual experiences) prior to making the decision to undergo irreversible transition will provide the most long-term benefit for affected individuals.
Detransition and Regret
The authors point out the growing evidence of significant rates of medical detransition, which has reached 30% in at least one comprehensive analysis of US data. They note that while not all detransition signifies regret, the claims of less than 1% regret rates are not credible.
Most studies reporting low regret rates define regret narrowly, such as requesting a legal change of sex markers or beginning the administration of natal-sex hormones. However, many detransitioners do not have their gonads (ovaries and testes) removed, so they have no need to supplement with natal sex hormones upon detransition. One of the most-frequently quoted studies of “very low regret” would not have considered Keira Bell, one of the best known regretters whose case contributed to the UK’s current restructuring of its approach to managing gender dysphoria in youth, to be a regretter.
The authors acknowledge that regret is a complex phenomenon, and regret and acceptance can co-exist. For many people who have undergone the most extensive physical changes, detransition is not possible, and many choose an adaptive approach of making the best of their lives without undergoing more invasive procedures. However, as the numbers of detransitioners grow, regret and lawsuits by harmed patients will likely increase in number and visibility.
The Reversal of “Gender-Affirming Care”
The authors note that public health authorities are increasingly aware that hormones and surgery are being administered to a growing number of children and adolescents with gender dysphoria who are unlike previous cohorts of transgender-identifying individuals. In years past, the majority of youth seeking to transition were male and had longstanding gender dysphoria. Today, the preponderance of young people with gender dysphoria are females whose transgender identities emerged only in adolescence and who suffer from pre-existing mental illness and neurocognitive disorders.
After public health authorities in England, Finland, and Sweden conducted systematic reviews of the available evidence to determine whether the benefits of youth gender transition outweigh the risks, they concluded that the benefits do not outweigh the risks and have revised their practices and policies, sharply restricting medical and surgical transition of children and adolescents. Reassessment of policies governing gender transition of youth also is underway in France, Norway, and several US states.
In the United States, a number of states have begun to pass laws that sharply restrict the availability of "gender-affirming" interventions in general medical settings. The authors suggest that politicization of this complex issue may have been a direct result of the US medical societies' decision to privilege civil rights arguments over the principles of evidence-based medicine:
Many US state laws have been introduced to limit or ban gender transitions of youth. The reluctance of the US medical societies to recognize the apparent problems with medical “gender affirmation” of youth may have contributed to the unfortunate and preventable politicization of this complex issue.
The authors remind clinicians that while social justice, civil rights, and freedom of expression are compelling arguments, they complicate “clinicians’ consideration of how to respond to gender dysphoric adolescents and their families." The authors note that concerned family members want to know: " 'Where is this identity coming from?' 'What about my child’s previous difficulties?' and critically, 'Will transition give my child the best chance for a happy and fulfilling life?' "
When faced with such questions, "clinicians are ethically bound to honestly represent the uncertainty of the current state of knowledge, rather than asserting that body modification is the best, safest, and most effective treatment. When a concerned family seeks our counsel, they are seeking our knowledge, not our political ideation and beliefs.”
Something troubling is happening in premier UK medical institutions like the Royal College of Psychiatrists. There is a schism between the i
By: Yasmin Zenith
Published: Jan 27, 2023
Something troubling is happening in premier UK medical institutions like the Royal College of Psychiatrists. There is a schism between the influential proponents of gender ideology, which is ascendant across the NHS, and those who view it as unscientific and an impediment to safe-guarding and freedom of speech. Dissenting clinicians are concerned about an increasingly dogmatic promotion of gender identity ideology. Their resistance was explicit during a fraught webinar presentation at the RCPsych on 23 November, which was partially leaked on Twitter.
The gender presentation and its themes will be familiar to anyone who has experienced similar training under the aegis of Equality, Diversity and Inclusion (EDI). The presenter was Dr Joseph Hartland, EDI Deputy Ed Director at Bristol Medical School. In the leaked slides, pronouns are pivotal. They are the visual symbol of allegiance to the new orthodoxy. Everyone is encouraged to prominently display them. Pronoun agnosticism is discouraged. One slide asserts that failure to use examples such as ze/hir correctly constitutes an “act of aggression”. In another slide, biological sex is described as “socially contrived” instead of fundamental to life. “People with testes” is presented as an example of “appropriate language”. Failure to insert a space between “trans” and “woman” is potentially pejorative language. This linguistic minefield requires delicate navigation and constant self-editing. Dr. Hartland concluded by exhorting his audience to stop talking about “gender dysphoria” and instead “help patients achieve euphoria”. The implication is that the pathway to this destination is pharmaceutical.
Perhaps Dr. Hartland expected applause or silent compliance. He was unprepared for questions from the members of the Royal College of Psychiatrists, and his reaction to being challenged was less than professional. He denounced the forty-five questions as “80 per cent transphobic”, posted a picture of nail marks he had made on his hand in an act of catharsis and then locked his Twitter account. This is surprising behaviour from one of the premier authors of a medical charter already signed by 80 per cent of UK medical schools. There are serious questions about the level of scrutiny conducted prior to signing this binding document and about its ambiguous contents.
According to its website, the GLADD (Association of LGBTQ+ Doctors and Dentists) charter was written by “queer medical activists” in conjunction with GLADD and Lancaster University Medical School. Its ostensible purpose is to effect a ban on “so-called conversion therapy”. Its critics are concerned that it is a flawed, unscientific document motivated by activism, not clinical considerations. They worry that it promotes the “affirmative care” paradigm which dominated the Tavistock and is currently under review by Dr Cass.
One experienced medic speaking under conditions of anonymity put it starkly. He told me, “This is not the language of medicine. It is the language of religion.” The charter’s language is clunky and repetitive; definitions are obscured. Its lack of clarity is striking. One core principle asserts that it is important to “affirm” the gender of LGBTQ+ people. Medical schools must “produce graduates” who do not “favour one gender over another”. What implications does this have for the clinical treatment of a 12-year-old girl who diagnoses an incongruity between her physical body and metaphysical identity? Should she be “affirmed?” Is the clinician’s role to facilitate a pharmaceutical pathway via puberty blockers and hormones to attempt an alignment? Will a graduate of a school welded to this charter be primed to prioritise that treatment? Another charter principle requires “joyful representation” of LGBTQ+ people in curricula. Will this prevent medical schools from discussing the phenomenon of detransitioners like Keira Bell? Will it prevent a scholarly examination of the troubling clinical decisions which enabled her to have irrevocable medical procedures including surgery which she now regrets?
What critical analysis was conducted by the institutions who have signed this document? Did they delegate it to their EDI departments? One possible reason for its rapid adoption by almost all the UK’s medical schools is that their students have been actively encouraged on social media to demand their colleges sign. There is an updated display online showing boxes with a blank space to highlight missing signatures. One of the Charter’s authors, who is an NHS doctor, told his Twitter followers that failure to sign was indicative of “queerphobia” and to “let them know we’re watching”. Is this an environment conducive to considered debate? Will the Charter’s adoption and implementation enlighten or hobble the medical education of future clinicians?
In a curious parallel, the Culture Secretary, Michelle Donelan, recently announced that the government intends to enact a legal ban on “trans conversion therapy”. The difficulties in writing such legislation without causing serious unintended consequences is already evident. How is “trans conversion therapy” defined? How can parents or clinicians discuss a child’s gender distress if any deviation from a rigid affirmative paradigm is criminalised? It will require surgical linguistic precision and rigorous critical analysis. If the last two decades of UK politicians exemplify one consistent principle irrespective of party, it is that bad policies and bad laws are simple to write. Removing them once written is an arduous, if not impossible task.
The Royal College of Psychiatrists denounced its audience for their “appalling” questions in response to the gender webinar by Dr Hartland. The RCPsych tweeted that “appropriate steps will be taken”, an ominous warning which elicited a scathing backlash. Does the RCPsych believe that unsubstantiated, unscientific assertions should be accepted without challenge by its members? An orthodoxy imposed from above which demands submission and views questions as heretical has no place in the medical arena. Its ascendancy within the medical establishment should concern us all.
