Several articles have recently been published that are airing concerns and painting complicated pictures of the issue of childhood/teen gender dysphoria in the United Kingdom. This is almost non-existent in the United States, as of now, in any media other than conservative news sites. Part of the reason is likely that the U.K. has a public health care system, and the public is being informed of the statistics showing large increases of youth identifying as trans.
An article in The Telegraph contains quotes from an expert in the National Health Service who believes socially transitioning children may harm them:
Parents are risking psychologically damaging their children by allowing them to “socially transition” their gender without medical or psychiatric advice, NHS experts have warned…
The GIDS psychologists, who practise at London’s Tavistock Clinic, said that younger children who believe they may have been born with the wrong body should be permitted to explore behavioural aspects of the opposite gender, such as dress or types of play.
However, they warned that many such children end up preferring to remain the biological gender they were born, and that to formally socially transition before puberty risks pre-determining the outcome.
GHQ covers the many statements by gender dysphoria affirming mental health and medical professionals who say that social transitions are fully reversible. Some health professionals do not believe there is any proof social transitions are reversible.
Dr. Wren from the Tavistock clinic is not sure a child who may desist will be able to re-identify with their natal sex after years of living transitioned as a child. GHQ members are also skeptical of this.
Dr Bernadette Wren, head of clinical psychology at the trust, said: “Social transitioning has become a really big topic.
“We have never recommended complete social transitioning but it has become a really popular thing and many advocacy groups really promote it.
“We take the long view because our concern has been that what might work to lower anxiety in a younger child may become the thing that is problematic when they get older.
“It can become harder for children as they move into adolescence, they are moving into puberty and the young person suddenly faces a wall of puberty.
“We think that is setting up problems for later.”
Daily Mail also published an article “Parents are encouraging children as young as three to change gender without consulting specialists, experts warn about social transition” discussing the subject of social transition.
The BBC and the Guardian have been promoting, almost entirely, positive transition stories and narratives around dysphoric youth and the affirmative model. A new BBC article quotes people calling for more caution in “Children with gender identity issues 'need help from all sides”:
Dr Polly Carmichael, consultant clinical psychologist and director of the Gender Identity Development Service (Gids), said many had complex social and personal histories.
"We think about all the needs of young people and try and work closely with local services to clearly manage risk around self-harm, and other difficulties, but also to raise awareness around gender issues," she said.
"I think there is sometimes a danger there can be a split - if someone is presenting with issues around their gender identity, that local services perhaps think that's going to be the answer to everything.
"Whereas in reality it's a complicated picture that needs to be addressed from all sides."
The BBC also covered the investigation on the use of puberty blockers happening in the U.K. in the article “Transgender treatment: Puberty blockers study under investigation.”
The study's full findings have not been published - but early data showed some taking the drugs reported an increase in thoughts of suicide and self-harm.
A Gender Identity Development Service psychologist, Kirsty Entwistle, who quit due to ethics concerns, posted an article on Medium recounting her experiences with the GIDs. She believes political pressure is guiding care. GHQ covers the political environment, often veering into extremism. She also talks about how some affirmative model advocates level accusations of transphobia at any suggestion of caution.
Daily Mail also covered the story of her concerns and how political pressure is driving a very pro-medicalization environment and that children with trauma and other issues are being transitioned too enthusiastically in some health professionals’ views:
In her message to the service’s director, Dr Polly Carmichael, she said ‘clinicians are afraid of raising their concerns for fear of being labelled transphobic by colleagues’…
Dr Entwistle raised another red flag about young people with a wide variety of problems, not related to their gender, being diagnosed as transgender and put on drugs to help them change sex. In addition to sex-abuse victims, she said significant numbers coming to the clinic were living in poverty and ‘risky situations’.
The Spectator also reported on the increase of health professionals expressing concerns about gender dysphoria treatment in Britain.
The Gender Identity Development Service gave The Spectator a statement regarding their treatment approach:
Update: The Gender Identity Development Service gave The Spectator the following statement:
The Gender Identity Development Service operates in a contentious field and appreciates and holds in mind the concerns raised by staff about the complexity and background of many of the referrals we see. There have always been many spaces for staff to share their concerns about the work in general and specific cases they are involved with. These include weekly team meetings, a fortnightly case discussion group, a monthly psychoanalytic group, monthly CPD meetings, a monthly reflective group and a monthly research meeting. In addition, all staff have regular supervision and line management. Senior members of the team are regularly meeting with clinicians to consider more complex issues as the need arises. GIDS, and the Tavistock more widely, is a thoughtful, reflective place to work. Our assessments are co-worked so there is space for discussion between colleagues who were both present with a young person. We also run two service-wide away days per year to discuss developments in the field and in our practice as well as encouraging staff to attend national and international conferences. The service organises regular CPD events which cover topics raised by members of the service. Obviously, specific safeguarding concerns should be raised with line managers and our safeguarding lead. Staff can also avail themselves of the Trust’s Freedom to Speak Up Guardian.
It remains that there are different views about how best to support young people with gender dysphoria. Fewer than half of patients who present to the service go on to our endocrine clinics and we do not hold a view on what the outcome will be for a child when they come in to the service. There is no pressure to provide medical intervention from the service, though there can often be from the young person or family. Our work seeks to minimise the impact of distress associated with gender development on general development, whilst spending time exploring gender identity and the range of possible pathways which may or may not include physical treatment.
We appreciate that people may want wider discussions about how best to care for this population and for this reason we continue to engage with a range of stakeholders, including our staff and patients. It is vital that the voices of young people are heard. We will continue to deliver our service in a considered, ethical and caring manner, as endorsed in our CQC inspections.
Bannerman, L. (2019, July 26). Puberty blocking drugs: ‘For the past four years I’ve been stuck as a child’. The Times [London]. Retrieved from https://www.thetimes.co.uk/article/experts-investigate-use-of-puberty-blockers-on-transgender-children-6l695lflf
Bannerman, L. (2019, July 26). Use of puberty blockers on transgender children to be investigated. The Times [London]. Retrieved from https://www.thetimes.co.uk/article/experts-investigate-use-of-puberty-blockers-on-transgender-children-6l695lflf
Bodkin, H. (2019, July 17). Encouraging children to 'socially transition' gender risks long-term harm, say NHS experts. The Telegraph. Retrieved from https://www.telegraph.co.uk/news/2019/07/17/encouraging-children-socially-transition-gender-risks-long-term/
Children with gender identity issues 'need help from all sides'. (2019, July 17). BBC. Retrieved from https://www.bbc.com/news/health-49020371
Cohen, D., Barnes, H. (2019, July 22). Transgender treatment: Puberty blockers study under investigation. BBC. Retrieved from https://www.bbc.com/news/health-49036145
Doward. J. (2019, July 27th). Politicised trans groups put children at risk, says expert. The Guardian. Retrieved from https://www.theguardian.com/society/2019/jul/27/trans-lobby-pressure-pushing-young-people-to-transition?CMP=Share_iOSApp_Other&fbclid=IwAR3V8gNC4D6Z_qmT20be6euLDKth1J5fpHbYplGBAMGnQC25S-ggEuuam-M
Entwistle, K. (2019, July 18). An open letter to Dr Polly Carmichael from a former GIDS clinician. Medium. Retrieved from https://medium.com/@kirstyentwistle/an-open-letter-to-dr-polly-carmichael-from-a-former-gids-clinician-53c541276b8d
Hayward, E. (20189, July 17). Parents are encouraging children as young as three to change gender without consulting specialists, experts warn. Daily Mail. Retrieved from https://www.dailymail.co.uk/news/article-7258767/Parents-encouraging-children-young-three-change-gender-without-consulting-specialists.html
Kirkup, J. (2019, July). It’s time to listen to the NHS gender clinic whistleblowers. The Spectator. Retrieved from https://blogs.spectator.co.uk/2019/07/its-time-to-listen-to-the-nhs-gender-clinic-whistleblowers/
Manning, S. (2019, July 20). NHS psychologist claims poor and abused children are wrongly being labelled transgender and prescribed sex-change treatments without appropriate testing by clinicians who 'fear being labelled transphobic.’ Daily Mail. Retrieved from https://www.dailymail.co.uk/news/article-7268807/NHS-psychologist-claims-poor-abused-kids-wrongly-labelled-transgender.html
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