This is one of a series of blogs on The Tavistock, the UK’s Main Gender Identity Service. Based at the Tavistock NHS Trust, in London, it is often abbreviated as simply GIDs. Marcus is an ex-employee of the Tavistock and an important voice in this debate. You can find him on twitter Here The paper is an excellent reference point. Open access and with comprehensive references to all sources. Great reading list for the curious.
Link to the paper here
Given the history of silencing research in this field here is the download Freedom to think- the need for thorough assessment and treatment of gender dysphoric children | BJPsych Bulletin | Cambridge Core
If you have read any of my earlier pieces you will already know there’s been an unprecedented rise in referrals to GIDs /Tavistock. There has also been a change in the sex of the referrals. The proportions have completely inverted, from 75% male to 75% female. In addition there is an increase in teenage onset cases. This has been termed: Rapid Onset Gender Dysphoria, and is a recent phenomenon. The changing nature of the referral population, numerically, by sex and teenage onset should have raised serious questions about treatment protocols. Yet in 2011 the Tavistock actually accelerated the pace of earlier medicalisation.
Affirmation Only.
The predominant treatment is to “affirm”. This means it is now unacceptable to question your own / any child. This, despite the fact that we know, left alone, most would desist from a trans-identity.
Practitioners are expected to support the child’s self-identification and not to explore or question it. Affirmation is a nice, positive sounding word and it has become the mainstream treatment protocol. The affirmative approach, as explained below, sets these children on a path to irreversible medical interventions. In the UK this can happen for children as young as 10 years old.
The political ideology under-pinning this approach is a belief that children can ,literally, be Born in the Wrong Body (sex) for their Gender Identity. Gender is an internal sense of self so only the child can determine the truth of their condition. This makes the child the ultimate arbiter of their authentic self. Parents are expected to affirm their child’s Gender Identity based on their child’s self-assessment.
Memorandum of Understanding/Conversion Therapy
This article, however, makes it clear that there are dissenting voices, and organisations, who are not wholeheartedly on board with Affirmation as the right pathway or at least not as the only one. Many organisations have signed a Memorandum of Understanding which treats questioning of Gender Identity as akin to Gay Conversion Therapy. However the Royal College of Psychiatrists declined to sign the MOU when the definition was expanded in 2015. 👇
The government are currently consulting on a new bill to ban Conversion Therapy. Whether, or not, it uses the expanded definition will be crucial for the rights of children labelled “Transgender”. Most people will look no further than Gay Rights and assume that, of course, it should be outlawed. However, for all the reasons I have covered in previous blogs, affirming a Gender Identity in young children/teenagers may literally be Gay Conversion Therapy. The Woke Gay Conversion Therapy?
A growing number of parents are expressing concern about the treatment of their children with Gender Dysphoria. 30% are estimated to be on the autistic spectrum and with other co-morbidities. Many are simply gay males and Lesbians. The parent’s, referred to here 👈actually managed to get a letter published in the Guardian. They also raised concerns about on-line grooming of their children into the tenets of Transgender Identity. In the UK there are now two groups of Parents who are questioning the current approach to their Gender Dysphoric children. Bayswater Support Group: Twitter here and Our Duty here. (Both groups have other on-line forums and real life meet ups for parents to reach out for support).
Professionals are also becoming more vocal in questioning the medical approaches. Carl Heneghan pulls no punches in this reference to Puberty Blockers.
I can’t stress this point enough. Once your child starts down this path they rarely go back and they will be dependent on cross-sex hormones for life to maintain this “identity”. Tragically some of the women, and men, who have de-transitioned are still dependent on synthetic hormones, for their own sex, because they had ovaries/testes removed.
👈Here are two more organisations calling out the dearth of evidence based research, under-pinning the treatment of these children/teenagers. The House of Lords seems to have more dissenters and Lord Winston has written/spoken on this topic, from his own experience, in dealing with consequent fertility issues. 
A high rate of complications and loss of fertility. A reminder that the hippocratic oath requires Physicians to Do No Harm. The existence of an unelected chamber has always been a source of concern, for me, but elected politicians seem, almost universally, cowed into submission. It seems we do need some people ,not bound to the electorate/ lobby groups, to voice these uncomfortable truths. The House of Commons remain is largely silent on this issue. Silence is complicity. A salutary lesson.
Here Bernadette Wren, of GIDs makes a startling, and actually quite frightening, admission: given that the GIDs protocol remains Affirmative. 👇. Must we wait an entire generation to discover we have been unwise?
Professor Donal Shea is another dissenting voice.
The NHS is based on the WPATH standards of care. Professor Shea & Dr Paul Moran regard them as harmful and clinically unsafe. Let that sink in.
De-Transitioners/Regret
The Tavistock experiment has been running for nearly 10 years. We are starting to see a new wave of people with regret but, here is some detail about regret from the 1980’s. I rarely see Trans Activists/Trans Allies demanding evidence based research, or long term follow-up studies. I would suggest this is where there is a role for activists. Demand better research and long term follow up studies.
The more vocal trans-activists seem mostly preoccupied with rapid access to treatment and the removal of safeguards which they call “gatekeeping”. That alone should set off alarm bells for clinicians. I cannot imagine anything worse than finding you had taken a healthy body, and destroyed sexual function, only for your patient to regret it. 👇
Watching Jazz Jennings , a 16 year old male, ask if an orgasm was like a sneeze here should have been a wake up call for the cheerleading parents. In Sweden there is a male who has obtaining permission to end his own life, after regretting surgery and realising he was simply a Gay Male. A Belgian Female was also euthanised after regretting their surgery. here
Informed Consent?
Disturbingly here is a claim that discussion of post surgery sexual function was actually a taboo subject at the Tavistock. Especially with the younger cohort who, let me remind you, are making these decisions as young as 10.
Why is this area of treatment operating outside the realms of normal practice?
Anyone who doubts that this is happening can listen to Tavistock practitioners openly discussing the question of children and fertility in my earlier pieces. Parents have direct experience of the cavalier disregard for the long term consequences in our children. They express a fervent wish to change “gender” but these kids/teens have absolutely no concept of the long term implications. They have an entirely superficial understanding about what thy are signing up to. Sadly, it appears, so do some clinicians.
Anger, regret, and impact on women.
Even if someone is expected to benefit from transition some counselling around the reality of the inescapability of your sex would seem to be in order. Yes there may be people who regret this decision and direct their anger inwards. At the same time there seem to be people fiercely committed to their “transition” but utterly unrealistic about sex based reality. This group seem to direct their anger outwards, at their target sex. I am talking of the male transitioners. It is disturbing, watching the violent, even rape, rhetoric, hurled at women on social media (& in real life). Even more terrifying is that our politicians seem to be wilfully blind to this phenomenon. What if you are not just admitting any males into female spaces but a particularly dangerous section who hate and envy women?
Adolescence.
More people should be saying this. I have seen youtubers, now de-transitioned, who genuinely didn’t know that nearly every woman has a terrible time with the onset of puberty and emerging womanhood. How soon this knowledge is lost when young girls are cut off from the wisdom of older women?
Yet instead of working to, therapeutically, resolve this “splitting” we are shutting this down. Only medical pathways are seen as appropriate. Clinicians are branded transphobic for a therapeutic approach.
Parents are alienated from their children who are groomed to see any obstacle in their path as an act of hatred/bigotry. 👇
De-transitioners are now speaking out about their time in the Trans community. They confirm parental reports about our alienation. They also expose the tactics used to game the system and overcome gate-keeping , by learning a script.
Even if children don’t desist counselling can teach them about the wider societal implications of rejecting your biological sex. It is an inescapable fact that a female will still need cervical cancer screening, and a male prostate cancer checks. Yet activists push for the eradication of any sex markers and even new NHS Identity numbers. This de-couple pre-and post transition medical history. This is evidence of an ideological belief / psychological compulsion which is undermining safe practice.
So why is there such utter and total capitulation to an incoherent ideology?
The answer is fear! Not an unrealistic paranoid reaction but a rational response to the consequences of speaking out. Ken Zucker and James Caspian are two high profile victims of the silencing. Urge caution, or wish to study the phenomenon of regret, and you will find powerful forces ranged against you.
Heaven forfend if you wish to research Rapid Onset Gender Dysphoria.
I have written about the silencing of Michael Bailey over his book: The Man Who Would be Queen, which also covers Lisa Littman here. Another paper, which posited an alternative hypothesis to Born in the Wrong Body, was also completely pulled after activists put pressure on the journal. I cover this here
It is a chilling atmosphere in which to try to serve these children and young adults.
The closing down of debate and discussion about this surge in Transgender Identities is creating a dogmatic adherence to Affirmation/Medicalisation which is already wreaking great harm on our youth and some adults.
Having revealed that there are dissenting voices and organisations, despite efforts to shut them down, Marcus makes a final recommendation. A truly independent service able to withstand the pressure from lobby Groups. Less rigidity in treatment protocols. A new regulator with appropriate oversight.
This needs to be addressed quickly because there won’t be enough alibis to go round.
