An exploration based on this paper by Lucy Griffin, Kate Clyde, Richard Byng and Susan Bewley. You can read it in full here 👇

sex-gender-and-gender-identity-a-re-evaluation-of-the-evidence

This paper seeks to critically evaluate treatments for Gender Dysphoria and the field of transgender health. As they point out there has been a rapid rise in referrals to gender clinics over the last decade. After some lobbying the condition was no longer to be considered a mental health condition but despite this medical interventions are frequently sought.

For more on the changes to the the manual for diagnosis (DSM-5) see my post which covers the response from Dr Ann Lawrence; self described transsexual.

Diagnostic Criteria: Gender Dysphoria

The medical profession is littered with mistakes and many of them relate to the psychiatry profession, homosexuality and their involvement in Gay Conversion Therapy. I could also point out that the man who introduced Lobotomies was given a Nobel Prize before he was discredited. It behoves us well not to be arrogant about our contemporary medical practice. As I have long argued, what if we are actually practicing Gay Conversion Therapy in our rush to affirm the “transgender child”?

It is because of Alan Turing that I use the phrase “Turing Treatment” for what is happening to my own, gay, son. I had imagined Turing was a tortured soul who hid his sexuality. I recently read a biography that dispelled this notion. Apparently he would drop broad hints about his sexuality to screen out those who were not accepting. He was not fired after the court case for “gross obsenity” , the crime of being gay. His suicide seems likely to be related to the, court mandated, enforced, chemical castration. The same drugs, we gave Turing, are now doled out, by doctors, to gay teenagers, with no counselling.

The paper reminds us that although great advances have been made on the rights of homosexuals and bisexuals, in many countries, this is not the case across the globe. We now have former gay rights organisations expanding their remit to cover “Gender Identities” as illustrated by this diagram. This includes a whole range of identities which are now wider than the list below. Historically some of these identities would have been found on the fetish scene.

For the purposes of this piece we need to look at how the trans umbrella has expanded to cover gender incongruence. This is where there are legitimate concerns. I was a tree-climbing, den-making girl. This was not unusual in my working class circles, in the North of England. It was so ”normal” all my girlfriends were the same and we were not even labelled “tomboys”. We played with boys and were very competitive. I lost count of how many buildings I was the first person, of either sex, to jump off. I had very traditional parents, by the way, who didn’t bat an eyelid. So, how have we arrived at a place where I would be pathologised in 2021? Are we policing ”sex stereotypical” expectations more now than we were in the 1970’s? Are we inculcating a discomfort with biological sex by pathologising normal variations of behaviour in males /females?

How do we identify those who are deemed to be “failing” expectations for their sex and might be ascribed a ”transgender” identity? As stated above I met some of the criteria as a girl.

The paper covers statements by the Royal Society of Paediatric and Child health. (RCPCH) which conflate gay conversion therapy with any attempt to reconcile someone with their biological sex. They assume it is not the ideal outcome to avoid a lifetime of dependence on cross-sex hormones /surgical modifications to your body. In fact desistance, with no medical intervention, should be seen as the optimum outcome. Yet there are vociferous campaigns to remove /lessen gatekeeping for access to medical intervention. The paper points out that between 60-80% of children, who present with gender dysphoria, desist. They also cover the proliferation /explosion of gender identities in the last decade; including pangender, agender and non-binary.

The authors proceed to raise the lack of consensus around the exact nature of this condition. What if this is just a natural variation?

This paragraph packs a lot in. There are contested arguments about what causes gender identity incongruence. The “wrong” hormones in utero, wrongly ”sexed” brains or just an internal, and disprovable, claim one simply ”feels” like a woman/man which leads to a circular argument. What does a woman/man feel like?

It is both unverifiable and unfalsifiable. It posits the existence of a ”gendered soul”. This is a belief system. It may be a fervently, sincerely, held belief but when you ask society to participate in that belief system, to the extent of shaping laws based on it, we require a firmer foundation.

The idea we are not sexually dimorphic has spread like wildfire through academia to justify the concept of ”transgender”. In order to validate this category inconvenient facts must be cast aside to reshape reality. Here is the reality we must defend.

Most societies across the globe adopt a hierarchy based on sex, enforced by social rules enforcing expected behaviours for both sexes with varying degrees of coercion or cajoling. People expressing a severe discomfort with their biological sex are compared to the condition of bodily integrity disorder or apotemnophilia. The latest crop of recruits to gender clinic are a very different demographic to those we say ten or twenty years ago. Since 2009 there have been a 25 fold increase in referrals to the U.Ks main Gender Clinic, most strikingly in natal girls; illustrates in the graph below.

Here is some research on co-morbidities in the referrals to a Finnish Gender Clinic.

Note the high incidence among foster kids. I wrote about that phenomenon in a series on this blog. 13% of referrals to the U.K Gender Clinics are fostered or adopted. Eating disorders and a background of bullying also feature prominently in the stories of detransitioners.

Another common feature is how many are same sex attracted. Over 40% of natal males and nearly 70% of females. This graph is from the Tavistock clinic, in the U.K.

It seems warranted to question whether this is a new form of conversion therapy for those struggling with internalised homophobia. Is this a new catch-all diagnosis that is being applied to children/adolescents wrestling with other issues that are going untreated?

The paper continues to question the use of puberty halting drugs which are promoted as a ”pause” when in reality near 100% proceed to cross-sex hormones. Moreover long term follow up, where it exists, do not support the current pathway.

Warnings are given about the current belief that encouraging reconciliation with biological sex is a form of conversion therapy. This is dangerous and ignores the role of therapeutic approaches to resolve more complex issues underlying the identification as “transgender”. Some of these issues include homosexuality but also autism and lack of secure emotional attachment, in those from unstable family backgrounds.

The authors also touch on feminist concerns in promulgating the idea there is a right way to be a woman or man. We are in danger of reifying sex stereotypes rather than challenging them. We are also assuming a treatment pathway developed for adult men is appropriate for adolescent girls and female children. In conclusion, they warn that Psychiatry runs the risk of colluding with, or being silent about, an uncontrolled medical experiment.

We simply do not know how many will regret these medical interventions, some of which are irreversible.

I would recommend reading the entire paper for more on the use of suicide statistics in this area and the lack of accountability for a treatment pathway that may involve therapeutic professionals, endocrinologists, parents, surgeons and the patient themselves. Legal accountability may be difficult to determine but I know who I hold morally responsible for doing this to my son.

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