Tavistock 5: Marcus Evans

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.

TAVISTOCK 4 : Michael Biggs

Michael has been indomitable in his research into the use of puberty blockers on, ever younger, children. Michael is an Oxford University academic who researches social movements and ordinary people, driven to extraordinary actions. He also researches self-harm as a form of social protest. An interesting background. As you will see from his paper he was told by some woke students to Educate Himself. So he did! Here’s what he uncovered.

As always I am happy for you to bypass my commentary and access the paper directly here. Either way I recommend reading the full paper.

PDF attached in case his work is taken down: Biggs_ExperimentPubertyBlockers

The pressure, on the Tavistock, Gender Identity Service (GIDs) to introduce earlier intervention is well documented. For neophytes you can can see the tensions, between Tavistock staff & Lobbyists, in this oral evidence to the Transgender Equality Inquiry. here. With contributions from Susie Green, of Mermaids, and Bernadette Wren, of the Tavistock.

The aim of Trans Activists was to get “The Dutch Protocol” embedded in Tavistock practice. This protocol advocated earlier intervention, seen as the key to a more passing Trans Community. Blocking puberty was one way to do this, since it halted the process of masculinisation/feminisation. Publicly Blockers were touted as merely allowing a delay to explore gender identity issues. Based on research this would seem to be pure Public Relations.

The paper goes into some detail on the activists involved in the campaign to institute this changed treatment protocol. One of the familiar names is Stephen Whittle. Whittle is a transman and has played a key role in instituting Transgender Ideology. The best way to pass as a man, it would appear, is to be to behave like the most regressive mysogynist and attack women’s rights. Below are some other key figures together with groups which provided funding. ( I did a double take at the Servite Sisters! My Uncle was a Servite Brother; which is a Catholic order. Sure enough, it’s a Charity run by Catholic Nuns. Why would Catholic nuns fund blocking puberty?)

Norman Spack was involved in the treatment of Susie Green’s child. Susie is now the head of Mermaids, the leading UK charity advocating for medicalising children. Parents with children, who have been through this process, are evangelical in their zeal to extend this to other children. I suspect the motivation is to reassure themselves they did the right thing. The over-investment of older Trans activists, for early transition, looks like retrospective wish fulfilment.

As stated above the argument for puberty blockers had mainly been promulgated as a “pause” providing a, temporary, halt to the development of sexual characteristics. So what happened in the Dutch study? We know that the Tavistock were aware of this study but they didn’t include this fact in their bid for funding and ethical approval. No adolescent withdrew from puberty suppression and all started cross-sex hormone treatment, the first step of actual gender reassignment (de Vries, Steensma, Doreleijers, et al., 2010) Source.

Biggs paper highlights the discrepancies in the statements from GIDS clinicians on Puberty Blockers as a pause. He even highlights near contemporaneous, and contradictory, statements on the topic. See Polly Carmichael, from the Children’s BBC programme, I am Leo, juxtaposed with a statement she gave to the Guardian at around the same time. “We just don’t have the evidence…”

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Ultimately Polly Carmichael got her wish. The Gender Identity Development Service eventually received ethical approval to administer Puberty Blockers to children. A first attempt was rejected but, undeterred, the application was made again. This time the Tavistock chose to submit the application to a different ethical approval body. It was then approved. The initial study was based on participants from 12 years old. However the evidence suggests the actual age of commencement can be as young as 10. [See Michael’s paper for how he deduced this. Also Dr Aiden Kelly admitting this in my earlier piece TAVISTOCK PART THREE (A)]

The paper illustrates how Tavistock accounts of the actual number of subjects involved have varied. The figure of 44 does not remain constant . This matters because one of the failings in much of the research, in this field, is a failure to follow up patients long term. Biggs traces the various numbers used in the public reporting on the study. Damningly, despite being the custodian of the research project, the Tavistock does not appear to be keeping adequate records on the experimental subjects or taking the opportunity to rectify the dearth of long term follow-up studies. A missed opportunity or a deliberate attempt at obfuscation? Dr Carmichael admits that they lose contact with subjects once referred, at age 18 to the adult services. She also admits that they have not tracked those given hormone blockers in a single database! Thus the medium and long term consequences are not being tracked. Despite this look at the growth in numbers being given this treatment and the reduction in the age at commencement. Moreover changes to names and NHS numbers also make it difficult to track those on the receiving end of this experiment. ⇓⇓⇓. All set out in the clips below.

Also note that almost all cases led to cross-sex hormones. Just as in the Dutch Study. Therefore this was not a pause and, 9 years on, the Clinicians involved must know this. Interestingly only in May 2020 did the NHS change its own guidance to stop referring to Puberty Blockers as “fully reversible”.

Biggs has some significant criticisms of the project. Only one of which is the failure to meet any reasonable threshold for informed consent by not revealing the seemingly, inevitable progression to Cross Sex hormones. He also highlights the risks of the use of the drub triptorelin, whose negative outcomes have either been ignored or supressed.

There is more information, in the public domain, about the treatment of dangerous sex offenders, than there is of children put on the same drug. Let that sink in.

Below are a couple of quotes. You can read the full study here Triptorelin.

You can read a detailed list here of : Side Effects

More details of the impact on male children include a stunting of genitalia and negative impact on sexual function. Given that any surgeries to create a “neo-vagina” rely on sufficient penile tissue, for the most common techniques, this is another serious concern.

Other damning evidence suggests a negative impact on fertility and even sexual function.

Even from the limited evidence that GIDS has shared, mainly in Abstract Form from presentations at conferences, Biggs argues that negative outcomes have been omitted or downplayed. Some of these relate to bone density, which should be increasing during puberty. Others relate to reported psycho-social functioning and even suicidal thoughts.

In the light of the concerns raised by the scant evidence in the public domain why has their been no detailed report over 9 years since the project commenced? Biggs raises some serious questions about how a “research project” , instituted in 2011, has been allowed to progress to 2020 without publishing a full evaluation.

Increasing media coverage and the beginnings of political scrutiny may finally be about to shine a spotlight on this experimental treatment. Currently there is an ex-patient, Keira Bell, in the process of taking the Tavistock to Judicial Review over the medical intervention she received. The Safeguarding Lead is to take the Tavistock to court after being informed that safeguarding information was being deliberately withheld from her. Another former member of staff , Susan Evans, commenced legal action over the treatment of children. The Cass Review will look at Puberty Blockers on behalf of NICE. Liz Truss has signalled a change of direction over the treatment of under 18’s.

More politicians are also waking up to this issue.

An Ex- Labour peer, and Doctor of Medicine, Lord Moonie, has been raising issues on the medicalisation of kids and the impact on women’s spaces for well over a year. (Banned from twitter & resigned from Labour over this issue.) Latterly a Conservative MP , Jackie Doyle-Price has begun to speak up. Baroness Nicholson another Conservative Peer has been a tour de force in raising issues about the creeping influence of Gender Identity Ideology. Another Medically trained peer, Lord Lucas raised a question in the House of Lords in May 2019.

At the time of that question we were told the data would be available in the next 12 months. We have heard that before. However Lord Lucas is on the case and assured me he intends to follow this up.

Michael acknowledges the support he had in putting this document together which I include here:

I will leave you with the original patient who triggered the establishment of The Dutch Protocol in the early 1990’s.

Patient B has been followed all the way up to age 35. One would assume that the outcome would have been positive and indeed patient B is highlighted as a success. Indeed they say they do not regret their transition. This does not look like a good outcome to me and I fear we will have many more before someone, finally, halts this experiment. Allow me to also make the observation that if were talking about a biological male there is no way an absence of a healthy sex life would be regarded as positive.

TAVISTOCK PART THREE (B): Aiden Kelly

Tavistock: 1989-2018

This is based on this youtube presentation by a member of staff at Tavistock in March 2018. You can watch this: here.

Here’s a transcript of the talk TAvistock part 3

I have covered the physical interventions we are visiting on children/youth, who present with Gender Dysphoria, here TAVISTOCK PART THREE (A)

I now want to examine what this talk tells us about how we diagnose these children and include a few quotes that didn’t make into part A. .

We are basing this diagnosis on the belief that, somehow, Gender Identity exists independently of biology and is sometimes in conflict with our biological sex.

⇐This slide shows that Dr Kelly recognises biological sex, sexual orientation and sexual identity exist. He also identifies, separately, Gender Roles, Gender Expression and Gender Identity.

Biological Sex is the easy one. Despite efforts to destabilise the definition of sex we are a sexually dimorphic species. Differences/Disorders of Sexual development (also referred to as intersex) don’t disrupt the “binary” of sex. Here are two people qualified to comment on the issue of sexual dimorphism. Claire’s comment, below, is a good one to keep handy as her article, published in the journal Nature, is often wheeled out to claim the opposite of what she meant. It is actually a fascinating Article

Dr Kelly defines our Biological sex as our anatomy and says it is an important part of our sexuality and sexual identity. I am not sure how sexual attraction is only partially reliant on biology, except that this matters in Transgender Ideology. Additionally, what does “sexual identity” mean here? It maybe to accommodate people who identify as the opposite sex (not just gender). Alternatively it is, perhaps, to include people who identify as a particular sexual orientation regardless of their sexed body. That is to be inclusive of self-described “male lesbians”, or female’s who identify as “gay men”.

Gender Identity is here described as a “personal and individual thing” which is not necessarily fixed. Yet another reason why it is not a good idea to base legal concepts on something undefinable and shifting. If Gender Identity relies on a personal, subjective feeling how is it sensible to codify it into Law?

Gender Expression. This seems to mean how you “perform” your gender and how you signal which gender you identify with/as.

Here Dr Kelly, an obvious biological male, talks about his identity as a man. We learn how this might be signalled by the way he dresses, manners, his hands and even the way he crosses his legs. This is all complicated by the notion of metrosexual males who may even cross their legs in a feminine way but still identify as male. Confused? Don’t worry. It is, apparently, complicated and kind of hard to think about. God help those of us with #LadyBrains.

Then there are Gender Roles.

Here he recognises these rely on gender stereotypes. Am I a woman because I pick up the dustpan and brush? Don’t be silly. That’s just a gender stereotype. We want to deconstruct those don’t we? And here we come to a startling admission. “The last thing we want to do is to have a young person changing their body to fit in with… societal rules”. Dr Kelly would love to take Gender out of this issue altogether. But, guess what, we have to deal with reality. I assume he means gender stereotypes are deeply entrenched and changing society is too hard. So what does he propose? We need to “carve out a space” for someone to express their gender, in ways that society will accept. Are we really carving up the bodies of young people because that is easier than transgressing expected norms of behaviour for fe/males? I am old enough to remember when Gender Non-Conforming behaviour was widespread. What happened? I give you Annie Lennox and Boy George. I could supply loads more examples.

Next we are introduced to the Gender Unicorn. (See Header). A slide that Dr Kelly uses to introduce concepts central to his work. Sex is, unsurprisingly, described as “assigned at birth”. People with DSDs are othered as a third sex. Sexual orientation is undermined by the inclusion of romantic/emotional attraction. We are using this tool in primary schools! So, is it entirely unsurprising we are seeing rising rates of Gender Dysphoria in girls, and boys? Who amongst us performs our sex stereotypical expectations 100% accurately?

It gets even more confusing when we examine how young children think about gender. We are provided with this slide which shows how children are socialised into expectations of what makes a boy or girl.

This kind of thinking, in a two year old, is quite cute. It is less so when espoused by our political, media and medical elite. I like my politicians to engage with issues as adults not toddlers.

There is not much to disagree with in the next slide except to wish the Dr would join the dots. Emerging sexuality and associated feelings of shame. (Surely worse for those who realise they are same sex attracted in a heteronormative culture). Anyone paying attention would see that the rigidity of the “gender binary” and the impact of parental or societal expectations has significantly worsened in the last twenty years.

Is the new rigidity of Gender Stereotypes a new Backlash against Women’s rights? As women encroach on male professions is this a new way to put women back in their box? Is the Public Femininity display a way to dispel the ball-breaking bitch trope? Are we displaying hyper femininity to signal we are no threat to men? This could be labelled compliance, or subversion, either way omething seems to be going on.

Moving on to the understanding of gender in 8 year olds. Dr Kelly makes an astute observation about the meaning of gender for young children compared to 38 year olds. Note that we are following one set of diagnostic criteria for both groups. Children pick up social cues which reflect the society in which they live. Adults, mainly males, also absorb expectations from adult depictions of female roles. Some of this in contexts (porn) that, you would hope, your eight year old has not encountered. See this interview with Andrea Chu who is remarkably honest about their pathway. You can read up on Chu’s thoughts on the role of sissy porn and the concept of the female as passive: here

Our kids are navigating such difficult territory. I was one of 8 children. Six of us girls. All the horrific statistics about sexual violence against women and children were played out on our bodies. I was a dungaree wearing, tree- climbing, jumper off buildings. We ran free and I was not unusual. Sure we had pretty dresses, for specific occasions, but overwhelmingly we lived in “playing out clothes”. These were the norm and we would nowadays, describe them as gender neutral. I was brought up in a pretty traditional household. Working class father. Manual occupation. Definitely seen as the breadwinner. Even in that context it was absolutely the norm for we girls to do this. Nowadays this would put us at risk of referral to the Gender Identity Industrial Complex!

Fast forward to puberty. As Dr Kelly recognises this is a hugely challenging time for young people. It’s a turbulent time for even the most well adjusted teen.

What happens if you throw in some complicated family dynamics? Below Dr Kelly outlines some scenarios. There are multiple everyday reasons why girls struggle during puberty. Growing up in a society with record violence against women, endemic woman hating porn, hyper-sexualised expectations for young women. No wonder girls are identifying out of their sex. For young boys, who don’t want to be associated with toxic masculine socialisation, who are gay and on the “femme” side the flip side of this equation comes into play. Throw in some domestic turbulence and you get some extreme rejections of what it means to be female /male in this society.

And lets not forget homophobia. Some parents would prefer a faux-straight child to a male child who they might think the behaviour, described below, signals their son may be a proto-gay male.

Dr Kelly goes on to talk about how people can hold toxic views about gender. People can also have quite toxic views rooted in homophobia.👇

I find myself bewildered that the Gender Identity Specialists didn’t anticipate this. The law of unintended consequences. Spend all your time banging on about undermining heteronormative culture and guess what? You did a great job of establishing a new, pernicious, way of establishing it. All your campaigning around “disrupting binary thinking about gender” and what did it achieve? We have actually established a way to make sex stereotypes “flesh” ; by carving up the bodies of boys and girls who don’t conform.

I wonder how many people, who have dedicated their lives to the furthering of this social revolution, have dark nights of the soul? They should.

Survey of Referrals to a Gender Identity Clinic.

This paper surveys 5 years of referrals to an Oxfordshire Gender Identity Service, up to 2009. Its well worth looking at this paper because it sheds light on the typology of referrals. It also raises the issues of informed consent, co-morbidities, sexual motivation and, crucially, highlights the huge change in the sex of referrals.

See below for a brief summary of the methodology:

We have seen a dramatic shift from mainly male, in this paper, to overwhelmingly female in the decade since. Turns out biological sex is a factor. Current youth referrals are now 75% female. This is a striking change as highlighted by ex staff from the UK’s main Gender Identity Service (The Tavistock). Over 40 staff have left over a three year period, some after expressing concerned about the response to this changing demographic. (Clips from an article in the Times of London. Full Article here. (Paywall) Feels Like Gay Conversion ⇓

As always, feel free to skip my commentary and read the entire paper yourself. You can find it here

This paper pre-dated the changes to the Diagnostic Statistical Manual; which no longer refers to Gender Dysphoria as a “disorder”. Activists fought long and hard to change the way this condition was described, to remove any reference to “disorder. The modern narrative is that our children are simply “assigned” the wrong sex at birth. To develop a sense of Gender, at odds with your sex, is now presented as a normal/natural variation and hence de-pathologized. Well worth reading Dr Ann Lawrence (Transsexual) on the politics behind this change. (Will add link when Dr Lawrence’s website is back after maintenance)

The above paragraph emphasises the rarity of this condition and the high incidence of co-morbidities in the community; i.e. the existence of other mental health issues in the Trans community. Axis 1 disorders are at the most acute level and include schizophrenia and depression. The paper is authored by psychiatrists who were specifically focussed on concurrent and historic, diagnoses of mental health issues.

Other notable features were the low rate of funding approvals for surgery, the rise in self-medicalisation, the prevalence of mental health issues and a disturbing finding of clients who admitted to paedophilia.

As with many other papers the rates of referrals, from those with a diagnosed autistic spectrum disorder, is also noticeable. The authors note that, in the main, their sample did not differ significantly from the findings of other research. They do note, however, the mental health issues were slightly lower than in other findings. The youth of the female subjects is noted.

Below is a breakdown of how many of the subjects were already accessing hormones obtained over the internet, without any medical oversight. Over 50% had either a current or pass mental illness. Depression was the most common diagnosis.

This study is to look specifically at psychiatric diagnoses so it is striking that none had a formal diagnostic interview. The authors conclude that comorbidity is, therefore, likely to be underreported. It would be interesting to see if the location in a student population influenced the rate of young females presenting at the service. ( I do wonder if there will, eventually, be a retrospective review that draws comparisons to females who succumbed to anorexia. My own personal experience was that it impacted, highly motivated/academic females at a disproportionate rate)

Reading the quote below it is refreshing to see reference to issues of capacity to consent in relation to those on the autistic-spectrum. For those of you on twitter it is instructive search “top surgery” and see how many openly proclaim “autistic” in their personal biography. I also signpost you to the #WeAreNotConfused hashtag. This was started to refute any notion that the high prevalence of Autistic youth, with Gender Dysphoria, was an issue of concern. A response which was a reaction to the open letter by JK Rowling which you can read here.

Expressing concern about the high number of autistic females suffering from Gender Dysphoria is not deemed an acceptable opinion within the field of Gender Identity Specialists.

The reference to paedophilia in this paper also triggers push back on social media. It would be interesting to know exactly how this information came into the possession of the clinicians undertaking the assessment. It would seem that this must have relied on a personal disclosure based on the wording below:

9AEF136F-C3EB-4448-9AA1-EB75A145F1A3 — Safeguarding

This is an unmentionable subject on twitter as it has echoes of the association of paedophilia with gay males. Gay activists were quite right to push against such an insidious narrative. At the same time Safeguarding101 is DO NOT create a priest class, who are beyond reproach. It is not that priests became paedophiles. Its that paedophiles became priests. Remember this when people push aside safeguarding concerns because transphobic.

To finish I am going to include this clip again. Pay attention. Reasons for non-referral were that the person was deemed not to be ready, or homosexual or having an autistic-spectrum disorder.

Now watch last night’s Newsnight segment here: Tavistock Ask yourself what has happened to make clinicians throw caution to the winds in the last 10 years?

Tavistock. Part Two: Clinical Dilemmas: Polly Carmichael

Talk by Polly Carmichael.

Part Two on the tension between different approaches for dealing with “Gender Dysphoria”. Hopefully part one provided some background for any neophytes. Tavistock Clinic: Part One.

Dr Carmichaels speech is : here The summary is taken from a transcription provided by Mumsnet volunteers; for which I am very grateful.

The talk took place in the following context:

4500% rise in the number of referrals, to the Tavistock, over a decade.
Rise in females (reversing sex ratio in less than a decade)
Tavistock pilot to place younger children on puberty blockers.

This change in protocol followed work done by Dutch Gender Identity Services. As you will see, from my earlier blog, the Tavistock were under some pressure to revise their treatment protocols to allow earlier medical interventions.

The evidence from introducing puberty blockers, at an earlier age, has resulted in children invariably progressing to cross sex hormones and entrenched on a medical pathway. The pro-medicalisation Lobby argue this is because they are 100% accurate in identifying those children who would persist. The alternative perspective is that the act of blocking puberty somehow locks in the Gender Incongruence. If this is correct we are medicalising those who would have desisted and, historically, many of those would simply be gay. I cover this here The Woke Gay Conversion Therapy?

There are many people working in this field who have raised this as a concern:

We don’t know whether these children would have desisted and reconciled to biological sex. The pro-interventionists have another perspective. They argue this is evidence the screening is working and it may be unfair to the children not put on this clinical pathway! This is also the argument used against setting up a control group. From the perspective of the Tavistock it would be unethical to leave a cohort untreated if they meet the diagnostic criteria for intractable Gender Dysphoria. I do wonder if anyone has thought to include parents, who oppose medical intervention, to see what the long term outcome is for our children?

Another startling admission is that we simply don’t know what the long term implications are on developing brains. 👇This is a clear admission this is an experimental treatment. Have politicians,and parents, been persuaded to take this risk because activists claim our children are at a high risk of suicide? Have activists managed this by leveraging questionable data on likely suicide? (I blogged about this here Suicide in the Trans Community)

This paragraph is important because there are still documents out there calling this intervention a “pause”. Indeed here is Polly herself from the CBBC children’s programme “Becoming Leo”.

Many people working in this field have postulated that going through a natural puberty resolves gender incongruence in the majority of cases. Dr Carmichael is clearly aware of this research and emphasises that the treatment, at Tanner Stage 2, means that these children will at least have had a partial puberty.

She concedes the paucity of long term data on outcomes. She also anticipates concerns about competing mental health diagnoses. In this way the “Gender Dysphoria”, it is implied, has to be treated to resolve these other difficulties. This neatly avoids any suggestion mental health issues underpin the “Gender Dysphoria”, or desire to find a label/treatment.

The framing of this discussion is entirely reliant on whether you believe in an “innate gender”. If you do believe a child can be born in the wrong body it necessitates treatment. If you believe gender is a social construct then societal sex stereotypes are the problem. These seem to be irreconcilable belief systems. Worth having a look at how Mermaid’s diagnostic criteria works. Would anyone not meet the diagnosis threshold given this criteria?

Dr Carmichael , below, frankly admits that the evidence has yet to catch up with practice. She further acknowledges there is no consensus and there is concern about the long term health impact. The only way this treatment can even approach an ethical justification is if you are confident that:

a) Gender Identity is innate

b) The Tavistock have a reliable system for targeting irreversible treatments only on children who would, in any case, have persisted.

c) You believe data that suggests there is a suicide epidemic in trans-identified youth. {This makes intervention a life saver & justifies pharmaceutical interventions}.

So what has effected this change? Political Interest and Lobbying. Let us not forget the role of the Women & Equalities Committee. Since it morphed, from a Women’s committee, it has been successfully colonised. In its original incarnation it focussed on women’s issues. As predicted, women’s concerns have been pushed to one side with a wider focus on “Equalities”.

The quote below👇 touches on the real change in the landscape surrounding “Transgender” children. Dr Carmichael acknowledges that some children are being socially transitioned at pre-school age. This is also a reference to the growing condemnation of “watchful waiting” , now badged as a practice akin to #GayConversionTherapy. The memorandum of understanding (MOU) she references commits to a ban on therapeutic work to resolve Gender Incongruence. BACP (British Association for Counselling and Psychotherapy) & the BPS (British Psychological Society) have signed up to a ban on Gender Identity “conversion”. The Royal College of GPs has also signed this MOU.

The fact most desisters are predicted to be gay seems to have escaped their notice. Counselling, to reconcile to biological sex, is now officially condemned by these, erstwhile, esteemed professional bodies. As of May 2020 there are is a further move to outlaw any therapy to address “Gender Dysphoria” by, once again, conflating it with Gay Conversion Therapy. See here ⇒ Gender Identity Conversion Therapy

There’s a huge amount to unpack here. 👇

Dr Carmichael is not happy the Tavistock are being accused of not being sufficiently affirmative. She does appear to be trying to raise awareness of the changing nature of the child referrals. Her interpretation of the parents, mentioned above. does not accord with my own perspective. Socially transitioning a three year old and then attempting to report a young child for the Hate Crime of misgendering another child! Is this the behaviour of parents who are simply being protective! If I was relaying this story, verbally, my incredulity would be at such a high pitch only dogs would be able to hear me!

In the section below there are a lot of erms as Dr Carmichael hesitates over the admission the treatment compromises fertility . She is anxious about this, but not for the reasons you might expect. She is concerned about young people who defer medicalisation to try to salvage their reproductive health. The reason for this is they may not “pass” ,if they delay long enough to have a chance at parenthood. This is not an uncommon viewpoint. One practitioner in this field praises the children who are kind enough to see themselves as future child adopters.

Sacrificing fertility is quite a significant thing to ask children to consent to and yet her concern is one of “presentation”. Polly is aware this is indicative of that great sin of “binary thinking”. {Its almost as if she knows, on some level, there are only two sexes!} No doubt Polly would consider me a “biological essentialist” but, like many women (and men), I was in my thirties before I desired children. I would not have made a mature decision, to place my fertility at risk, at age 12.

And that last sentence! Actually wondering how the Tavistock can support children to feel comfortable enough to live with their bodies! Klaxon Klaxon Klaxon!! This is what parents would like to know! Shouldn’t the first line of treatment be body-positive? In less than a decade we seem to have normalised a bodily dis-associative disorder and completely over-turned decades of work, especially for the female body.

Another thing that is hard to keep up with is the removal of any reference to mental health issues. The diagnostic criteria for Gender Dysphoria has now officially been re-classified to remove suggestions it is a Mental Health issue. I sense Dr Carmichael really wants to find a way to talk about co-morbidities here. However activists have successfully rebadged Gender Dysphoria as a naturally occurring variation and references to mental health are removed from the official diagnostic manual.

How many of these children/teens placed on an irreversible pathway may have benefited from some good therapeutic exploration of their motivations? Therapeutic Interventions to resolve Gender Dysphoria

This is a good summary of what the impact of this Conversion versus Affirmation model does to practitioners in this field. I diverge on many points with Dr Carmichael but she is right that we are favouring medical solutions to resolve psychological issues. The lack of psychological support has also been raised by Tavistock staff who have now left and are whistleblowing.

To balance the pressure for medical intervention we need a diversity of voices. These should include detransitioners, It should include parents of children struggling with this “condition”. It should include people who understand the concept of an iatrogenic “illness”. It should include people who have expressed concern about what we are doing to young people. We need a countervailing voice to Lobby groups like Mermaids, Stonewall and Gendered Intelligence.

The above is not a bad summary.

We need more empirical data, less opinion.
We need to look at contextual factors. (School teaching on Gender Identity, for one)
I disagree about taking a lead from young people. Detransitioners have taught us that.

We need to urgently take measures to make certain we are not medicalising children who could have lived a life without hormone dependency and surgical interventions.

The problem with this service is that it seems to be driven by people who see this as a social justice cause, They are excited at disruptive thinking, eroding or destroying social norms. I will leave you with this quote from Bernadette Wren, who also works at the Tavistock. This is from the Transgender Equality Inquiry in 2015. I sense that Dr Wren should have been more careful. Sometimes a social revolution doesn’t take the form you, naively, imagine it will:

The Woke Gay Conversion Therapy?

Sexual Orientation and Gender Identity.

Let me state, for the record, I don’t believe anyone has an innate “Gender Identity”. Gender is a social construct, super-imposed on biological sex to uphold Patriarchal structures.

Gendered expectations limit and constrain women whilst grooming boys to occupy a dominant role, as men. Historically, feminists made a distinction between “sex” and “gender” to deconstruct, biologically determinist, theories of sex differences. It was never a radical feminist position that women, or men, were born with a “natural” gender. (Note to evolutionary biologists. I am not a proponent of blank slate theory. I am, however, wary when biology is used to justify women’s position in the sex hierarchy). Feminists dispute that gendered roles are a natural, inevitable, consequence of our biology. Our Gendered role is distinct from our Biological Sex.

Gender versus Sex discourse is now distorted into the antithesis of a feminist analysis. We now have a political class who have accepted the proposition that “gender” is real and innate, and biological sex merely “assigned at birth“. Since gender comprises sexist, stereotypes the reification of “gender” is regressive. Furthermore medicalising gender non-conformity, has some serious implications for the health and well-being of our youth.

As a feminist I have principally registered the impact of sex stereotypes, on women. As a mother of two sons I have an increasing awareness of gendered expectations, for males. Watching them navigate the world, as boys, inducted into the male tribe, exposed the deployment of, often brutal, sanctions for boys who don’t perform “male” behaviours. As a parent of a same sex attracted, son, this has brought things into even sharper focus.

Not conforming to sex stereotypical behaviour is not unusual for Gay males (& Lesbians). They may exhibit non-conformity early and it will often pre-date sexual awareness. Many of these children, like mine, will be brutally punished because they are deviating from expected “normal” behaviour. They may have atypical interests for their sex, hang out with, and even identify “with” members of the opposite sex. For males they are often explicitly rejected by their own sex and isolated by their peers. All of this is painful and confusing and years of bullying can, and does, lead to internalised homophobia.

Homophobia & The Cotton Ceiling

Homophobia is not a thing of the past. A focus on the UK context can, superficially, suggest the main battles are won. Sexual orientation is a protected characteristic, under The Equality Act 2010. Same sex marriage is legal. Currently we are seeing a vicious attack on same sex attraction from within the LGBT community. For Lesbians their same sex attraction is badged as transphobic. There is even a name for this: “Cotton Ceiling”. This is a play on the notion of a “glass-ceiling”, a phrase coined to describe the barrier to female achievement. This term has been repurposed to refer to Lesbian underwear, as a barrier to “all-inclusive” sexual availability. Lesbians are explicitly under attack for rejecting male bodies in their “Lesbian” dating pool! This is the new “progressive” Corrective Rape. Article here: Cotton Ceiling.

As always this is a tale of two sexes. There is no comparable campaign to shame gay males over their vagina-exclusionary orientation. They are not, on any significant scale, condemned and policed about their sexual orientation. Some of the battles we thought had been won are being undermined, ironically, under the banner of “progressive” thinking. None of the leading Gay publications, or Advocacy groups, have condemned the rhetoric of #CottonCeiling, indeed most deny it exists. Same sex attraction is being undermined by organisations which purport to represent the gay community. (Cough…Stonewall).

Inculcating Gender Dysphoria

It is in this context we need to examine how the concept of an “innate Gender Identity” is being proselytised in our schools. Children are being taught that “sex” is no longer dimorphic but exists on a spectrum. Homosexuality is the attraction to one’s own sex. Its predicated on the notion of two sexes. How do prospective gay adults reconcile this to the idea that they exist “on a spectrum?

The phrase “assigned male at birth” is being used in the media, by medical professionals and by our political elite. Somehow the idea that a small number of disorders of sexual development (DSD), leading to “intersex” conditions, has morphed into a belief that accurate determination of sex is not possible, at birth. There is no evidence that DSDs are more prevalent. This belief is not borne out of concern for people with intersex conditions. It is ideologically predicated to privilege “gender identity” above sex. Same sex orientation is then seen as in conflict with attraction based on “gender”. Gender can be de-coupled from “sex” and even sexual characteristics. This places definitively homosexual males, & females. in the “wrong” for excluding opposite sex partners.

Here is an example of school based training. A pack which has been used in various forms across the Education Sector: All sorts Trans Inclusion Kit Here is a critique from the Transgender Trend organisation of the training in our schools: Transgender Trend

It is my contention that this training is inculcating Gender Dysphoria: a disassociation from biological sex. Nobody conforms 100% with the expected behaviour for their sex. Yet children are being taught that failure to adhere to these , culturally determined, expectations may mean they are “Born in the Wrong Body”. Lesbians and Gay Males frequently deviate from “gendered” behaviour and are much more vulnerable to this ideology. Its confusing and de-stabilising. The meme below was sent out by a young, gay male. 👇

Here is an example of Mermaids training slides. (Mermaids is an organisation which exists to support “trans” children and youth). This is being rolled out to schools and teaches a spectrum of “gender identities” with which children are asked to “identify”. At one end of the spectrum is Barbie and at the other end is GI Jo.

The use of regressive stereotypes is only one area vulnerable to critique. If we were teaching the variety of ways people express themselves and deconstructing sex stereotypes this could be a force for positive change. We are , instead, using it to push the notion that one can be, literally, “Born in the Wrong Body”. Instead of celebrating difference we are instead advocating that these children/teens should be medicalised and handed over to #BigPharma for Life.

I have one son who does sport most days, captains football and rugby teams, and has, largely, gender typical interests. Based on that criteria you could allocate him to one end of the spectrum. The same son does his own washing , irons clothes, watches boxing but also likes poetry. Where does he now go on this “spectrum”?. Are we not just pathologizing personalities which deviate from the “man-box”?

I have another son who loves music, hates sport, identifies “with” girls and has always had female friends. He also came out as “gay” when he was in his early teens. When puberty hit he was still not accepted by his male peers but now female peers were retreating into same sex friendship groups. Parents were not including him in female bonding experiences, like sleepovers. Those parents had every right to exclude him but it did increase his isolation. Its not difficult to understand why a boy like this would identify out of his male sex, and his homosexuality, by retreating into a faux-straight, medicalised closet. Superficially this can look like an attractive option.

Gender Dysphoria is a relatively recent historical phenomenon. In the last decade, in the UK, we have seen a spike of over 4000% increase in girls referred to Gender Identity Clinics. For boys the figure is 1152%. Parents who are resistant to the dominant “affirmation” model of treatment won’t be included in these figure. Many know better than to enrol our offspring in these “treatment” centres. Article here: Behind a paywall. Rise in Gender Identity Clinic referrals

Are we medicalising away the Gay?

Recently whistle-blowers at the UK’s main Gender Identity Clinic ,The Tavistock, have broken ranks to highlight the real threat to gay children who are using their service. Below is a clip from this article in The Times newspaper. Full article here (paywall) Transgender Experiment

Here is a youtube from another expert in this field asking: Why are lesbian and gay children being transitioned?

Professor Eric Vilain

Here is another article summarising studies which show that most children who identify as the opposite sex eventually reconcile to biological sex and, many are gay. Author is James Cantor who works in this field. Remember also that this much of this research predates the meteoric rise in referrals. There is every reason to suspect that desistance rates would be much higher in the current “crop” of trans kids IF (and its a big IF) they were not subject to irreversible medical treatment.

Do Kids stay Trans

Here are quotes from two other experts about the impact of early medicalisation on children. Dr James Barret, a consultant at the UKs oldest Gender Identity Clinic, makes it clear most would desist, reconcile to biological sex, and be gay IF allowed to go through a natural puberty.

Ray Blanchard another expert, in this field, makes it clear that the addition of Puberty Blockers locks those self-same children on an irreversible path to medicalisation.

Proposal to criminalise “affirming” Biological Sex?

The standard model of “treatment” is to accept the child/teens self-assessment of their “Gender” and to socially, leading to medical, affirm that identity. Affirming a child in their biological sex is the least invasive approach. Since most desist from a “trans-identity” and many are merely gay this seems to be the obvious approach and indeed has been the standard treatment for decades. Fast forward to 2019 and this is seen as akin to Gay Conversion Therapy. At this very moment affirming biological sex is outlawed in many US states. Here is the UK we have a bill, currently going through parliament, which proposes to outlaw my parental practice. Now I am told it is unlikely this will proceed but I have lost all faith in our political class over this specific issue so I am keeping it under scrutiny. (Clip from Hansard below).

Silencing dissenting Parents.

On Social Media parents, like me, adopting a cautious approach, to medicalising our children, are subjected to quite a lot of criticism. Little of it is evidenced based. Here is a sample. Not all of these screenshots were to myself but I have had pretty much all of this type of abuse.

@Terfblocker were particularly egregious and their follow up, to the tweet above, was to find my real name and add it below to “out” my son. Nice Touch. Here is a reminder of the person who set up @TerfBlocker.

Former Green party candidate now ensconced in the Liberal Democrats. You may remember the name and a public statement that this person was dangerously unaware of basic safeguarding. Also, as of June 2019, still appears an advisor to Stonewall. Stonewall Trans Advisory Group

More here if you are unfamiliar with. Aimee Challenor

What other alleged campaign for “Civil Rights” routinely labels caution and research as bigoted? What other campaign uses the threat of children’s suicide as a tactic to terrorise parents into submission? If anything the vehemence of the attacks has made me more confident that this is wrong.

Since writing this I commented on the issue of trans sports and was treated to another lovely comment, No wonder perceptions of hate crime are sky-rocketing when someone sees hate in this comment.

There will be a reckoning when society wakes up to what is being done to children under the, mistaken, belief that they are Born In The Wrong Body. I hope we wake up to the problematic, and unquestioning, affirmation of a child/teens belief that this is the right path for them. My biggest fear is that EVERY single political party and most politicians have gone along with this. What will it take for them to reverse this position? Are our children to be electoral cannon fodder?

Tag: Conversion Therapy

Tavistock 5: Marcus Evans

Affirmation Only.

Memorandum of Understanding/Conversion Therapy

De-Transitioners/Regret

Informed Consent?

Anger, regret, and impact on women.

Adolescence.

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TAVISTOCK 4 : Michael Biggs

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TAVISTOCK PART THREE (B): Aiden Kelly

Tavistock: 1989-2018

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Survey of Referrals to a Gender Identity Clinic.

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Tavistock. Part Two: Clinical Dilemmas: Polly Carmichael

Talk by Polly Carmichael.

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The Woke Gay Conversion Therapy?

Sexual Orientation and Gender Identity.

Homophobia & The Cotton Ceiling

Inculcating Gender Dysphoria

Are we medicalising away the Gay?

Proposal to criminalise “affirming” Biological Sex?

Silencing dissenting Parents.

What other issue has cognitively captured the political elite so swiftly? One thing for certain is that this is not a grass roots movement!

Like this:

Affirmation Only.

Memorandum of Understanding/Conversion Therapy

De-Transitioners/Regret

Informed Consent?

Anger, regret, and impact on women.

Adolescence.

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Tavistock: 1989-2018

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Talk by Polly Carmichael.

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Sexual Orientation and Gender Identity.

Homophobia & The Cotton Ceiling

Inculcating Gender Dysphoria

Are we medicalising away the Gay?

Proposal to criminalise “affirming” Biological Sex?

Silencing dissenting Parents.

What other issue has cognitively captured the political elite so swiftly? One thing for certain is that this is not a grass roots movement!

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