bmj.com/content/385/bmj.q837...
Studies in gender medicine fall woefully short in terms of methodological rigour; the methodological bar for gender medicine studies was set too low, generating research findings that are therefore hard to interpret.
"Trans children have been lied to by adults – the Cass report may now see the legal dam break
The alarm bells have been ringing for some time, but now the entire narrative around adolescent gender dysphoria is breaking apart
SUZANNE MOORE9 April 2024 • 6:00am
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I remember as a teenager reading about a strange disorder called anorexia. I had never heard of it – and then I noticed one of my best friends cleaning her teeth several times a day and exercising manically. And it wasn't just her that was acting weirdly. Several girls I knew were clearly suffering. Then came bulimia, which turned the school loos into sad places in which certain girls spent worrying amounts of time.
Then, as a mother of daughters, I remember reading about an epidemic of cutting among teenagers. Surely this highly unusual behaviour was not rampant? Well, the internet told me it was and an NHS psychiatrist informed me about self-harm circles in certain schools.
These thoughts occur because I am trying to understand how we started talking of "trans children" and thought this was somehow some kind of "progress". This, after all, is a new phenomenon. In 2010, for instance, with the Equality Act, which made gender reassignment a protected characteristic, the intention was surely to avoid discrimination against adult transsexuals. This is a laudable aim but no one was talking about children then. The phrase "gender dysphoria" was not bandied about. It was rare to come across a child who had such severe gender issues they needed specialist services. Indeed in that year, only 75 children were referred to Gids (the NHS's Gender Identity Development Service, based at the Tavistock centre in north-west London). By 2021 it was 5,000.
Now we are in a situation where celebrities wear T-shirts saying Protect Trans Kids and where schools, even primary schools, are colluding with the idea that children are whatever they say they are, that their bodies are somehow wrong and that they can change their names without parental consent.
The alarm bells have been ringing for some time about Gids. What was most alarming was this sudden spike in girls presenting with gender dysphoria and the increasing evidence of the harms of puberty blockers.
When Dr Hilary Cass was commissioned to report on standards of care within the NHS, it was as if finally an adult had stepped into the room. She and her team have looked at the evidence and practices that had recently evolved the affirmative model (designed to support and affirm an individual's gender identity) and found much wanting. She also signalled the high levels of comorbidities with gender dysphoria. A high proportion of these girls who did not want to be girls were autistic. Many had troubled childhoods or had been in care. Many were gay. All of this resulted in the unravelling of Gids and a ban on puberty blockers.
In the full report, which is due to be published this week, Cass is not only concerned with medical intervention (puberty blockers, cross-sex hormones, surgery) but is also expected to come out against "social transition". Though this is not something that happens within the health service it is, she says, an "active intervention because it may have significant effects on the child or young person in terms of psychological functioning. There are different views on the benefits versus the harms of early social transition... it is not a neutral act and better information is needed about outcomes."
Some believe that socially transitioning kids will lock them into a gender identity and medical pathway that is detrimental. Cass emphasises that gender expression is indeed fluid and changeable for adolescents and that many may take till their mid-20s to settle. In other words, leave these kids alone.
Indeed, faced with this huge increase in kids saying they are trans, many schools have acquiesced. Yet teachers are not clinicians, nor are they there to diagnose children. Do they understand what they are doing? The entire narrative around trans children has been imported from America but it is breaking apart.
Those who want to see themselves as compassionate and modern have embraced some seriously dodgy ideas. The evidence against puberty blockers, which were sold as "a pause" and reversible, mounts up. The Mayo Clinic has suggested that these drugs can lead to cancer. There is a court case coming up in Italy, and many predict that once the dam breaks, many who have been prescribed these drugs will sue their doctors.
This has all been allowed to happen because children have been lied to. They are told they can change sex; they are told that puberty will be awful; they are told they will feel suicidal. Anyone who challenges this has been deemed a pariah. So, we end up with newly qualified English teachers now deciding that they are doing the right thing by keeping a child's fantasy identity secret from their parents.
Many are terrified of this issue and go along with what they must know to be dubious. We have yet to see where the Labour Party will go on this, because it too quakes in front of its own activists. Yet any serious person must address the issues around safeguarding. The gender dysphoric child must be protected of course but so must the other kids in the class who have a right to single-sex changing rooms.
Now is the time to step back and ask ourselves how we got here. The trans child is a manifestation of a recent story that the culture has told itself. This is a story of social contagion combined with the genuine distress of mostly young girls.
Children cannot be blamed for acting out but the adults who have encouraged this, while patting themselves on the back for their progressive views, still need to be challenged. Cass is but the start. "
Studies in gender medicine fall woefully short in terms of methodological rigour; the methodological bar for gender medicine studies was set too low, generating research findings that are therefore hard to interpret.
"Trans children have been lied to by adults – the Cass report may now see the legal dam break
The alarm bells have been ringing for some time, but now the entire narrative around adolescent gender dysphoria is breaking apart
SUZANNE MOORE9 April 2024 • 6:00am
•
•
•
•
54
I remember as a teenager reading about a strange disorder called anorexia. I had never heard of it – and then I noticed one of my best friends cleaning her teeth several times a day and exercising manically. And it wasn't just her that was acting weirdly. Several girls I knew were clearly suffering. Then came bulimia, which turned the school loos into sad places in which certain girls spent worrying amounts of time.
Then, as a mother of daughters, I remember reading about an epidemic of cutting among teenagers. Surely this highly unusual behaviour was not rampant? Well, the internet told me it was and an NHS psychiatrist informed me about self-harm circles in certain schools.
These thoughts occur because I am trying to understand how we started talking of "trans children" and thought this was somehow some kind of "progress". This, after all, is a new phenomenon. In 2010, for instance, with the Equality Act, which made gender reassignment a protected characteristic, the intention was surely to avoid discrimination against adult transsexuals. This is a laudable aim but no one was talking about children then. The phrase "gender dysphoria" was not bandied about. It was rare to come across a child who had such severe gender issues they needed specialist services. Indeed in that year, only 75 children were referred to Gids (the NHS's Gender Identity Development Service, based at the Tavistock centre in north-west London). By 2021 it was 5,000.
Now we are in a situation where celebrities wear T-shirts saying Protect Trans Kids and where schools, even primary schools, are colluding with the idea that children are whatever they say they are, that their bodies are somehow wrong and that they can change their names without parental consent.
The alarm bells have been ringing for some time about Gids. What was most alarming was this sudden spike in girls presenting with gender dysphoria and the increasing evidence of the harms of puberty blockers.
When Dr Hilary Cass was commissioned to report on standards of care within the NHS, it was as if finally an adult had stepped into the room. She and her team have looked at the evidence and practices that had recently evolved the affirmative model (designed to support and affirm an individual's gender identity) and found much wanting. She also signalled the high levels of comorbidities with gender dysphoria. A high proportion of these girls who did not want to be girls were autistic. Many had troubled childhoods or had been in care. Many were gay. All of this resulted in the unravelling of Gids and a ban on puberty blockers.
In the full report, which is due to be published this week, Cass is not only concerned with medical intervention (puberty blockers, cross-sex hormones, surgery) but is also expected to come out against "social transition". Though this is not something that happens within the health service it is, she says, an "active intervention because it may have significant effects on the child or young person in terms of psychological functioning. There are different views on the benefits versus the harms of early social transition... it is not a neutral act and better information is needed about outcomes."
Some believe that socially transitioning kids will lock them into a gender identity and medical pathway that is detrimental. Cass emphasises that gender expression is indeed fluid and changeable for adolescents and that many may take till their mid-20s to settle. In other words, leave these kids alone.
Indeed, faced with this huge increase in kids saying they are trans, many schools have acquiesced. Yet teachers are not clinicians, nor are they there to diagnose children. Do they understand what they are doing? The entire narrative around trans children has been imported from America but it is breaking apart.
Those who want to see themselves as compassionate and modern have embraced some seriously dodgy ideas. The evidence against puberty blockers, which were sold as "a pause" and reversible, mounts up. The Mayo Clinic has suggested that these drugs can lead to cancer. There is a court case coming up in Italy, and many predict that once the dam breaks, many who have been prescribed these drugs will sue their doctors.
This has all been allowed to happen because children have been lied to. They are told they can change sex; they are told that puberty will be awful; they are told they will feel suicidal. Anyone who challenges this has been deemed a pariah. So, we end up with newly qualified English teachers now deciding that they are doing the right thing by keeping a child's fantasy identity secret from their parents.
Many are terrified of this issue and go along with what they must know to be dubious. We have yet to see where the Labour Party will go on this, because it too quakes in front of its own activists. Yet any serious person must address the issues around safeguarding. The gender dysphoric child must be protected of course but so must the other kids in the class who have a right to single-sex changing rooms.
Now is the time to step back and ask ourselves how we got here. The trans child is a manifestation of a recent story that the culture has told itself. This is a story of social contagion combined with the genuine distress of mostly young girls.
Children cannot be blamed for acting out but the adults who have encouraged this, while patting themselves on the back for their progressive views, still need to be challenged. Cass is but the start. "
