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Transcribing request - Victoria Derbyshire programme.(42 Posts)
Hi wims, I know there are brilliant transcribers among us, but with all the recent name changes, I'm not sure who to tag or PM about this!
Victoria Derbyshire had an interview with Polly Carmichael on her programme today 2/3/2020, and I'd really appreciate a transcription because Carmichael was really wily in her use of language, and at one point, during the crucial ability to consent question, said that children had specialist knowledge or something. I'd really like to be able to examine what was said with a bit more clarity.
Many thanks for any takers!!
I can have a try. Give Pombear and Pencils a break
Thanks Mangoes, it's not my skill set at all!
Is Victoria Derbyshire slightly better informed these days? I seem to recall that a year or so ago she was very woke and completely on the side of woke people.
Its not to do with being 'woke' as such.
Victoria Derbyshire has actively promoted Mermaids Charity for years & also failed to challenge trans rights activists.
I think the children's safeguarding element of this - and the judicial reviews - are giving a lot of people in the media a real scare, and quite rightly so, as these journalists and presenters realise just what they've been condoning.
I missed the VD Show segment, so would also really appreciate a link to a clip, or a transcript.
Thank you for explaining it better ROwantrees.
I just remember switching the TV off one morning as she was annoying me so much. I have deliberately avoided watching her show since then.
I just wondered if she had changed her approach at all.
I havent watched today's episode yet.
Im steeling myself.
I have though rewatched Victoria Derbyshire promoting that very young children might somehow be 'born in the wrong body' back as far as 2015.
VD: Victoria Derbyshire
Dr PC: Dr Polly Carmichael – Director, Tavistock Clinic
KB: Kiera Bell
AH: Alison Holt (BBC)
Starts at 27: 50 minutes in…
VD: Next a 23 year old woman is taking legal action against an NHS gender identity clinic saying that she should have been challenged more by medical staff about her decision to transition to a male as a teenager.
A judge gave the go-ahead last week for a full hearing of the case against the Tavistock and Portman NHS Foundation Trust, which is expected to go to the heart of the controversy surrounding the age at which young people become capable of giving informed consent to medical interventions to help change their gender.
In a moment we will speak to the boss of the clinic Dr Polly Carmichael
But first lets hear from the woman – she’s called Kiera Bell. She’s now 23 and she started taking puberty blockers aged 16, followed by cross sex hormones, testosterone in her case, and she had a double mastectomy
Kiera bell has been speaking to the BBC’s Alison Holt
KB: I would have liked to have … some sort of intensive therapy really. I think that I should have been challenged on the proposals or the you know the claims that I was making for myself and I think that would have made a big difference as well.
AH: There will be young people who say going to the clinic literally saves their lives because it is essential someone listens to them and believes their need to change.
What would you say to that?
KB: Well, I did say the same thing you know years ago when I went to the clinic. It felt like it was saving me from suicidal ideation and and just depression in general.
At the time I felt like it relieved all of those mental health conditions that I was you know, struggling alongside, you know, gender dysphoria. It’s something you need to kind of work through but it’s not something that should be rushed into.
I think it’s up to these, you know, institutions like the Tavistock to step in and make children reconsider what they are saying because it is , you know, a life altering path that you are going down and it’s not guaranteed to work.
AH: Do you feel any anger about what’s happened in the last 5-10 years for you?
KB: I do, yeah. I felt angry that, you know, no one was there to really say any different and I was allowed to run with this idea that I had, you know almost like a fantasy as a teenager I was allowed to run with that and it has affected me in the long run as an adult.
VD: Well, let’s talk now to Dr Polly Carmichael who is the Director of the Tavistock clinic, NHS clinic in London. Thank you very much for coming on the programme.
VD: How can you be absolutely sure when a child or teenager comes to your clinic that they do genuinely want to live as the opposite gender?
Dr PC: I think the first thing to say is this is a really complex area and the truth is you can’t ever be a 100 % sure about a lot of things and certainly in this area you can’t be a 100 percent sure.
Having said that, our assessment process is wide ranging. it’s over a long range of time.
We look at the development of gender, we look more widely at relationships and how young people are doing in school and so on. And, moreover, less than half of the young people who actually come to the service would ever be referred to the clinic. And for those that are, they continue to meet with psychosocial professionals, to explore their gender and importantly think about a whole range of pathways.
VD: Right. let’s talk more specifically about what happens if someone does come to your clinic then. How many therapy sessions would you have with a young person before puberty blockers would be part of the conversation?
Dr PC: ok, so we work according to NHS specifications. We are a commissioned service and in the specifications it says 3-6. I think in reality…
VD: That’s an hour long?
Dr PC: That’s an hour long, maybe longer sometimes, with two clinicians, I guess that’s around giving young people a space, but also giving their parents a space.
VD: And over what period of time would those 3-6 sessions be?
Dr PC: So… it would vary. it’s all individual, it’s case by case but over a period of six months or so. But I think it’s important to say that the reality is one outcome of the assessment period is not infrequently, ongoing exploration and thinking
VD: rather than at the end of that period prescribing puberty blockers
Dr PC: Yes
VD: 3-6 sessions, each about an hour long, 2 clinicians over a period of about six months - does that strike you as not enough therapy and over too short a period?
Dr PC: So, I think if it were that after that period everyone was being referred to clinic, then I think there would be rightly questions. But the truth is often it’s much longer than that. And indeed, I think we are well aware of some of the concerns that have been coming out more recently around large increases in numbers of referrals, there have been concerns about more assigned females being put forward for services. And I think within that, if anything, we are more cautious, more careful.
We also have a network model, so young people come from all over the country. And we convene professionals meetings locally and many of the young people we see have co-occurring difficulties and so it’s most appropriate really that any therapeutic input happens locally.
VD: Right. How can a child or teenager give their full informed consent to taking puberty blockers? That’s what critics suggest they can’t and Kiera Bell is one of them.
Dr PC: Yeah, so… Obviously people over the age of 16 are able to give consent. And the consent process we have is a robust one, it’s a process, it’s not an event. it’s not one occasion where you obtain consent. But I think it’s involved in numerous discussions around thinking about all the different pathways. If an individual is pressing for any physical intervention there would be extensive discsussions around their hopes for that, their expectations, ensuring they are realistic. There would be discussion around potential side effects, known side effects, unknown ones, unknown unkowns. And all of this before a young person even gets referred to the clinic. And then formal consent would be taken within the endocrine clinic. The first visit would only ever be a full discussion from a medical doctor around the treatment. And education and so on.
And so formal consent would never be taken until at least the second meeting.
VD: Right. Again, is that too soon. And again, how can a 13 year old really give formal consent for taking puberty blockers, taking cross sex hormones?
Dr PC: Well, a 13 year old isn’t giving consent for taking cross sex hormones. There’s a lot of misinformation and
VD: Lets stick with puberty blockers, lets just stick with that. Sorry, that was my mistake
Dr PC: No, that’s fine. But I guess… blockers… sorry – you were asking about informed consent. I think young people are able, My view is they are able to give informed consent. They are given full information round the intented action, the potential risks and so on. Over time, on more than one occasion. I think there is also evidence in general, that young people can develop, if you like, specialist areas of knowledge, beyond their developmental stage, if you like. when there’s been work around that particular area. I think that’s evidence that comes from pediatrics in general.
VD: Right. Do you mean why, because they are going online and joining forums so they have knowledge?
Dr PC: I think that’s very different. The knowledge that they obtain within the clinic is a robust knowledge based on the evidence. That’s not always the case online.
VD: Keira Bell was 16 – so she was able to give informed consent as a 16 year old, Regrets. she says that your clinic did not challenge her enough. Do you accept that?
Dr PC: I think we do challenge, without a doubt. My heart goes out to Kiera. I think Kiera is incredibly brave and speaks really well. I think it’s really important that individuals can come forward. there’s a place for them and there’s a place to discuss this. But this needs to be kept in a context. The detransition rate is, across studies, very low, 0.3 to about 3%. And also detransition means many things. So, for most, the reason that is given is around a lack of social acceptance, the loss of family and peer support. So, I think, whilst it is really important to think about that, we also need to hold in mind the many people who go forward and can lead a full life with support around their gender identity.
VD: My son, this is from a viewer, my son started with the Tavistock when she was at the time 13 years old. They’ve spent years cancelling before treatment and the only argument I have is that at nearly 24 years, he is still awaiting the final treatment. This caused depression and anger with things not moving quickly enough. I understand this but I wish my son to feel complete and happy with himself.
In terms of the puberty blockers, you will know that those who criticize the use of them in young people say this is experimental treatment that can have life long consequences, you are using a drug which is most commonly used to or licensed to treat advanced prostate cancer in men and to chemically castrate male sex offenders. And to halt very early puberty, it is not licensed to treat gender dysphoria in children, that is true , isn’t it?
Dr PC: So, I’m not a medical doctor but I think you will find that many drugs used in pediatrics are not licensed for use in children.
VD: Do you have any worries about the long term effect on individuals, psychologically , on their brain development, on their fertility? We don’t know what they can do to people.
Dr PC: Well, the blocker has been used for over 30 years so I think , there is actually quite an evidence base. Clearly it is really important, as numbers increase, awareness increases, that there is more research. But I think you have to weigh this up against the effects of not intervening. We are talking about young people whose sense of themselves does not match their physical body and the distress associated with that is often huge.
VD: Finally, let me ask you why you think there has been an explosion in referrals of young people to gender identity clinics. In 2009 -10 there were 77 referrals; 2018-19 – it’s gone up to two and a half thousand. That is a 3263% increase. it’s astonishing. Why?
Dr PC: Well, that’s a really difficult question. I guess there are multiple reasons for it. We need to hold in mind, as much as we are talking about transgender people much more, actually, this continues to be a marginalized, stigmatized group. And so, part of that, I think is likely to be greater awareness and that can be nothing but positive. But, of course, we are also aware that there may be changes in the demographics and that we need to be, if anything, more cautious. And I think, as a clinic, that is exactly the approach we take.
VD: thank you very much for coming on the program. We appreciate your time this morning, Dr Poly Carmichael, Director of The Tavistock. Thank you.
And here's the link from BBC iPlayer: www.bbc.co.uk/iplayer/episode/m000g19g/victoria-derbyshire-02032020
Dr PC*: No, that’s fine. But I guess… blockers… sorry – you were asking about informed consent. I think young people are able, My view is they are able to give informed consent. They are given full information round the intented action, the potential risks and so on. Over time, on more than one occasion. *I think there is also evidence in general, that young people can develop, if you like, specialist areas of knowledge, beyond their developmental stage, if you like. when there’s been work around that particular area. I think that’s evidence that comes from pediatrics in general.
VD: Right. Do you mean why, because they are going online and joining forums so they have knowledge?
*Dr PC*: I think that’s very different. The knowledge that they obtain within the clinic is a robust knowledge based on the evidence. That’s not always the case online.
Highlighted the section which raises the most alarm bells, in amongst the verbiage and fibbage.
PC has been asked if a 13 year old can give informed consent for puberty blockers, which means being fully apprised of the potential risks and consequences and therefore able to truly weigh the decision.
She not only says yes, she says that the child can actually have a specialist area of knowledge beyond their developmental age. Remember she is saying this in response to a query about a 13yo consenting to medication which will halt their physical and mental development, via natural puberty, risking all kinds of attendant health problems, like bone weakening, etc, very possibly no mature sexual function, and which leads, in a huge proportion of cases, to cross sex hormones which will cement lack of fertility.
She is saying that children are capable of consenting to all that. I am going to be careful about spelling out exactly what I am driving at here, because although i think she is a snake oil saleswoman, I don't think she has nefarious intent, but these are PIE arguments. The suggestion that children can give consent because they are 'wise beyond their years' is incredibly dangerous.
I wish Kiera Bell all the luck in the world, not least because this is uncovering a terrifying level of foolish naivete in these circles that must be challenged.
I note Dr PC is clear that 13 year olds are not giving consent to CSH - she immediately distances herself from that. And yet if you know that nearly 100% of children consenting to puberty blockers go onto CSH? I can only conclude that she is confirming that they do NOT get consent from children for the medical pathway she is setting them down. That, regardless of ability to consent, consent is not even being sought.
And as she says “I am not a medical doctor” - that will be news to many.
Not a medical doctor?
What sort of doctorate does she hold?
Most people would assume that someone with the title "Dr", in charge of a medical clinic, would have a medical degree and further medical qualifications.
Polly Carmichael is a Consultant Clinical Psychologist.
Dr Helen Webberley (online GenderGP business is now relocated to Spain after being prohibited from trading in UK)
April 2019 The UK is lagging behind the States, when it comes to supporting trans youth
The subject of the discussion was: Children’s Access to Medical Transition Pathways through a Model of Informed Consent
In a discussion around informed consent to medical treatment, it was unfortunate to have no medically qualified representation from the UK on the panel. Neither Carmichael nor Wren are able to prescribe medication to young people and, in their capacity, should not be advising on either treating or withholding treatment. Even though Carmichael and Wren use the prefix Dr, due to having a PhD doctorate, they are not medically qualified and this can cause confusion.
In her presentation, Carmichael acknowledged that the UK services sees young people of all ages, with the majority being adolescents. She talked about the fact that there has been a great increase in referrals over the last few years, culminating in a big spike in around 2015. Interestingly, she noted, the referral rate is now beginning to level off, with 11% of young people seen by GIDS identifing as non-binary. Olson-Kennedy then presented her figures from the USA and it was reassuring to see the similarities between the two countries. In America, Olson-Kennedy also saw an increase in referrals which spiked in 2015, before beginning to level off.
Carmichael relayed the current UK model that is in use, which involves families being assessed by two clinicians, with an assessment phase of 3-6 sessions over many months. She described a network model, working with local mental health services and then onward referral to a medical clinic for those deemed suitable for medical treatment by a doctor.
This is problematic for children and young people who are desperate to receive medical intervention. Once they have reached the top of the waiting list to be seen (nearly two years), they must then navigate the assessment system BEFORE being allowed to see a doctor." (continues)
Dr Helen Webberley (a GP) & her husband Dr Mike Webberley (Gastro- enterology) have both being sanctioned by GMC. Helen Webberley received a criminal conviction.
Cheers, Mangoes! I
ought to be working don't have much time today, but can do transcription next time if someone shouts.
This is fab Mangoes thanks so much for this.
I'm also up for some transcribing next time.
How are they explaining the levelling off of cases, I wonder? If, as they maintain, the acceptance of trans people is at the root of so many showing up at the clinics, then this would remain static, surely. Especially amongst youngsters, who will be realising they are 'trans' as they grow up. A steady stream, one would have thought.
And in terms of consent, if Polly Carmichael's clinic has not done any studies, or not released the results, on the long-term effects of puberty blockers, how the hell are they giving children sufficient information to then ask them to consent.
How can they give them enough information, when they don't have it or are withholding it?
So VD unintentionally said cross sex hormones when she meant to say puberty blockers.
PC had a get out of jail card handed to her on a silver platter with that mistake by Victoria Derbyshire.
As to the special knowledge that children get with their own ailments, that is true for everyone. But this cannot apply to prepubescent children talking about puberty which they've never had.
For gender dysphoria, it's a ridiculous statement.
And, and Polly Carmichael is not even a medical doctor.
Thankyou Floral for noticing that detail.
Thankyou Mangoes for highlighting this even further.
Not a medical doctor
Beyond their development stage
Quite a few "quote of the day" candidates.
The other thing that struck me was that the therapy sessions seem to be all prior to being referred to the clinic and also "in the community". So nothing at the Tavistock itself? Did I miss something?
Not a medical doctor
Beyond their development stage
This demonstrates that Dr Polly Carmichael (& it seems many other psychologists & medical doctors who have chosen to specialise in 'gender services) have ignored well-established knowledge of child development and age-specific understandings of sex difference.
May 2019 Dr Katie Alcock (Chartered Psychologist, Senior Lecturer in Psychology at Lancaster University) article:
'Young children, reality, sex and gender'
I’m a researcher in developmental psychology, and I’m interested in how young children learn symbols and how they think about the world. Most of my research is on children learning vocabulary but as a feminist (and mum of a boy and a girl) I’m also very interested in how children learn about sex and about stereotypes.
This is a rough summary of a talk I gave on April 27th in Lancaster as part of an event I and other members of For Women Lancashire organised entitled Gender Identity: Safeguarding Children and Young People. The talk itself was recorded and this isn’t a transcript, it’s more me writing up my notes and adding some thoughts." (continues)
What have psychologists found out about children’s developing knowledge of sex and gender?
Well, this research has been going on for a loooong time. All the studies I’m going to talk about are really robust — well replicated — this means that lots of researchers have found the same thing time and time again. We have known about some related aspects of children’s thinking since the 1920s or earlier and some of the main, older studies in this area are from the 1960s. This is not a flash in the pan.
What this also means is that terminology has changed. When this area of research first started, everyone knew, and was clear, that they were talking about children’s knowledge of biological sex. The terms “sex identity” and “sex constancy” were used, to mean children’s knowledge of whether they were a boy or a girl, and whether they or others could change into the opposite sex. Around the 1990s everyone started getting squeamish about the word “sex” and started using “gender” as a euphemism. Researchers, however, still meant a child’s knowledge of biological sex." (continues)
So researchers are clear that we are talking about children’s knowledge of sex, and that this can’t change. A nice quote from a 2003 paper:
“Categorical sex is an essential, immutable attribute of people that is maintained (by self and others) independent of changes in physical appearance (e.g., in hairstyle, clothes, or make-up) and of changes in behaviour (e.g., cross-sex play behaviour or homosexuality).” (from Trautner et al., 2003, in the International Journal of Behavioral Development)
Nevertheless, it takes children some time to work out both whether they themselves are a girl or a boy, and that both they and others cannot change sex. Working out which they are themselves happens earlier, and is based in all the studies that have been done on physical appearance and stereotypes. Have a look at what James, aged 3, has to say on the matter:
So, based on the idea that girls have long hair and boys have short hair, James is also age-perfect in thinking that when appearance changes, sex changes too. Until the age of about 7 (yes, 7 — in some children it’s older) children think that when something changes its appearance, its underlying reality changes too. This doesn’t just apply to sex, it applies to pretty much everything." (continues)
see also important articles by Dr Alcock:
December 2019 'But HOW CAN YOU TELL'
So, how do we tell whether someone is male or female? Well, we are very good at it and — like a lot of human cognitive skills — we base it on a number of cues (pieces of information). In fact, we’re very good at it from the time we are tiny babies.
One of the best ways to tell a male body from a female body is gait — how you walk. You don’t need a whole body in front of you, or even the outline of a body, to tell male from female bodies. A nice little point light display will do the trick. Adults and babies aged 4 months or older can tell male from female in this type of video " (continues)
'Sex stereotypes and the development of Gender Identity Disorder in children.'
2nd March 2020
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