Urgent: banning gender identity conversion

For a young person to access medical support they need a referral from a professional GP, Psychologist, etc. The wait time to see a specialist gender development at GIDS is currently 14 months. This process is not fast and the professionals involved only take action to prescribe treatment where necessary.

Are you aware of the push by GenderGP, some from the charity Mermaids and other prominant TRAs to enable GPs to issue a 'bridging prescription' (this would I understand require that the child/young person identified three key points) . Associated with this would be referral to alternative private clinics (such as GenderGP) rather than to GIDS due to waiting times (though of course it widely recognised that there is a difference in approach)

We are not talking about people with gender variant behaviour here, like preferring to play with boys or girls or types of toys or games. We are talking about people who are insistent about their gender identity with the understanding that it differs from the sex/gender assigned at birth.

Firstly nobody is assigned a gender at birth. Nobody is assigned a sex at birth either. Sex is assessed and observed. If there is any ambiguity, there is a mechanism for a time delay to the usual registration while medical investigation including genetic testing is carried out.

Secondly: the first part of your comment here is contradictory. We ARE talking about gender variant behaviour. Because there is no gender variant anything else.

‘The above would prevent the need for additional surgery.’

No, sorry. This is absolutely not an ethical position to take. ‘We treat everyone just in case to avoid the ‘need’ for surgery later.’ Absolutely not. Pre emptive surgery or seriously invasive treatment is restricted to life threatening conditions. And even then it’s not a given. Even women who have certain Brca variants for example don’t have this as a default option, and these are women who have an 80%+ risk of ovarian/breast malignancies (which tend to be very aggressive.)

The very idea of such a dramatic intervention as puberty blockers unless there is a serious and compelling reason like very early precious puberty is unethical in the extreme. they are not a harmless pause. They are not totally reversible. They have lifelong, negative consequences across many systems. In some cases they result in permanent sterility. This cannot be done ‘just in case to avoid surgery down he line.’

I am horrified, and shocked, that this is even considered as an option.

FloralBunting Can I just look at that last point you made, Hilary?

Would it not be possible to allow and indeed support a child's 'gender identity', however that may be expressed, but draw the line firmly at any form of hormone intervention or body modification, including slightly less invasive measures like binders?

Currently in the UK young people diagnosed with gender incongruence (Gender Dysphoria) are not offered any surgery, body modification until they reach 18 years of age and attend an Adult Gender Clinic.

(Gender incongruence of adolescence and adulthood is characterized by a marked and persistent incongruence between an individual´s experienced gender and the assigned sex, as manifested "by at least two of the following:

1. a strong dislike or discomfort with the one’s primary or secondary sex characteristics (in adolescents, anticipated secondary sex characteristics) due to their incongruity with the experienced gender;
2. a strong desire to be rid of some or all of one’s primary and/or secondary sex characteristics (in adolescents, anticipated secondary sex characteristics) due to their incongruity with the experienced gender;
3. a strong desire to have the primary and/or secondary sex characteristics of the experienced gender. The individual experiences a strong desire to be treated (to live and be accepted) as a person of the experienced gender. The experienced gender incongruence must have been continuously present for at least several months. The diagnosis cannot be assigned prior the onset of puberty. Gender variant behaviour and preferences alone are not a basis for assigning the diagnosis).

We are not talking about people with gender variant behaviour here, like preferring to play with boys or girls or types of toys or games. We are talking about people who are insistent about their gender identity with the understanding that it differs from the sex/gender assigned at birth.

For those with the above diagnosis taking no action is not preventing harm.

Harm can be caused by development of secondary sex characteristics, harm can also be caused by not accepting a persons sense of their gender identity. This harm manifests itself through anxiety, isolation, depression, self harm and suicidal thoughts. These are the physical symptoms of someone with gender incongruence if they are not given the support they need. This support can be in the form of social transition, use of prefered name and pronouns.

For a young person to access medical support they need a referral from a professional GP, Psychologist, etc. The wait time to see a specialist gender development at GIDS is currently 14 months. This process is not fast and the professionals involved only take action to prescribe treatment where necessary.

It is not the case that all individuals attending a gender clinic are automatically offered treatment to put puberty on hold, or hormone treatment. This course of action is only offered when a clinician and the individual involved feel it is appropriate.

Placing puberty on hold prevents the bodily changes that can cause harm to individuals with gender incongruence, it also gives the individual time to investigate their feelings and options before taking any decisions about their future.

The above action would prevent the need for additional surgery should the individual decide to live as the gender they say they are.

The comparison with homosexuality needs to be clarified - for a starter are they saying transgender is a sexual orientation? Then this needs to be made clear - that men are dressing in women’s clothes and entering women’s spaces as that is their sexual preference and the changes they want in law is to require women to enable this.

Alternatively (and purposely mixed up with the above) is it a body dysphoria? In which case it needs active intervention. We can argue whether this would be psychotherapy/counselling or drugs/surgery but both of these are interventions. A comparison with homosexuality would be to do nothing at all - which is fine for the middle aged men for whom it is a sexual orientation but not for kids with gender dysphoria.

As is so often the case, focusing on semantics obfuscates the key underlying issues.
Whether it is labelled a condition , a disorder or a natural occurrence, experiencing distress about aspects of ourselves to the extent that it impacts on well being and everyday functioning is a problem.
There are a range of interventions available aimed at alleviating the distress and it is easy to create a hierarchy. Those with the fewest contraindications being the highest ranking.
Therefore, it is preferable to help people feel at peace with their physical bodies without resorting to physical intervention. Much of the time this is achievable, sometimes it isn’t. I cannot fathom why any well intentioned person or medical professional would not seek to exhaust non invasive approaches before resorting to invasive ones.

I have heard parents of trans-identifying teenagers say that the only people NOT denying the existence of their child is the parents. The parents are the only ones who accept them unconditionally for who they are, who always will, who don't think they need to be cosmetically altered to be accepted by society.

Article in today's Guardian by Hadley Freeman:
(extract)
"As an adolescent, I was terrified of becoming a woman. In part this was because I believed the gender stereotypes. Being a woman, I thought, meant wearing makeup and high heels; men expecting things from me that I in no way wanted to give them. Being a woman seemed limiting and terrifying, and definitely not me. So as soon as I started to go through puberty, I starved myself until I looked safely asexual and boyish again. That was my solution, in 1992, to avoiding being a woman.

I thought about that period of my life this week when I read an interview in the Daily Mirror with a transgender teenager who was born female. At the age of six, he told his mother he wanted to climb trees with boys. “Don’t do that, it’s not what girls do,” his mother replied. According to the report, the six-year-old replied, “Well, I’ll have a sex-change then.”

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“I never fitted in with the girls at school. I didn’t like makeup, or dresses, and I never wanted to shave my legs or armpits, like everyone else. I really wanted to do all the things boys did, and wear masculine clothes. I think even that young, deep down, I knew I wanted to be a man,” he told the Mirror.

Whether somebody really decided to change sex because of climbing trees and makeup or, as is far more likely, this was oversimplified reporting on the Mirror’s part, nowhere in the article is there any suggestion that an aversion to feminine clothing doesn’t prove you’re a man. This interview was strikingly reminiscent of an interview on BBC Radio 4’s iPM programme, aired in 2016, in which a mother said she realised her three-year-old daughter wasn’t really a girl because she played with Wolverine toys instead of baby dolls. The interviewer did not challenge her. CBBC screened a documentary in the same year, I Am Leo, about a trans boy, in which transgenderism was explained with the help of pink brains for girls and blue brains for boys." (continues)

www.theguardian.com/commentisfree/2018/jul/05/dolls-dresses-no-proof-not-girl-pink-v-blue?

If you deny a trans persons existence

I hear this phrase a lot and it sounds very hyperbolic to me. Nobody is denying anyone’s existence. They’re right there in front of you. They exist. No one is denying anyone’s existence.

Imagine a young girl who isn’t conforming to gender stereotypes. Is it more harmful to:

1. Support her, tell her that she’s fine as she is, that she doesn’t NEED to conform to stereotypes. To allow her to explore this in a safe environment with NO affirmative treatment (she cannot ever be a boy - to tell her she can is biologically wrong) and to allow her to go through puberty in a safe, supportive environment.

Or 2. Tell her she’s a boy, and start treatment.

The second IS conversion therapy. She cannot ever, under any circumstances become Male. It’s lying to her to say she can. Perhaps she’s a lesbian - in which case that really is conversion therapy. Dr. Carmichael at the Tavistock actually says that a significant proportion of female patients are struggling with sexuality.

To me, it’s obscene to lie to a child, to pigeonhole a child into a narrow stereotypical box and to put a child on powerful, damaging drugs with irreversible side effects.

Supportive watch and wait is the ethical pathway. Supportive, but NOT affirmative.

Can I just look at that last point you made, Hilary?

Would it not be possible to allow and indeed support a child's 'gender identity', however that may be expressed, but draw the line firmly at any form of hormone intervention or body modification, including slightly less invasive measures like binders?

R0wantrees

To answer your question TransgenderTrend's toolkit was that it was regarded as 'conversion therapy'. When it was published there seemed to be some suggestion this was the case.

I do not know if it is linked to our used by organisations or people who support conversation therapy, but advocating a course of action that has failed to support young trans people in the past is in a way denying young trans peoples existence.

If you deny a trans persons existence would you consider it to be an attempt to force that person to conform to a gender stereotype against their will. Some would say this would align with conversation therapy in practice, and I would agree

hilary

Do you believe humans can change sex?

HilaryMGSDC
Thank you for responding & I appreciate your opinion.
I'm aware of some of the other toolkits.
I used to teach & also worked in Social Care so am used to accessing a range of materials & resources, often conflicting ones.

I hate to ask again, but its been bothering me if amongst the reasons for rejecting TransgenderTrend's toolkit was that it was regarded as 'conversion therapy'. When it was published there seemed to be some suggestion this was the case.

I thought you might know.

Two things are happening. The government is funding gender clinics and organizations that teach children and parents that if their children choose to play with gender coded toys they are that gender and need affirmative therapy.
The government is considering a law that outlaws subjecting Gays and Lesbians to conversion therapy while mandating affirmation therapy of gender non conforming children.
Anyone with a brain will tell you that most of the gender non conforming children they are targeting are not trans. They are children who have not yet learned the adults rules of what they are allowed to like.

R0wantrees,
I have read the Transgender Trend Toolkit, but I disagree with its conclusion.

I did not recognise it as a toolkit but rather document pushing material to persuade readers of the authors concerns and beliefs.

Beliefs which have been tried in the past, pre 2010 equality act.
Beliefs that failed trans children by not providing a supportive environment for leaning.
Advocating no affirmation, which goes against professional advice given by specialists in gender development.

There are several toolkits for schools which give good advice.

Identity is social. It develops socially and impacts on others. We all get a say in identity. It is a conversation, a narrative. If we aren't professionals it isn't therapy.

There is no anti-trans cause just a pro-science, pro-evidence, pro-reason cause.

Apologies, not read whole thread... don't get something... genuine question...

Banning therapies which aim to change someone's MIND is completely different from banning therapies which aim to change someone's BODY - so why is this thought to be something potentially good for the anti-trans cause?

Sexual orientation and gender identity are two entirely different things. You can’t just lump them together and say that everything applies to one therefore applies to the other.

There is zero scientific evidence that ‘gender identity’ is innate. There is zero scientific evidence to support a blue / pink brain theory that would prove that you could have a brain / body mismatch.

To tell children to believe in things which have no basis in reality is misguided at best. To pathologise healthy children and to label and stigmatise them with terms made up by adults is wrong and cruel.

Let children be children. Let them play with whatever toys they want, wear the clothes they want, socialise with who they want. Let them understand you can be an astronaut, a plumber, a ballerina or a childminder regardless of what sex they are.
Let them know that none of those things mean there is anything wrong with them . Don’t teach them to hate their perfect healthy bodies. Teach them body positivity. Teach them that there is no such thing as ‘born in the wrong body’ Teach them that they don’t need to take untested cancer drugs that will stunt their development (both physically and mentally) and that they don’t need to live a life where they will have to battle against their healthy normal body by taking dangerous medication for life and possibly amputate healthy body parts.

Teach them to love themselves and to accept themselves and reality.

Be yourself. Be natural. Be free. Don’t waste your previous time and health forcing yourself to fit into society’s s stifling stereotypes.

The MoU makes clear that it is not intended to stop psychological and medical professionals working with trans and gender questioning clients from performing a clinical assessment of suitability prior to medical intervention
Gender variant behaviour and preferences alone are not a basis for assigning the diagnosis. ( in children) WHO
Any professional treating children should be concerned with correctly diagnosing and prescribing treatment. Automatic affirmation would be as unacceptable as 'conversion therapy. The latter would be something of the level of child abuse not watchful waiting. A high proportion of children do not transition and to push affirmation could do great damage to these children. It is not the same as sexual orientation.

Hilary, thanks for the advice. It may reassure you to know that I do entirely support my child without judgement, though it is profoundly depressing to have to say that and it not be assumed tbh, given what I have already written.

HilaryMGSDC
Thank you for your links etc.

I am aware of gay conversion 'therapy' and some of the horrific experiences people faced. Yesterday on The World at One there was an incredibly moving account by a caller who described what had been done to him.

As I mentioned above though, I am still a little confused with regards the scope. I'm not sure if you are specifically aware of the Transgendertrend School's toolkit?

I know that there are a range of opinions as can be seen in this Guardian article:
www.theguardian.com/education/2018/may/15/transgender-row-teachers-afraid-challenge-breast-binding

I am still unsure though if it was regarded and condemned as being specifically associated with 'conversion therapy'.

People of all ages should be allowed to develop and understand their own gender identity and sexuality.

HilaryMGSDC Does developing and understanding one's gender identity require any medical treatment?

FloralBunting, If your child is in need of support, the best way forward would be to listen to your child's concerns and try to understand them. be supportive of your child and believe what they tell you without judgment.

If you feel your child would benefit from a psychological assessment or counselling then do seek professional help. This would not be to persuade the child they were X but to listen to them.

If the professional advice is to see a Gender Development Specialist then follow their advice - see gids.nhs.uk/parents