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Original poster

Letter to the BMJ re gender services

40 replies

pattihews · 03/09/2022 10:46

Courtesy of Glinner:
Dear Editor,
The Clinical Advisory Network on Sex and Gender (CAN-SG) (1), a group of UK and Ireland based clinicians calling for greater understanding of the effects of sex and gender in healthcare, welcomes Dr Hilary Cass’s interim report and recommendations (2). Serious concerns about the Tavistock Gender Identity Development Service (GIDS) were raised by parents, staff and governors, an initial Judicial Review judgement (3), the Care Quality Commission (4) and an Employment Tribunal involving the Trust’s Lead for Child Protection (5).

The origin of poor governance and lack of data collection needs to be openly addressed as GIDS is not unique. Globally, there are significant difficulties in discussing, let alone challenging, the practice of gender clinics, due to the belief systems of those who adhere to gender identity theory – a non-clinical ideological perspective for which there is little to no empirical support. This position requires clinicians to believe that everyone has an innate, subjective gender identity and that individuals whose bodies do not match this should be provided with ‘gender-affirming’ medical interventions regardless of the harms and lack of evidence of benefit (6,7,8). However, a child or adolescent’s sense of gender is part of a complex inner sense of self that can change during the process of development. Medicalising young people on the basis of unsubstantiated theory is unethical: there are many reasons why they might feel dysphoria, disgust, dissociated or ‘cut off’ from their physical bodies, including internalised homophobia, histories of trauma, cognitive difficulties and mental health problems. Each person suffering from such distress requires space and time to understand their feelings.

Offering puberty blockers, cross-sex hormones and radical surgery with the implicit promise of almost magical transformation may cause, and has caused, serious harms. With inadequate follow up by GIDS, no comprehensive long-term observational studies, and no reliable clinical trial data, there is simply no evidence on which to base these interventions (2,6,7,8). It is unsurprising that ‘detransitioners’ (disillusioned people who wish to reverse the effects of ‘treatments’) are coming forward; some may want legal redress and plaintiffs’ firms are seeking them out (9). Without outcome information - let alone understanding how any pre-pubertal child could make a decision to alienate adult functions they cannot understand (like sexual pleasure) - patients and their parents were never in a position to give properly informed consent to uncontrolled experimental interventions (6) clinicians failed to properly describe. These initial cases may herald more as increasing numbers of patients, parents and clinicians question the so-called ‘affirmative model’.

We would advise that the NHS proactively set up clinical services to support detransitioners, and that the NHS Litigation Authority and Medical Defence Organisations prepare. The government should look closely at materials provided by advocacy groups (such as Stonewall, Mermaids, Gendered Intelligence, and others) that teach children and clinicians (e.g. GPs, nurses, medical students and mental health professionals) gender identity theory as if it is fact, without referencing the concerns and uncertainties in the evidence. Until this is addressed young people will be at increased risk of misinterpreting their complex difficulties as proof they are ‘trans’ and believing there are simple and medical solutions to their distress.

Dr Louise Irvine, General Practitioner; Dr Juliet Singer, Child and Adolescent Psychiatrist; Dr Aileen O'Brien, Consultant Psychiatrist; Dr Seth Bhunnoo, Consultant Psychiatrist; Dr Tessa Katz, General Practitioner; Dr Jane Martin, retired Consultant Psychiatrist; Stella O’Malley, Psychotherapist; Dr David Bell, retired Consultant Psychiatrist, former President British Psychoanalytic Society; Dr Bob Withers, Jungian Analyst; Dr Antony Latham, General Practitioner, Chair of Scottish Council on Human Bioethics; Dr Angela Dixon, General Practitioner; Dr Sinead Helyar, Registered Nurse; Dr Robin Ion, Registered Nurse; Dr Az Hakeem, Consultant Psychiatrist.

On behalf of CAN-SG

This is the link that provides the original and all the footnotes/ references etc
www.bmj.com/content/378/bmj.o2016/rr?utm_source=substack&utm_medium=email

OP posts:
Malie · 04/09/2022 14:08

pattihews · 04/09/2022 12:35

Maybe, but I'm starting to realise that very, very clever people who think in the kind of ways very clever people think (which I've started to think is often different to the ways ordinary fairly clever people like you and me think) can persuade themselves to believe in anything.

Do you remember Cathryn McGahey (I hope I've got the correct name and spelling there) who argued at Allison Bailey's tribunal that Allison (a black working class lesbian) was behaving like a white South African apartheid supporter for refusing to consider transwomen as lesbians and therefore as potential sexual partners? It was a repugnant comparison: you have to wonder what kind of person McGahey is to even think of it, let alone insist on saying it in a tribunal. What she demonstrated, in my opinion, was a horrifying lack of judgment. She's an example of an exceptionally clever person who — I would say — has lost touch with reality.

My former friend the Consultant Paediatrician is a bit like that. She'd argue with me in a highly scientific way about the chemical make-up of the human body and hormones and when I countered with large gametes and small gametes and the human race (and all mammals) being binary she'd just say 'it's more complicated than that' with the strong implication that someone like me could never hope to understand.

Helen Lewis in one of her interviews for her series The Spark on Radio 4 talked briefly about how sometimes people are so clever and their brains so flexible they can persuade themselves of anything. That series has some fascinating insights and is well worth listening to. You can Listen Again on BBC Sounds.

Show quote history

George Orwell used to say that you had to be a member of the intelligentsia to believe this sort of stuff because ordinary people aren’t that stupid.

Original poster
pattihews · 04/09/2022 12:35

xxyzz · 04/09/2022 11:44

Well, that's horrifying, @pattihews

Maybe, but I'm starting to realise that very, very clever people who think in the kind of ways very clever people think (which I've started to think is often different to the ways ordinary fairly clever people like you and me think) can persuade themselves to believe in anything.

Do you remember Cathryn McGahey (I hope I've got the correct name and spelling there) who argued at Allison Bailey's tribunal that Allison (a black working class lesbian) was behaving like a white South African apartheid supporter for refusing to consider transwomen as lesbians and therefore as potential sexual partners? It was a repugnant comparison: you have to wonder what kind of person McGahey is to even think of it, let alone insist on saying it in a tribunal. What she demonstrated, in my opinion, was a horrifying lack of judgment. She's an example of an exceptionally clever person who — I would say — has lost touch with reality.

My former friend the Consultant Paediatrician is a bit like that. She'd argue with me in a highly scientific way about the chemical make-up of the human body and hormones and when I countered with large gametes and small gametes and the human race (and all mammals) being binary she'd just say 'it's more complicated than that' with the strong implication that someone like me could never hope to understand.

Helen Lewis in one of her interviews for her series The Spark on Radio 4 talked briefly about how sometimes people are so clever and their brains so flexible they can persuade themselves of anything. That series has some fascinating insights and is well worth listening to. You can Listen Again on BBC Sounds.

OP posts:
EmbarrassingHadrosaurus · 04/09/2022 12:02

Years ago, that letter would have made no sense at all.

It speaks to the mess of the changed landscape in evidence-based treatment that the letter was necessary at all.

Cuck00soup · 04/09/2022 11:57

I can only hope some of the BMJ readers will not only hear the warnings in this letter but will start arguing against ridiculous policies at their own trusts.

We need senior clinicians to push back against social science ideology with facts.

xxyzz · 04/09/2022 11:44

Well, that's horrifying, @pattihews

Original poster
pattihews · 04/09/2022 10:23

xxyzz · 03/09/2022 22:06

Great letter. Seeing it in black and white makes it incomprehensible that highly educated medical professionals, who sign up to 'do no harm' could ever have thought that it was ethical or acceptable to give untested drugs to children or perform drastic and irreversible surgery on children, in the absence of any evidence base that this works.

Truly depressing.

And yet until very recently a Consultant Paediatrician of my acquaintance — head of her department in her hospital — was arguing that sex is a spectrum and doesn't really exist because hormones fluctuate throughout life and hormones are what makes a person male or female. She would argue that gender identity is who one truly is. She also happens to be very masculine-looking, which she cultivates. She never actually uses the phrase 'born in the wrong body' but that was essentially what she was arguing. For all I know she still is because we reached a stage where we could no longer communicate. Her DP is a GP and shares the same views.

Watching what's happened in the NHS and knowing several aggressively pro-trans medics (my social circle used to include three other female GPs who no longer speak to me because of my 'transphobic' views) I can never again enter a hospital or clinic or surgery with a basic expectation that I can trust the people looking after me to be rational or sharing the same understanding of basic biology.

OP posts:
Apl · 04/09/2022 10:06

Malie · 04/09/2022 09:21

We will see you in 10-20 years time how much this lunacy costs the NHS / taxpayer in court cases. There are already some in the pipeline.

This is why Thailand stopped doing sex changes on teenage boys. The boys grew up and sued.

That information was readily available on a quick google before the NHS started subscribing to all this nonsense. Some people in the NHS should be liable personally for negligence, in my opinion. If the doctors prescribing chemical castration drugs to kids aren’t personally liable, they’re not motivated to stop doing it.

Weird thing is, the country is broke. So why isn’t this nonsense top of the pile to be defunded? There needs to be a massive cut in what taxpayers money is wasted on.

Apl · 04/09/2022 10:02

👏

Sad thing is, none of this needed saying. You and I have always been able to see the problems with letting teens (and preteens 😱) make irrevocable changes to their bodies on the basis of the internet musings of a fanatic lobbyist movement - so why can’t the BMJ see it? Why does it take a wave of detransitioners suing the NHS to stop taxpayers money being used for sex changes? It’s all so disappointing.

”Do no harm.” Ha. If only.

Malie · 04/09/2022 09:21

We will see you in 10-20 years time how much this lunacy costs the NHS / taxpayer in court cases. There are already some in the pipeline.

Wheresthebeach · 04/09/2022 08:54

2Rebecca · 04/09/2022 08:52

I hope this means more clinicians stand up against gender woo ideology. Many medical students are getting Stonewall influenced "education" as well.

Stonewall are truly dangerous to kids

2Rebecca · 04/09/2022 08:52

I hope this means more clinicians stand up against gender woo ideology. Many medical students are getting Stonewall influenced "education" as well.

stealtheatingtunnocks · 03/09/2022 23:02

Sandy Ford In Glasgow is the same as Tavistock in that they so they same “treatment” but aren’t suspended.

i think there is on in the midlands roo.

Thousands of kids. Thousands

xxyzz · 03/09/2022 22:06

Great letter. Seeing it in black and white makes it incomprehensible that highly educated medical professionals, who sign up to 'do no harm' could ever have thought that it was ethical or acceptable to give untested drugs to children or perform drastic and irreversible surgery on children, in the absence of any evidence base that this works.

Truly depressing.

Igmum · 03/09/2022 21:33

Good - particularly about the help and support detransitioners need. Here's hoping

MrsOvertonsWindow · 03/09/2022 11:01

An excellent letter. These doctors in hock to the queer theory extremists are only going to be deterred by the threats of financial and reputational consequences for their actions.