Review of suicides and gender dysphoria at the Tavistock and Portman NHS Foundation Trust

Lucky you, in Germany it's standard reading in 11-12 th grade. (For some reason, we didn't ' we read Woyzeck instead)

Werthers unoriginals!

Honestly by the end of the opera, I was ready to go and kill the manipulative little shit myself.

It's a good analogy as Werther is a young man, wrecks others relationships,and spends a lot of time threatening to kill himself to get his own way. This is so popular that a lot of Werther merch is made, the book gets banned in some countries and some of the suicides do it dressed in their Werther outfits.

Obviously, I was thinking of Werther's Originals! 😀

Werther is the leading character in The Sorrows of Young Werther, a massive best seller in the 1770s and a foundational text of German literature.

Werther is a sensitive young man who wanders about generally being teenage, falling in love and finding this intensely painful. He eventually kills himself as he is so upset that the object of his affections is married to someone else. It is strongly hinted that she dies as well, despondent that Werther has died (despite him essentially making her miserable for most of the plot)

This caused a huge craze of soppy aristocratic men, idling about in blue velvet jackets talking about how they were tormented by love. While the fashion craze was OK, the copycat suicides were not and the movement was heavily criticised as self-indulgent.

While I haven't read the book, I have seen the opera and honestly a more annoying and self-centred character it is hard to imagine.

It is. I didn't understand the reference to “Young Werther”, though, could anyone clarify?

Thank you for the link. Powerful and heartfelt writing.

That's a very powerful article.

I have put this sharetoken into the Jolyon thread already but it fits here too. Libby Purves' comment in the Times today:
https://www.thetimes.com/article/2f8a4fd5-28e5-43f5-8959-d710a10accfe?shareToken=d99097b9913c6b75ee87db02f3235d96

Yes. He seems a lovely, empathetic man.

The one thing that shines through to me is Professor Appleby's humanity. What a wonderful human being.

https://x.com/ProfLAppleby/status/1815101420775027050

Thanks to those genuinely asking how I went about my examination of data on suicides by patients with gender dysphoria at the Tavistock.

I’ll put together a thread soon. In meantime, suggest reading the report which explains my remit & data source.

https://x.com/ProfLAppleby/status/1815096931384692810

As an illustration of better suicide data on young people with gender dysphoria, our 2023
@NCISH_UK
report.

High rates of PD diagnosis, autism & eating disorders. Childhood abuse & past self-harm.

Suicide has multiple factors, as does prevention.

The last paragraph here (taken from the report) seems to show that those waiting WERE taken into consideration and that any causal attributions should be avoided (for any one element of care along the pathway) as they would go beyond the data.

Yes. Cass also explained, clearly and precisely to the HoC, about the bits her report was accused of having not properly considered or having discarded. I'll wait now to see if the same card is played of 'this doesn't count because x was discarded' hinting that if it had been counted, it would prove whatever the arguer wished it did.

As usual, the facts are set aside so that noise and spin can be created and people who tend to outsource their thinking are persuaded that it has been discredited. I'll await Mr Streeting's response, as I'm sure he's learning a great deal from all this.

I am noticing the 'toxicity of the debate' seems to be very slowly gliding away from 'both sides' for very obvious reasons

Once that's done we just have to sort out hearing aids for Harriet Harman

Appleby's thread:

'My conclusions so far? Start with the fundamental issue. Young people with gender dysphoria face bullying, family conflict, isolation - risk factors for suicide. The risk is real. It is also complex. Single causes are unusual. Depression/anxiety are common. Also treatable.'

2/It’s right to point out that young people’s experience of health care may reduce risk. Applies not to one treatment but a whole system. Non-judgemental attitudes, skilled staff in primary care & CAMHS. Support while waiting or in a crisis.

3/Suicide prevention takes in the wider context beyond gender services. It’s about understanding young people’s distress & how the NHS & society as a whole should respond. About the national rise in suicide in young people over the last 15yrs - now 200 deaths/yr in <20s

4/How we discuss suicide matters. We need to extend media guidance to social media (below). No-one has justified the “dead child” rhetoric. Can we agree it should stop?

5/My review highlights the need for better, more comprehensive data. Bringing together gender services with national sources:
@NCMD_England
, reporting suicides in all <18s.
@NCISH_UK
, my own unit, recording suicides by all mental health patients with gender dysphoria

6/On this topic strong views, robustly stated, are inevitable. X is a polarising medium. Can social media ever be a forum that distinguishes belief, opinion & evidence? Not yet. And please, I’m not comfortable with my findings being the basis of personal attacks on others.

Interesting point being made on the X thread, around the claim that the number of deaths by suicide of those waiting for treatment were not considered in the report (which seems to me to be more alarmist scaremongering).

The last paragraph here (taken from the report) seems to show that those waiting WERE taken into consideration and that any causal attributions should be avoided (for any one element of care along the pathway) as they would go beyond the data.

I tend to agree but I think it also depends on locale and individual scenarios.
I'm sure at times they do get bullied for their presentation and as the hold of gender ideology lessens I expect certain types will be emboldened to bully them more, unfortunately.

Also agree. This is exactly how to do it. Listen, address it properly and seriously, and share the results as publicly as possible. Objective, professional, factual.

I am noticing the 'toxicity of the debate' seems to be very slowly gliding away from 'both sides' for very obvious reasons.

Agreed, credit where credit is due, I'm impressed.

This is excellent news. I have to say Wes Streeting has handled this well. By commissioning a review and report from the top expert in suicide, he has brought clarity.

Interesting and helpful.

I'm not sure I agree with him that gender identity is a cause of bullying: considering that failing to affirm is more or less a lynching offense in many schools, I'd suspect that a gender identity is more an escape from bullying rather than the cause of it.

And absolutely the next rational question is, why is this child vulnerable? Why is this child needing to escape their current low social status and what forms it, because gender identity is about creating an identity and about raising status.

And we're immediately into the list well known.

Autism, trauma, CSA, mental health struggles, socially vulnerable, depressed and anxious. (And 'anxiety' has become a catch all term for a massive problem in upper primary and secondary schools that's increasing.)

And it's all of it treatable. But largely isn't.

Yes, even if we could be sure:

(1) the increase is real
(2) there is a causal link to the change in policy

That wouldn't tell us that puberty blockers are an essential and safe and proven medicine would it?

It could just be, that tragically, the policy change had triggered despair in already troubled individuals. But how much weight can you give to that risk when making medical policy?

Prof Appleby has posted on twitter commenting on his report
x.com/proflappleby/status/1814939710965383178?s=46&t=aWQLrPtVicDNf6MQpq5WVg