NHS to open detrans clinic

Where does this journey end?!

Exactly. It’s the only NHS treatment I’ve heard of that is actually intended to damage the patient’s body. In all other cases, mastectomies, amputations etc are intended to prevent worse physical harm, eg from cancer.

Psychologically, for some people, that probably is how it seems. But not all. And each medical step causes more physical damage. So cheerily encouraging people to take more and more medical steps, to transition physically to one gender, then detransition back to another, transition on to a third... is dangerous. It's a "journey" to nowhere. People need help to figure out where they are and what is healthiest where they are.

I've seen detransitioning referred to as just another step in a person's transition journey

It's good that the needs of these people are being acknowledged and understood. And maybe some good research could come out of it.

But I worry that detransition could come to be seen as just another valid medical choice, so not really challenging the bad medicine that leads to the need for it.

Richie Herron in the Telegraph, also contributions by Stella O'Malley

https://archive.ph/wDw0D so easy to bypass paywalls, other walls though...not so much

https://www.telegraph.co.uk/news/2024/08/13/regret-transgender-surgery-nhs-detransition-service/

What he's been through, what he's still suffering seem absolutely horrific. We need a Cass for the adult gender making it up as they go along service.

Such terrible stories. High time the growing number of detransitioners voices were heard and their needs met.
The removal of adults with a vested interest in transitioning children from being able to influence child health & psychological care can't come soon enough. Cass clearly outlined the pressures from self interested trans lobbyists and groups and it's a relief to see that the new government is taking an evidence based, informed and safeguarding children centred approach.

Such good news about the clinic. Detransitioners are treated appallingly in the current healthcare (if we can call it that) regime. I agree, for most the transition itself should never have happened. Here's hoping the whole system changes to prioritise good mental and physical health.

puberty, whichever way, isn't fully reversible shit after all

I'd be a bit more sensitive if this utter bullshit wasn't being made up on the spot to argue for child sterilisation.

Puberty is only ever one way.

Puberty is not and never was reversible.

Stop fucking making shit up.

Have a look at what this detransitioner has to say about herself and her experiences. A young woman who was allowed to make irreversible decisions about procedures that would cause permanent, harmful changes to her body - while she was still too young to legally buy cigarettes. I wonder why cigarettes are are-restricted? Could it be anything to do with the fact that they can cause permanent, harmful changes to the smoker's body?

^For Hineman, the whole project of gender identity was “kind of like a punk thing,” she says. But rather than sex, drugs, and rock and roll, it was just drugs. And surgery. “It’s a medicalized version of normal teen rebellion. And I got completely sucked into that.”
…
Occasionally people assume she’s male, but she’s made a conscious decision to shrug it off because getting “emotionally bogged down about being misgendered” is what led to transition in the first place, she tells me. “I had the realization that I can’t continue to let this bother me in any direction.”
…

Anna also looks back with bafflement that her depression and other medical factors didn’t give providers pause. “I was lost. I was hurting. I was a fucked-up teen who needed help,” she told me.
…
she wants young people like herself, their parents, and the providers who are pushing ideology over good care to know that there are safe and humane ways to address the kind of distress she suffered. “The answers are not just transition or suicide. There are ways to work through these feelings without altering your body,” she says.^

https://www.thefp.com/p/how-did-planned-parenthood-become?r=615mx&triedRedirect=true

What do you consider to be effective healthcare for people expressing gender distress?

You talk about placating an unevidenced minority - what evidence do you consider necessary to confirm the existence of detransitioners? What evidence do you consider necessary to confirm the gender-distressed individual's claim to be the opposite sex? Do you consider that such individuals deserve treatment with well-evidence medical care? If so why aren't you up in arms at the substandard treatment these people receive compared to others receiving medical care, considering how poor the evidence is concerning gender-affirming treatment?

Yes YABU. People dont usually do this stuff for fun - they come to it because they are desperately unhappy. As humans we are really bad at knowing why we are unhappy and what is best to do about it. Every generation there is a new fashion to explain our unhappiness - at the moment it is gender. It is not the fault of these vulnerable people that they fell down that rabbit hole.

Can I ask what you mean by "puberty, whichever way". I'm not sure if it's slightly odd phrasing or whether you are saying there's more than one way to go through puberty.

No, there is no "transitioning a second time" for these young people. I am not going by the press but what they say for themselves.

It's so incredibly dependent upon the individual young person's needs that I would never want a uniform, axiomatic approach without very, very careful evaluation. 12 seems extremely young to embark upon the less-reversible parts of this journey (puberty, whichever way, isn't fully reversible after all), especially since it's still well within the window covered by normal delays. I'd be most comfortable advising blockers until 14 and then evaluation for CSH if persistent incongruence remains from there?

Thanks all for your responses.

I completely agree that those detransitioning have been let down by those who should have properly supported them, now we are understanding what 'proper support' really means.

And my heart aches for those whose hopes may be raised that the harms they have suffered may be reversed, when sadly it may just be about support, monitoring and important data collection.

One of the terrible pressures put onto Ritchie Herron is that he was threatened that if he didn't transition surgically he would lose the support of his gender therapist. He was older than a child but mentally extremely vulnerable.

@ButterflyHatched did you ever make your mind up about whether a 12 year should be allowed to take cross sex hormones if they met all the tests below?

1. Are they actively and directly asking to be?
2. Have they done so consistently and coherently for an extended period of time?
3. Are they able to describe the long-term, permanent implications of doing so?
4. Have they demonstrably reached Tanner stage 2 at an appropriate age?
5. Have they been on a course of GnRH agonists for at least a year's 'cooling off period' since the initial request

The way nonlinear gender-affirming care needs have been treated in the press is absolutely atrocious. There are small numbers of people who experience surgery regret or (these are two different things) wish to entirely 'detransition' (effectively transitioning a second time). They need to be taken seriously, listened to and given space to continue their own extremely personal journeys, rather than turned into a divisive political football. They should be able to get support from gender clinics that are actually able to do their job and are currently being failed just as badly as the rest of the population who are experiencing gender incongruence.

It's infuriating - and so bizarrely self-defeating - to see the damage that has been done to the clinics that should be sufficiently resourced that they can take complex, nonlinear journeys in their stride.

Yes; and you are therefore not typical of the current batch of mostly female, mostly teenage, mostly neurodiverse transitioners.

There are those being caught up in transition who will not, long-term, benefit from it. So they need help during detransition. Some of my favourite young people may well benefit from this clinic in future.

Not every young person is you.

I'm coming at this topic from the angle of someone who transitioned as a GIDS patient decades before it became a culture war headline-driver, and has thus been in a position to observe the trajectory of this entire saga from its early days.

It's great but I do have mixed feelings about the way this has been framed. A lot of the people who have been wrongly transitioned either can't or don't want to "detransition" because there is no physical way back, reconstructive surgery is incomplete and can be retraumasting, and sometimes also because they are just fed up with the whole gender identity business. But they may still need a lot of help for their health and for their psychological wellbeing.

Really it should be framed more broadly than just "detransition".

Butterfly is one of those who has transitioned, Nothingeverything, and he/she is coming at this topic from that angle.

That doesn't make current transition rates any more medically justifiable but it may explain the tone of the post.

I don't understand what you want? You think all children should be able to go straight down the medicalised route but you don't see that as them being wrongly 'pushed'? Don't you think they should be having therapy to see if they have MH issues, Autism, are being bullied, body dysmorphia, a fear of being gay or any other reason that might make them wrongly think they are trans? Or would you consider that 'conversion therapy'? You know that up to 94% of gender dysphoria cases resolve on their own or with puberty?

How do you suggest the genuinely trans kids are teased out from the large majority that aren't and will grow out of it? Do you think they should all be medicated regardless?

I think it's awful that detransitioners even exist OP, they obviously should never have been able to go down the path of transitioning in the first place. The impact on their life may be enormous if they've had surgery and or cross hormones. It's a huge mess IMO.