Trans toddlers......

Thank you.

I remember reading a medical publication on Rapid Onset GD and it made the point that historically Gender Dysphoria or Gender incongruence was identified in pre-school age children. The key point was historically the numbers involved were always very very small but there have always been people with GD.

The tiny number of people with GD have not disappeared they have been swallowed up and forgotten by the much wider trans umbrella. The employees with GD I encountered 20 years ago were so different from the TRAs we see today.

Thanks to Baroness Cass these children should be treated with watchful waiting and the right support. Baroness Cass was clear there are many reasons children identify as trans and GD or gender incongruence is one reason. The difficulty is separating out those with GD/GI.

@LonginesPrime
I think another factor in GP decision-making is the volume of "trans" patients. These children are few and far between, so an individual GP practice will rarely come across them, and when the odd one comes in asking for a referral, it's easy enough to just do it. If an individual GP were inundated with referral requests, I expect they'd think twice and take a closer look at the situation.

Anecdotally, I have heard of GPs refusing to make referrals, and declining to prescribe cross-sex hormones. I've also heard of a couple of practices that are happy to prescribe, and one that flies the Pride Progress flag outside. It seems like the service provision is really inconsistent across GPs, and I don't blame them, because it's not as though there's a good evidence base they can refer to.

Also, there are unscrupulous (in my opinion... looking at you, GenderGP) private clinics, doctors overseas issuing prescriptions to UK patients, and there is a black market. With that in mind, I think it might be for the best that these kids are in the NHS system where hopefully someone sensible can keep an eye on them.

Plus the fact that many GPs will naturally regard gender woo as being outside of their field of expertise (because its not grounded in science and is completely subjective and unfalsifiable), so I can imagine many wouldn’t have the confidence to say “I’m not referring you as I’m convinced you definitely don’t have a problem” when the whole concept is so incomprehensible to the majority of people already.

And as you say, the fact there is a specialism you can refer to that relates to the patient’s concern and has somehow gained professional respect over the years means it would be an odd decision to pretend that department doesn’t exist or isn’t doing reputable work.

I can absolutely see why a GP would decide to make the referral, but I do find it odd that the Cass review recommended empowering GPs and CAMHS to take the lead on gender in the first instance (with appropriate training and resources, of course), so widening the age-range for the specialist gender services does seem contrary to that, as it will inevitably encourage GPs to refer those children, as you point out.

Hasn’t the NHS got enough on its plate without this additional (and of dubious requirement) workload?

I don't see how you'd know what sex the child was? All kids of three clothed look the same?

Meanwhile schools won't even consider an assessment for various learning issues until a minimum age of 6 in so many cases, because its too early to tell.

Whoops, sorry meant to answer ^

Ha. If only. I am a GP and believe me, very few care about this subject at all. With 10 mins, a demanding parent and an available secondary care service, how many GPs will be knowledgeable and committed enough to spend the time they don't have in trying to persuade the Internet-educated parent that gender dysphoria in a child is not a thing and they just need to provide a non-judgemental environment and hang in there?

It's already an issue with ADHD. If I think after discussion, that a child does NOT have ADHD and needs to get off their phone, interact with the world and mature a bit (and maybe have a little extra individualised help) it takes so long to explain this sympathetically, and parental demand is such that I risk being seen as obstructive and unnecessarily gatekeeping. It is so much easier to refer. And on we go, pathologising the normal. (I do try, btw. I always run late, but it takes its toll).

Having said that, the new gender service is actually 'tertiary' (so GPs refer to paeds/CAMHS and then child is referred onwards if needed). I guess there is an extra level of time/filtering but I have no faith in the ability of clinicians to divert trans-parents in these services either. If the service is there, the assumption will be that it is needed.

If it’s the same people who run CAMHS services then I’d cynically say the services will be set up to suit the staff/commissioners and will pay no attention to anyone else. I’ve seen too much total nonsense and poor service from incompetent people who make things worse for families. I’m yet to find anyone who was referred to CAMHS and feel like they were helped. The commissioning is all wrong. If they can’t offer basic services well the. I just can’t believe these same people can deal with the gender stuff. As usual there will be headlines and then they’ll write policies saying whatever they like behind the scenes

Cass and backlash

Isn't a GP the first step here? Why are they referring these children? Why are they pathologists normal child behaviour?

I know a couple of intelligent five-year-olds who are absolutely convinced that "boys can't wear jewellery". Children that age don't even have a developed grasp of gendered social roles beyond the crudest stereotypes.

At this point there is absolutely no evidence that the NHS will offer anything other than total affirmation. This goes to trust Board level so I can't see how individual services can do anything different if that comes from the top

To someone with a hammer, though, everything looks like a nail.

I can’t imagine a gender clinic, whose very existence is predicated on firm adherence to gender identity ideology, is going to say “actually, your child doesn’t need our support”.

If children that young are eligible for the service, that suggests that someone in the NHS believes that at least some of the children in that age group will be “genuinely trans” and will require help at that age.

I don’t know why the NHS believes they’ll somehow be able to reliably identify which children are genuinely trans and which are just normal kids experimenting with their place in the world, but the underlying assumption from the fact the public will be funding this is that they are planning to give it a go anyway.

This is child abuse. If this way of thinking was around when I was small I would certainly have been thought to be a “boy in the body of a girl” at certain points in my development. I’m trying to imagine if I’d been put on puberty blockers and what kind of mess my life would be now 🙁

My DGD refused to wear a dress, even when a bridesmaid. She only wore boy’s clothes, hated girly toys and then hit 13. She sent out a birthday list asking for makeup, perfume and jewellery. She couldn’t be more feminine now. It would have been so easy to have labelled her when she was at primary school. Thank goodness nobody did.

But surely it’s worth screening for neurodivergence and checking for a history of abuse since these things are so highly represented among children presenting as trans?
Also worthwhile to be able to talk to the parents about what is actually developmentally normal and offer advice
The value depends entirely on how the clinics are approaching the families

Depends what advice is offered

If parents take child to clinic and the clinician tells them it's entirely age appropriate for a boy to play with dolls, No he's not trans, get over yourselves, then that's valuable, if the parents take the advice on board

That’s exactly how I read it Seethlaw, thankyou!

I disagree with this - I think it’s really dangerous to tell a normal child having normal feelings that there’s something wrong with them and to suggest they need professional help to navigate the normal ups and downs of growing up.

I can see how pathologising normal childhood benefits clinicians (especially in private healthcare) and transactivists, but it’s of huge detriment to the child who relies entirely on the adults around them to keep them safe and educate them about the world.

Seeing a specialist makes the child think they’re different and abnormal, and that makes it far more likely they’ll view their own feelings through a certain lens. It’s similar to what the Cass review said about social transitioning - sending a child to a gender specialist is not a neutral act.

I have a friend whose little boy always referred to himself as "she" from as young as anyone can remember. The child was into some 'girly' things but not overly so.
The wonderful parents respected the child but avoided using 'she / her' and did not force or correct pronouns etc.
By around 6/7 this child had decided he was in fact a boy. A boy that liked playing with girls more than boys, liked a lipgloss and was very much a mummies boy.
He is now a preteen and is firmly a boy and has come out as gay.
I honestly think his parents were amazing though out. They said we hope he is not trans, but if he is ok... and didn't push it. They let the child be a child.
Imagine if they had gone down the drugs etc route. This poor young man would be mutilated and poisoned.

These parents that are trying to trans their young children are abusers at worst and narcissists at best.

I am hoping that these clinics will follow a holistic approach to those children referred into them, weeding out the parents who are trying to make lifelong decisions for their young child because they "like pink and playing with dolls" and it's currently cool to have a trans kid (read: narcissism), from those who are neurodiverse, from those who genuinely are suffering from gender dysphoria (very few I suspect).

I think the NHS should be involved. I know someone who transitioned their 4yo (now 12) and the NHS basically told them that the child had no concept of gender, to mix and match the stereotypes a bit (female super hero, male ballet dancer) and they'd be fine and get over it. Obviously parents stomped off to Mermaids shouting about discrimination.

For some parents, the NHS telling them not to get carried away would be enough. It's not fair that the NHS gets a hard time for seeing these kids but is bound by patient confidentiality and can't say they told them it was nonsense. They are up against people thinking their baby is trans because it grabbed a pink muslin once, it can't be ignored.

Agreed.

But the point was that the clips were in the 'trans colours', which is more likely an adult statement, not that there was a boy wearing hair clips. Kids should be able to play with what they want and wear what they want, the point is that this does not make them the opposite sex. My son wore dresses, it was fun, but the issue would have been if I started telling people this made him a 'trans child'.