Netherlands Puberty Blocker Review Comes to Opposite Conclusion, Dismisses Cass Review

I explained in an earlier post how I've heard people talk about how their feelings of distress about their body were exactly the same when they were suffering from the distress of anorexia, as when they then went on to labelling those feelings as 'gender dysphoria'. The distress and discomfort had the same depth and intensity.

The only difference between the two was the language/symbolism and the 'solutions' surrounding those two episodes of distress. One was housed in the language of food control and restriction and the other housed in the language of 'gender' and the solution was to suppress bodily processes through use of drugs and the elimination of certain body parts through surgery.

Throughout history people have utilised the terms of whatever the faddish condition of the day was - in order to express their distress. In Victorian times young women would be prone to fainting, and there was a widespread condition in which young women ( mainly) would become bed-ridden and unable to use their legs. Anorexia was unknown in Japan until it was introduced by American/Western agencies; and 'gender dysphoria' in children was simply not a thing until reatively recently here. I know this because I was a teacher and it just wasn't a thing - even 15 years ago. After covid there was a rapidly growing trend for young people in schools to develop Tourette's Syndrome.

We can all give examples, though, of how we struggled with our developing selves as children and how we became aware of sex based stereotypes and expectations ( and how we felt about them). Struggle with self and social expectations is in the very nature of growing up and navigating the social world.

We also know that many boys ( for whom certain forms of expression are still particularly frowned upon) start cross dressing in childhood. This is often in secret, and it is usually accompanied by strong, awakening sexual feelings and responses. Many cross dressing men have discussed this and how this habit developed ,and some have even described what the emotional motivation for cross dressing was. Many of these boys, who go on to be men, don't have particularly 'feminine' interests or preferences but they do have a compulsion to wear the clothes of the opposite sex and to fantasise about being girls or women ( as you suggest).

There used to be an organisation for Cross dressing men ( and their wives) called 'The Beaumont Society' ( originally 'Full Personality Expression') - in which men could meet up with other men at weekends and indulge freely in their cross sex imaginings - while their wives sought solace in the company of each other.This society, formed in the 1960's, is now a full on trans organisation in which the men involved now refer to themselves as women. Many have now taken what was a secret or P/T practice or habit full time and have declared trans identities. Men like Debbie Hayton have written about this, and he tells of how he even went on to have the 'full' surgery. He's still married to his wife and has children. This grouping of men now forms the bulk of male transitioners ....and many have re-invented their past to suggest that they " always knew they were trans from childhood".

Trying to block male puberty is an attempt to help a boy pass more easily as a girl and then as a woman. Something that many of these men have longed for.

Pointing out inconsistences is productive.

This is what Cass wrote about 'Jo'. You said Jo was a stupid example. Why is it stupid?

“There was considerable discomfort in the House and more widely on social media about my account of ‘Jo’, a biologically male child who was socially transitioned to a girl at 2½ and presented at around 10-11 afraid to go to secondary school for fear of being ‘outed’, later retreating to their bedroom and developing weak bones due to inactivity. ‘Jo’ is not a specific case, but represents a group of similar children being seen in the new services, and previously at the Tavistock. Although social transition is usually later (from 4 onwards), I was told during the Review about children who had been transitioned at Jo’s age and younger. “I have been asked why safeguarding procedures would not have been initiated when ‘Jo’ was a toddler, but these children are frequently living in stealth (i.e. those around them do not know their biological sex) and do not come to medical attention until much later as puberty looms. A male child who has socially transitioned at 4 and presents at 11 will have next to no recollection of being a boy. They are not making a decision to be a girl – by that time they just believe themselves to be a girl and have no frame of reference to think differently. Even with input from the very skilled therapists in the new services, encouraging them to think more flexibly about their identity is rarely successful, regardless of what their natural trajectory would have been if they had not been socially transitioned at that very early stage.”

Thank you for your productive engagement ,

Maybe I just don't understand how you have presented it. This is nonsensical- although of course I don't believe Cass wrote it. "He is not even that elusive creature the 'truly trans' child with the magical internal feeling."

What is it that you want me to comment on?

I agree that assessment processes should have robust safeguarding procedures to ensure parents aren't pushing this on a child because they have FDA or some such.

Those stereotypes may influence how dysphoria is expressed, but they are not generally understood to be its underlying cause

Next post:
We don't have the scientific understanding to explain why some people have gender dysphoria

You are all over the shop @Sunnibee

I didn't say it was 'stupid'. Why do you think Cass's example is stupid?

Those stereotypes may influence how dysphoria is expressed, but they are not generally understood to be its underlying cause

Unevidenced assertion.

That's fair, I haven't said why, because we don't know. We don't have the scientific understanding to explain why some people have gender dysphoria any more than we yet have ti explain why some people are autistic.
I suspect that eventually (as with so many things!) we will find evidence that there is a (complex / multiple) genetic aspect to it- although of course there may be a range of different causes, and anyway this is just my personal prediction , we don't have the evidence yet.

I agree with you that Cass's example is stupid, along with most of her report

Gender' only exists in social contexts because it is predicated on how people perceive and attribute certain characteristics based on one's sex.
Yes
The problem is not one's sex - but one's feelings about it based on what one thinks is expected because of it.

I don't think that's quite right.
These feelings aren’t caused by what someone thinks is expected of their sex. Gender dysphoria isn’t about believing “boys should like football” or “girls should wear pink.”
It's a deep-seated, embodied sense that one’s body or sex category is wrong. The distress isn’t produced by stereotypes; it’s about the body/ sex itself.

A child may hate the colour pink, prefer football to netball, and have no interest whatsoever in conventionally feminine things. Yet every day they may still beg to wear a pink dress and play netball—not because they enjoy those things, but because doing so allows them to be recognised by others as the girl they feel themselves to be. The pink dress isn’t the cause of the dysphoria; it’s an attempt to alleviate it.

So yes we could eliminate the idea that certain colours or sports are for boys and girls (and we definitely should because gender stereotypes suck). But there’s no reason to think that eliminating those stereotypes would eliminate gender dysphoria, because those stereotypes weren’t what caused it in the first place.

There is, however, a more philosophically interesting argument. If sex categories themselves had absolutely no social meaning or consequence, perhaps gender dysphoria would disappear because there would be no meaningful category in which to feel misplaced. I can see the logic in that.

Even then, though, people would still have different bodies, and many people with gender dysphoria experience profound distress about those physical characteristics themselves. And in any case, the premise is entirely hypothetical. Sex categories exist because human beings are sexually dimorphic. Those biological differences have significant social consequences—for example, only some people become pregnant. It isn’t realistic to imagine a society that simply doesn’t notice or attach any significance to those differences.

So no, I don’t think it’s accurate to say that gender dysphoria can be “cured” by abolishing gender stereotypes. Those stereotypes may influence how dysphoria is expressed, but they are not generally understood to be its underlying cause

But if a child is in distress specifically due to their embodied feelings about sex, but otherwise meets gillick-Fraser competence and seems to have the right support in place etc, they would be eligible.

This mythical child has been transed by his parent(s) at 2 1/2. Cass said so. He is in distress because his identity has been foreclosed by all the abusive adults around him. He fears puberty because he has been told to fear puberty. He is not even that elusive creature the 'truly trans' child with the magical internal feeling. Yet the solution proffered is for the adults to continue the conversion therapy and to shut down the future choices for that child until only one remains. That is a safeguarding fail and for that reason this child fails the inclusion criteria.

Oh we’re getting more of the same, I see.

You did waffle on for a couple of posts about social meaning given to sex roles and when I asked you for specific examples you didn’t respond, which of course is fine, there’s no obligation. However, to see you now telling other posters that you’ve had that conversation, given those examples when you really haven’t is annoying.

Perhaps the conversation you’re thinking of was on another thread, in which case you can easily link the posts where you did it.

So it's not that a person thinks "I love pink so I must be a girl"- they may prefer the colour green- but they may wear pink so that they have a better chance of being seen by others as a girl, because that reflects how they see themselves.

The explanation which has been missing from your posts is why the boy in your example sees himself as a girl. I would say this is due to a delusion, or if the child is very young, due to him not having reached the developmental stage where he understands the fixed nature of sex and how it applies to him. How would you explain this?

The wearing of pink even though he prefers green just emphasises the fact that he isn't a girl, since a girl would never have to do anything to be seen by others as a girl.

As already explained numerous tines Dysphoria is a disturbance of the mind. That is literally what it means.

'Gender' only exists in social contexts because it is predicated on how people perceive and attribute certain characteristics based on one's sex. The problem is not one's sex - but one's feelings about it based on what one thinks is expected because of it.

The truth is that in our society there is now no compulsion to have to perform gender.The best way to resolve psychological difficulties rooted in feelings around 'gender' is to resolve them through modifying and adapting one's responses. We all struggle with issues around social perceptions and as a result we can all feel misunderstood or mis-read. Such is life.

A more secure and relaxed sense of self comes about by no longer being so dependent on other people's perceptions of us.( which we cannot control). Though if you want to attempt to modify their response you could opt to wear different types or styles of clothing and experiment with different hair styles, for example - or you could become more conscious of the way you hold your body and/or the way you move through space. ( though it is easy to imagine how one's life could spiral into being compulsively focused on trying to control people's perceptions of us, which would not be healthy)

This understanding is what we need to be enabling in children and young people; not encouraging them to effectively self harm because of psychological distress; and not by encouraging them to believe that they can somehow change sex just by mimicking gendered performances associated with one sex or other.

If a child wants to experiment with 'performing gender' they can do that without physical harm to their growing and maturing body, though encouraging them to expect that others will go along with, or validate, their cross sex imaginings is irresponsible - because we cannot compel others to see us as we see ourselves; and we cannot demand, or control the terms of engagement in social situations. And finally, we cannot actually change our sex or its biological blueprint; and in certain types of situation sex actually does matter and it has certain consequences.

I think there is a central contradiction here, and it's one that people who support a more permissive informed consent to access to hormonal treatments also point to. On the one hand to receive a clinical diagnosis of gender dysphoria and be eligible for treatment a child must demonstrate clinically significant distress, on the other hand evidence of this distress can be treated as an exclusion criteria as evidence the child doesn't possess capacity to consent.
I imagine in the context of the trial this will be navigated pragmatically. So yes if a child is in a psychotic state at the time of assessment, they obviously won't be able to consent to participate. But if a child is in distress specifically due to their embodied feelings about sex, but otherwise meets gillick-Fraser competence and seems to have the right support in place etc, they would be eligible.

Yes that quote is from me. It was by no means all I said- the conversation went on for pages, the examples I gave are just simple examples of where we give meaning to biological categories in society- that is the "social" part. It's the act of meaning making, not the content of the meaning itself . So it could be anything. So it's not that a person thinks "I love pink so I must be a girl"- they may prefer the colour green- but they may wear pink so that they have a better chance of being seen by others as a girl, because that reflects how they see themselves.

Im sorry you don't see evidence of my attempts to understand the other side. Thats all that interests me in engaging with these conversations.

I've just had a look back at that discussion, and all you said is that gender' dysphoria isn't about stereotypes, it's about a feeling of being in the wrong social role. When pressed you mentioned that this meant distress about being referred to with correct sex pronouns and not being able to use opposite sex toilets.

This is a quote from one of your posts:
So anything that society does to recognise and give meaning to their placement in the “assigned/ observed/ correct” (whatever word you prefer) sexed category causes them acute distress. whether that’s referring to them by their birth sex pronoun, or making them wear a particular uniform, or use the toilet according to their birth sex, or anything else.

Perhaps it's time you made an attempt to understand the other side, because I haven't seen any evidence of that in this discussion so far.

All I said was that we’d already had a lengthy discussion about these points. Whether you found my explanations convincing is a different question entirely.

If you think what I said was “obfuscatory”, then quote the bit you think was unclear or evasive and I’ll happily try to explain it differently or more clearly . But simply repeating the same basic questions we’ve already spent hours discussing like you've never heard an answer to them , isn’t engaging with the conversation.

At some point it starts to look less like an attempt to understand the other side and more like a determination not to. That’s exactly why discussions on these forums so often go round in circles

Well quite. It’s a cheek to pretend that anything at all was explained when it very clearly wasn’t. It was just the usual obfuscatory tripe.

There is nothing to gender but stereotypes.

Yes. This was almost certainly why "trans children" were invented.

That and the Dutch Frankensteins who had the bright idea of experimenting on children.

Not really long. You said it was just names / pronouns/ and access to the facilities for the opposite sex

Didn't make sense then. Doesn't make sense now.

Indeed. Except, of course, for that other cohort of trans-identified males - the adult fetishists who come 'out', often after marriage and children, and then retcon their childhood narrative. They have a vested interest in the invention of the 'trans child' as a way of drawing a veil over the fact that their transition was for sexual reasons in adulthood.

Again- this is just circling back to a long conversation earlier in the thread