What do people want the outcome from this JR to be? Stop GIDS from working with young people I presume? So what should happen to those young people? Do you want them to be just left to struggle with no help? What do you propose should take the place of GIDS?
Great question.
Firstly, I absolutely support the existence of GIDS. It should be better funded, so it can do a better job. Right now, according to many former clinicians, it's not doing its job. Which should be to treat gender dysphoria on a case-by-case basis, solely in the interests of each individual patient presenting in front of them. It's being alleged that they are pretty much blindly affirming transition in far, far too many cases. Hence the Judicial Review.
As the mother of two autistic children, I'd like the impact on autistic kids of negotiating a school system that offers them fuck all in the way of decent support examined. I'd like proper, serious therapeutic intervention to support autistic girls - because that's who we are talking about now - through adolescence. The explosion in cases is, in my view, evidence not of gender dysphoria being more prevalent than we realised, but autistic adolescents being horrendously failed. It's rarer for kids not to be failed. 95% of parents taking their Local Authorities to Tribunal to force support win, and given the overwhelming majority of parents can't afford to do that, so their kids have no hope of getting what they need, it gives you some idea of how terrible provision is. Those autistic kids are in the system right now, trying to manage the unmanageable. Throw in adolescence, and you have the perfect storm of shit.
Autism means finding change hard, the process of transition hard, mess and dirt and smell hard, and pain hard (autistic people often suffer more from pain than those who are not autistic). They find social interaction harder and are more likely to be bullied. They are also more likely to be gay, and more likely to be gender non-conforming. Finally, they are more likely to be sexually harassed, assaulted and abused because they don't pick up on red flags as swiftly, and are likelier to be naive and vulnerable. They are also more likely to spend a lot of time online as it favours someone who struggles with non-verbal communication.
So, imagine being a girl who hates change, as she starts to grow breasts. Someone who hates the process of transition, as she enters one of the greatest transitions of our lives. Someone who hates dirt and mess and smell, as she is told she will start periods. Someone who feels pain more acutely, as breasts grow. Someone who is told being gay is disgusting, as she feels attraction to girls. Someone who sees girls engaging in intensive peer socialisation that she can't connect with or share, and which in turn makes her bullied and on the fringes, and longing to connect and belong. Imagine that girl doesn't really notice the grooming that starts to be enforced, instead remaining in comfortable clothes... which in turn makes her more likely to be dismissed by the rest. Imagine being the butt of jokes over that. Then imagine that girl is still subjected to sexual harassment from boys at school (but predicated on how disgustingly unattractive she is) and conversely from creepy men in the street (who just see a vulnerable young girl growing boobs). Imagine that girl spends a huge amount of time online, finding a tribe who accept her and find her likeable and fun, and admire her brains and the things about her that she herself feels pride in. Imagine that she starts to read that not fitting in, not feeling right in her woman's body, not feeling that she fits with the girls and their intensive interest in boys and makeup and peer pecking orders may have a simple answer - one which coincidentally means she's not gay, and attraction to girls is just another piece of the puzzle... because she's trans. Imagine how embraced she feels by this new online community, calling themselves her, 'glitter family' and telling her that her parents will either get it and support her or they are bigots and the problem.
Imagine, then, that this child reaches GIDS. What do you think would be optimal? Therapy that explores what it means to her, being autistic and a woman in a world that is not a friendly one? That supports her exploration and anxieties, and thinks about what her best future could look like? One that affirms her worth and value as a lesbian autistic girl, with everything to reach for - that It Gets Better?
Or would you think she should be affirmed at once, put on puberty blockers with very little therapeutic input, and launched on a lifetime as a professional patient?
Yes, the system is broken. I agree. But if the system for detecting cancer were broken, we wouldn't launch fully half of patients who find a lump, and want aggressive treatment, into a pathway that is extremely likely to end in surgery and chemotherapy. Yet that is, allegedly, what presently happens at GIDS. Assumption that the patients will not revert to the mean, given time... even though all evidence is that they will do just that if properly supported through adolescence.
As a final resort, the availability of gender transition care is really important. Gender dysphoria absolutely does exist in rare cases, and those kids need support and help, including medical help. But that's light years from offering disturbed, traumatised, and/or autistic kids a convenient hook to hang all that feels wrong to them about who their are, their lives, and the very process of adolescence itself, and failing to offer proper, careful, serious levels of therapeutic intervention.
Adolescence is about dysphoria. For everyone. Treat the kids who find that most unbearable, absolutely. But not, in most cases, with a range of powerful drugs, whose long term effects are as yet wholly unknown. Save that for those who, after intensive and careful therapy, will benefit. That triaging via proper investigation is the key here.
I think methylphenidate can be life changing in a good way for some children. But the point is that the medication used in GIDS is not necessarily so different in terms of how much or little is known about future impact when first used, than other medications that are or have been prescribed in camhs.
As someone who is ADHD, and has an ADHD & ASD daughter, I don't know whether to laugh or cry.
Methylphenidate is a drug that calms your brain (if you're ADHD - if you're not, it hypes you up, apparently). If you stop taking it, the effects stop. And that is all it does: calms your brain. The comparison is pretty ridiculous, bluntly. The effects of seeking to alter the impact of hormones on human development at a key life stage... there's no statistically very significant drop in IQ for a start. These drugs have huge, lifelong implications. For most, they will be a massive and lifelong solution to a temporary adolescent problem.
ADHD meds have done wonders for me and for my daughter. But would I take them, or allow her to do so, if the effects could be as huge and lifelong as hormone blockers and cross sex hormones? God no. We'd cope without.
You can't get a tattoo or use a sunbed salon in this country until you're 18. Because the risks aren't ones kids can fully calibrate. Abortion is preventing a huge lifetime responsibility when a child is not ready for it, and preventing, in fact, huge medical change and risk. So is contraception. Comparing any of that to transition - which is the diametric opposite, in being a huge and irreversible change - is either worrying, or founded in a lack of understanding in what actually is happening.
Please research. Please, everyone. Look into this. It's not okay. People need to know what the hell is happening. Keira Bell is trying to ensure that they do. Bless her for that.