Tavistock psychologist is worried about rush to label kids as trans

[EmpressOfTheSpartacusOceans]

Dr Bernadette Wren told the Sunday Times she thinks it's all happening too fast. This is an accessible link.

www.thetimes.co.uk/article/schools-rushing-on-whisper-to-label-pupils-as-transgender-0d8zm53qs?shareToken=315f17227c1c052cb0287315f3d589a4

Where are the parents in this

Going by (I think) the Scottish schools guidance the parents must not be told (safeguarding issue much!?).

I'd the parents are aware but unsupportive they should be reported to SS.

The follow up as adults is interesting.
I assume the 87 treated in 2009 were very dysphoria. So their reasons/follow up patterns might be very different than the 2000 people last year.
Recent figures smack of social contagion, but there hasn't been a long enough period to do follow up as adults. I don't know what the answer is. I would be horrified if any of my children wanted blockers/cross sex hormones. I don't think I would be letting them have treatment, they'd have to wait until they were old enough to consent without me being involved.

I think that article has a lot of sense in it. I’m very pro equality having to fight every day against inequality of my own.

But the way this has developed isn’t helping these children, and clearly great harm can be done in the name of policy and fear of misplaced hate rhetoric.

I believe in inequality for all. Not that one group become powerful and erode other minorities rights, whilst doing harm to their own selves. That makes no sense. And doesn’t pass mybasic ethics test - does that do good?

I do believe resigning is the right thing.
How can an ethical person continue to be a part of of an unethical business and contribute to perpetuating harm by lending any credibility to it? It's like continuing to invite passengers on to a sinking boat but thinking it's OK because you're bailing it out with a thimble and suggesting some people might get wet feet.

It's not enough.

There's perhaps a small window of opportunity whereby you can plan your whistleblowing to have maximum impact. But not a large one.

And if even one child is harmed by you whilst you self-justify your continuation in the business, how do you live with that? Collateral damage?

It's arrogant, lacking in knowledge of children and teenagers and so professionally dangerous.

It's the professionally dangerous part that seems to cut both ways.

As BarackerBarmer says, why don't they speak out?

Answer, probably professional suicide.

As guardian says - why must they speak out? Answer professional suicide when this hits them back in the face and everyone asks why they didn't do something.

It's no joke contemplating the death of your livelihood.

But it is possible that will happen if they do speak out now, or if they don't in a few years.

What a knife edge.

When the existence of your job depends upon timing.

But it is possible that will happen if they do speak out now, or if they don't in a few years

The article referred to an upcoming conference. I suspect she might speak out then. This will be behind closed doors. Maybe other HCPs will start to nod. Maybe she will follow with an article in a professional journal. Maybe others will follow ... One can hope.

You didn't even see this level of questioning or dissent a mere eight months ago.

There is absolutely a pushback.

And whilst the transborg will ratchet the pressure, they have nothing left in their arsenal.

They've used every disputed argument going. Hormone washes, oppression, suicide statistics, abuse, equality, whiny unfairness.

There is nowhere else to go.

There is no depth to their argument, no logic, no collective agreement.

'Transwomen are women' is not going to be cutting the mustard for very much longer.

Schools have always been susceptible to dodgy psychology. If you look back at the popularity of things like ‘brain gym’ you can see the rubbish that can get into schools, partly because teachers are really busy so don’t have time to critically investigate these things. But the potential harm of the current trans stuff is terrifying.

You can see by the way that Mermaids cheerleader mimmymum is frothing at the article that it is right on the money. Anything that upsets Mermaids must be on the right track.

Yep anything that upsets them is definitely a good barometer. I miss mermans (wonders what Helga Iceland is up to these days in her Audi)

I miss Mermans too. I keep clicking my shortcut to see if it's come back.

It would make good fan fiction - the further adventures of Helga

Sorry - it is Dr Wobbly who has the audi - doesn't like to get it messed up.

I hope this post answers the questions I have been asked. I am posting on both threads about The Times article as I can’t recall which questions came from which.

There are around 40 staff working with the GIDS service (across the London and Leeds clinics). Not all of them are full time. Recently, the service has increased with over 30 new members of staff. Prior to this the team was relatively small. NHS England funded the increase in staffing because waiting times were well over the 18 weeks requirement. The increase in referrals has been huge and the waiting time, even after expansion of the team, is well over 6 months.

The children that get referred to GIDS have complex needs, they are not simply GNC. Many have autism and co-morbid mental health issues and many experience suicide ideation or have attempted suicide. The service does not try and intervene or change patients’ gender identity (as being GNC is not a mental health issue in itself) and focus is on the all aspects of the child and their lives, not just gender identity. The goal of intervention is to help the young people referred feel comfortable and content in themselves.

The team are gatekeepers to physical intervention and do come across a lot of pressure to ‘deliver’ these. However, there is a multi disciplinary approach and therapists work together to ensure considered decisions are made. Even when physical interventions are given there is a staged approach. Hypothalamic blockers are considered after onset of puberty and cross-sex hormones only after 16. Surgery is only available from adult services (post-18) only. Tavi staff have published a number of articles about the challenges associated with the gatekeeping role and the pressure they come under. I don't think anyone is failing to 'speak out' because the team are getting on with supporting young people and holding the multiple boundaries they need to hold.

The conference discussed in the article is open to a range of professionals (the cost to attend is only £40) and its purpose is to discuss how academics, health practitioners, youth workers and charities can work together to better support trans young people. I expect the range of advice currently circulating in schools will be discussed and critiqued.

I have no doubt that the vast majority of staff would resign if they felt ethically compromised by the way in which they were required to work. Work is not hard to come by as the qualifications and experience are transferable to all aspects of child and adolescent mental health and so I don’t think fear of being out of work would be a factor.

A reference for the 80% desistance rate can be found in an article written by Helen Hingley-Jones, Sarah Davidson and Claire Gregor (Understanding the Experience of Parents of Pre-pubescent Children with Gender Identity Issues, Child and Adolescent Social Work, Child and Adolescent Social Work, June 2015, Volume 32, Issue 3, pp 237–246).

How are the staff affected by the new Memorandum of Understanding on Conversion Therapy, Ms Beaujangles?

Yes I've seen the 80% desistance rate talked about fairly widely. As I understand it that figure relates to children with gender identity issues who are treated with watchful waiting.

This is why it is so very alarming that Bernadette Wren has disclosed that only 10% of children referred to Tavi change their minds and opt out of the treatment programme.

How can we account for this massive difference?

This is why it is so very alarming that Bernadette Wren has disclosed that only 10% of children referred to Tavi change their minds and opt out of the treatment programme.

She may have meant discontinue with the service. Therapy counts as treatment, too, not just medication.

Maybe. It would be good to have some clarification.

I am pleased to see that the conference may look at the information going into schools. There is a huge pressure to persuade adults to 'step away' from gender non conforming children - keep confidentiality, don't share with parents, accept medical experimentation and self harm and don't worry about any underlying mental health issues - all core principles of "Working Together' being subverted by a group of adults with their own agenda.
And nobody is formally challenging this. Where are the safeguarding leads? Where are the Headteachers? Why is nobody joining up the dots?

Pencils. I read that to be 10% who are referred decide not to opt for treatment whereby they either choose not to attend the initial consultation by the time the date arrives or following the initial consultation decide not to pursue treatment (treatment includes talking therapy and would always begin with this).

I think the memorandum fits with an approach the Tavi has always adopted. They don’t seek to challenge or change an individual’s gender identity. They do seek to enable patients to feel comfortable in their own skill and to tolerate feelings of uncertainty and discomfort.
I don’t think the memorandum implies physical interventions should be automatically provided or that previous ways of working need to be changed.

Oh this conference!

tavistockandportman.nhs.uk/about-us/news/stories/improving-support-trans-youth-conference/

I was thinking it would be a proper academic or medical conference. Sounds like it will just be more kool aide, but here's hoping Wren introduces some criticality.

The kool aide drinking in the support professions is astounding.

"They don’t seek to challenge or change an individual’s gender identity."

Perhaps they should. Not change from one identity to another, bit to challenge entirely the idea that there is such a medical thing as gender identity at all. If a patient holds a false belief, by all means listen, but don't in any way validate that belief, and do provide sound medical evidence that the belief is contrary to facts.

If a patient approaches a doctor convinced that they need homeopathic pills or else they will die, the doctor will hopefully explain that those pills are without benefit and no doctor can prescribe them in good conscience, because to lie to a patient about the efficacy of a useless sugar pill is unethical. And hopefully that doctor might investigate the real medical problem and discuss genuine treatment options. But 'do no harm' should be an unbreakable principle.

If an ethical doctor wouldn't provide sugar pills to treat an imaginary condition, why the hell would they provide hormones and surgery?

Barrak, I don’t think they medicalise gender or being GNC and children are only referred because they have complex mental health needs that are impacting on them leading fulfilling lives.
Gender dysphoria is different to gender non conformity and issues around tolerating a sense of mismatch between natal sex and GI will be encouraged.
The conference isn’t an academic one it is a practice based one. Non evidence based ideas will inevitably be challenged by academics and evidence based practitioners. As will propaganda.
I have no doubt that people will come with agendas. If the room has a number of psychotherapists in it, much questioning will take place. I predict they’ll be some flouncing!

I think one can operate in life without being cognisant of any gender identity. I wouldn’t appreciate someone challenging me on this. I identify with my natal sex and kick against any expectation that people have of my choices because of this.
Not everyone at the Tavi identifies with a specific gender and they are not encouraged to adopt a binary one.