Transgender child on R4 World at One

[Poppyred85]

Following on from a report about waiting lists to attend GID clinic, there was an interview of a 10 year old transgirl and her mother. I really don’t know what to make of it. Both the child and the mother sound to be genuinely struggling with this and I found it incredibly sad to listen to the story of her child self harming after identifying as a girl. Her mother commented that she wasn’t looking for her child to start on blockers or surgery but felt she needed psychological support and how lacking this was. Clearly the mother was doing her best but I couldn’t help but feel uneasy listening to why the child felt they were really a girl and the whole “born in the wrong body” narrative. From the sounds of things came across the term transgender because it was used as an insult by her classmates but had previously told her mother she has the heart of a girl. I thought the response from the specialist after the interview was quite measured.
It’s on now so not on Iplayer yet.

How will we find out when independent research into this is not commissioned due to the political and socia climate created by activists with an extreme ideology?

Through scrutiny and close examination of methodology. Critical analysis of all research is an essential thing. There isn't nearly enough of it. Many of these things are well known and written about: see Ben Goldarce, Margaret McCartney, White Hat Bias.

I've looked at ideological bias with regard to maternal C-sections in the past, and find it deeply frustrating about how difficult it is to navigate through and find things of value. Media reporting and even medical journal reviews are not immune from it and the effects of lobbying.

Its not an easy subject.

In most examples it ultimately often comes down to 'on balance' decisions for individual cases rather than black and white policy being applied universally.

When the political climate does not allow for this type of questioning that's when you get real issues, and this is why I am extremely concerned.

I think by taking physical intervention off the table it would force us to offer on-going psychological intervention (of which there is very little).

Rather like physical intervention is, in a rational society (which thankfully so far we live in) taken off the table for "transablist" and body dysmorphic individuals. Who are also going to need to learn to live with some ambiguity before (hopefully) they come to see that their healthy body parts are just that, healthy.

Elletorro -
There are no safeguarding procedures in respect of possible harm associated with gender dysphoria. There is the faux guidance of those that promote the affirmation model which suggests a parents lack of support for their childs transition should lead to a referral to children's services.

The children I have met who are said to be gender dysphoric have been referred due to a separate issue such as sexual offending or substance misuse.
There are other parents who have similar traits to parents who fabricate illness (which has a correlation with pd) or who exaggerate illness due to anxiety.

The danger is a "terrible thing" will happen and policy will come full circle. A pigs ear piece of law will be passed that will cause more harm than good.

MsBeaujangles - your point about uncertainty (although I didn't read the article!)
Living with uncertainty is difficult for parents and is a whole other topic.
For professionals - like child protection the gender "issue" seems similar to a hot potato. No one wants to be the last person holding the risk and so it is thrown along a line of professionals. Dysphoria ends up in the lap of the medical profession.
Pastoral staff in schools are trained by trans activists. This leaves them poorly equipped to sit with the uncertainty of a child/ young persons emotional or mental health need and to manage the anxiety of parents who want an easy answer to their childs distress.
It is easy to talk about managing risk and uncertainty but the effect on individual professionals cannot be underestimated, particularly in todays world.
I heard talk a couple of years ago of bringing in clinical supervision for school safeguarding leads, sadly that never happened.

And they are going bonkers on twitter saying this thread is about conversion therapy.

Yes of course, thats exactly whats been said. Fucking ridiculous. They are so overly defensive it is impossible to have a conversation about the subject.

Its about the need for time and space. Not preventing transition. Its about the need to ensure ethics are not thrown in the bin. Its about trust. Its about ensuring kids are not under any sort of pressure in either direction. But hey lets shout about conversion therapy because we are so emotionally wound up we can't deal with anything that does not agree with us to the letter. Talk about illustrating the point and the issue with lobbying taking over from calm considered concerns.

Step back. Step back from it. Or it will destroy you whether you realise it or not. You have to learn to deal with this and not automatically assume its an attack or doesn't have the best interests of everyone involved at heart.

Which as I say the inability to have these type of conversations is more dangerous than anything else because it removes the ability to find the best way to help anyone whether they be kids who trans, kids who don't trans or kids with co-morbid issues. And this inability to speak freely undermines trust and is potentially harmful to other family members.

Of course my comment about how family members deal with this might have struck a nerve.

I hope it does. It needs saying. Families need better support and they need a safe space to rant and rave without judgement. The current political climate prevents this. It just means feelings are internalised and bottled up. Eventually they come out one way or another.

As someone who this has affected as an adult with an adult sibling, I really do feel for families with kids in this situation. I don't know how they cope. It is hard enough as adults.

This enemy shit is bullshit. You know it. But you participate in it for your own reasons because you want health to be a monolith so all your own demons and tiny pieces of doubts don't appear. Its self defence. But there are no 'right answers', just the best fit for each and every kid based on who they are.

Its ok to say, this is hard shit to cope with.

And they are going bonkers on twitter saying this thread is about conversion therapy.

The thread which is being highlighted by some TRAs as 'calling for conversion therapy' is www.mumsnet.com/Talk/womens_rights/3228447-Transing-children

started in response to the DM article
"The health of hundreds of children is being put at risk by sex-change drugs doled out on the NHS, a leading doctor warns today.

Dr Lucy Griffin, a consultant psychiatrist at Bristol Royal Infirmary, says she is ‘extremely worried’ about the long-term effects the medication is having on adolescents.

She is the first NHS doctor to publicly voice fears about the damage being done by the huge increase in young people receiving irreversible medical treatments after declaring themselves transgender"

When the political climate does not allow for this type of questioning that's when you get real issues, and this is why I am extremely concerned.

Me too.

It is an understatement to say this is hard shit to deal with.

Everyone would want their child to be supported in making their own healthy decisions without pressure from anyone. So no blackmail about suicide; no banning of language; having access to therapy which takes on board their whole body and all their difficulties; treatment offered with honesty and kindness which is based on evidence.

The World at One segment raised the issue of parity for Mental Health referrals having identified the length of time children and young people currently wait for The Tavistock Clinic.

From NHS England www.england.nhs.uk/resources/rtt/
In England, under the NHS Constitution, patients ‘have the right to access certain services commissioned by NHS bodies within maximum waiting times, or for the NHS to take all reasonable steps to offer a range of suitable alternative providers if this is not possible’. The NHS Constitution sets out that patients should wait no longer than 18 weeks from GP referral to treatment

"the fixed view of somebody insisting there is no such thing as an inner sense of self in relation to ones sexed body despite this being the experience of some"

Is this your interpretation of what I'm saying @MrsBeaujangles?

If so, you've completely misunderstood me.

Let me clarify:
I absolutely accept that there exists an inner sense of self in relation to ones sexed body.

I'm amazed you assumed I thought otherwise.

What I contend, is that it is impossible to have an inner sense of self in relation to someone else's sexed body despite this being the claim of some.

"Sense of self" =/= "sense of others"

I think your post claims a false equivalence between two viewpoints as if they were equally fixed and unreasonable views:
"I am male but I know how girls feel" =false
"I am female and can only know how I feel" =true

I assume your wink was for me?

There's no doubt in my mind (Hi Helen! and your best mate whatshisface with blonde hair and a weird side profile pic... erm, Julian or something) that transing kids is a form of abuse. The wholesale lies about puberty blockers being reversible is one of the reasons I'm advising my kids to consider a career in law, imagine the vast amounts of cash to be made when these transed kids sue their parents for the irreversible harm done to their little bodies???

Early day motion from 10/10/2017
includes recommendation that 'specialist GPs be trained so that they can provide bridging prescriptions whilst patients wait for referral to specialist centres'

Link to discussion about recent Home affairs committee, including questions by Stephen Doughty MP
[[https://www.mumsnet.com/Talk/womens_rights/3233421-Home-Affairs-Committee-Hate-crime-enquiry-Newspaper-editors-interviewed
questioning of newspapers]]

Barrack - I think you are right and that we are misunderstanding each other.

What I contend, is that it is impossible to have an inner sense of self in relation to someone else's sexed body despite this being the claim of some I agree. I haven't come across this argument, so I think I am probably still misunderstanding you.

Are you saying that transwomen feel like they are women because they imagine they know what 'feeling like a women' feels like and subsequently decide that their feelings match this?

That isn't what I have come across. I have come across people feeling as though their sexed body and their internal sense of self conflict. They conclude that this is because there is a misalignment and realignment would happen if their body was differently sexed. In my experience, I don't think other people's internal worlds come in to it in the way I interpret your stance.

@R0wantrees

That sounds absurd. Prescribing before diagnosing!

MsBeaujangles

I'm sure that there must of course be diagnosing first though there may perhaps be differences in approach?

Having listened on a few occasions to Dr Polly Carmichael, I am struck by the more nuanced nature of her comments.

It is great that you are not experiencing undue pressure MsBeaujangles. Many others are though. I spoke to a gay psychiatrist recently who said they felt the affirmation only pressure raised all sorts of ethical problems for them in their work. And the biggest negative impact was on young lesbians.

I think the 'Memorandum of Understanding' is significant and would endorse the focus on speedier access to treatment.

From article November 2017

"The therapist said that official guidelines issued in October made it risky to help patients explore alternative explanations — such as autism and anxiety — rather than simply “affirm” that they must be transgender and assist their transition.

The therapist, who is based in Scotland, said: “You have a young girl who has turned up and said she is trans and at the end of working with you [she] decides maybe she is not.

“I could now get a reputation as someone who was not sticking to the professional body’s ethical framework and that is not a position you want to be in at all . . . potentially struck off.”

She blamed new guidelines issued within a Memorandum of Understanding on Conversion Therapy in the UK for governing the treatment of those uncertain about their gender identity. The memo expects therapists to assist patients wishing to change their gender identity rather than explore alternative treatments"

www.thetimes.co.uk/article/wrong-gender-feelings-could-be-teen-anxiety-bpr7jr3wd

How does a 10 year old even know about being 'born in the wrong body'? FFS ludicrous

Article from 2015 by Susie Green CEO Mermaids
www.independent.co.uk/voices/comment/ive-been-called-an-abusive-and-dangerous-parent-when-all-i-did-was-listen-to-my-transgender-child-10165241.html

"This week the press are outraged that three-year-olds are being referred to the NHS for gender identity treatment. But this isn't of the medical kind. These children are being referred so that the whole family can get support. Because they are suffering.

For children who don't identify with their birth gender, no medical intervention is even considered without there already being a history of gender variance. And it can only take place after puberty has started.

Puberty is in itself a diagnostic tool. If it doesn't not cause distress, then the likelihood is that the child is not transgender. If it does cause distress, then hormone blocking medication is given, which is completely reversible if needs be"

Really interesting and powerful perspective in this blog:
@morerote "a female, autistic UK medical student in her 30s."
morerotethanmeaning.wordpress.com/2017/11/19/first-blog-post/

An open letter to the medical profession
Includes her personal experiences with gender identity, trans activism, transition/detransition and medical ethics
& writes:

"Earlier this year NHS England, NHS Scotland, the Royal College of General Practitioners and a host of other healthcare organisations signed a Memorandum of Understanding on Conversion Therapy in the UK. Contained within is the following paragraph:

‘For the purposes of this document ’conversion therapy’ is an umbrella term for a therapeutic approach, or any model or individual viewpoint that demonstrates an assumption that any sexual orientation or gender identity is inherently preferable to any other, and which attempts to bring about a change of sexual orientation or gender identity, or seeks to supress an individual’s expression of sexual orientation or gender identity on that basis.’ (10)

There are numerous problems with this statement (don’t even get me started on the conflation of sexuality and gender identity so often and erroneously used to throw weight behind the latter), but what strikes me most is the wording. Such vague and easily misinterpreted language is oddly reminiscent of the infamous ‘Section 28’, where a lack of clarity lead to generations of British children being denied the chance to talk about their sexuality at school because teachers were terrified of being seen to ‘promote homosexuality’.

Doctors have a duty to ensure any interventions are in the patient’s best interests. Where there is doubt, or said interventions are irreversible and life-changing, it is absolutely essential that we feel safe to explore the patient’s thoughts, feelings and expectations. When confronted with a child manifesting gender dysphoria, a part of any initial consultation or assessment should include exploring the possibility of the feelings passing with time, especially since the research we currently have suggests most trans children will not persist with their gender identity (11). With this in mind I’m, curious to know how registered UK medical professionals (particularly GP, since your college has signed up it) feel about this document."