Urgent: banning gender identity conversion

[Pratchet]

www.buzzfeed.com/patrickstrudwick/gay-cures-could-be-banned-under-a-new-law-in-the-uk?origin=shp&utm_term=.nw24d18NQk#.keZANE7n3Y
Homosexuality 'conversion cures' must be banned,

They are sneaking in 'gender identity' to the law so that ONLY AFFIRMATION will be sllowed. 'Watch and wait' could be banned as conversion therapy. Kids need our help.

This legislation must be restricted to homosexuality, to allow childrenntime to become happy in their changing bodies. Help.

HilaryMGSDC
Thank you for responding & I appreciate your opinion.
I'm aware of some of the other toolkits.
I used to teach & also worked in Social Care so am used to accessing a range of materials & resources, often conflicting ones.

I hate to ask again, but its been bothering me if amongst the reasons for rejecting TransgenderTrend's toolkit was that it was regarded as 'conversion therapy'. When it was published there seemed to be some suggestion this was the case.

I thought you might know.

hilary

Do you believe humans can change sex?

R0wantrees

To answer your question TransgenderTrend's toolkit was that it was regarded as 'conversion therapy'. When it was published there seemed to be some suggestion this was the case.

I do not know if it is linked to our used by organisations or people who support conversation therapy, but advocating a course of action that has failed to support young trans people in the past is in a way denying young trans peoples existence.

If you deny a trans persons existence would you consider it to be an attempt to force that person to conform to a gender stereotype against their will. Some would say this would align with conversation therapy in practice, and I would agree

Can I just look at that last point you made, Hilary?

Would it not be possible to allow and indeed support a child's 'gender identity', however that may be expressed, but draw the line firmly at any form of hormone intervention or body modification, including slightly less invasive measures like binders?

I think it's important to tell trans-identifying children right from the off that it's impossible to change sex. That is a fact. Do you think they should be lied to in order to affirm their identity?

If you deny a trans persons existence

I hear this phrase a lot and it sounds very hyperbolic to me. Nobody is denying anyone’s existence. They’re right there in front of you. They exist. No one is denying anyone’s existence.

Imagine a young girl who isn’t conforming to gender stereotypes. Is it more harmful to:

1. Support her, tell her that she’s fine as she is, that she doesn’t NEED to conform to stereotypes. To allow her to explore this in a safe environment with NO affirmative treatment (she cannot ever be a boy - to tell her she can is biologically wrong) and to allow her to go through puberty in a safe, supportive environment.

Or 2. Tell her she’s a boy, and start treatment.

The second IS conversion therapy. She cannot ever, under any circumstances become Male. It’s lying to her to say she can. Perhaps she’s a lesbian - in which case that really is conversion therapy. Dr. Carmichael at the Tavistock actually says that a significant proportion of female patients are struggling with sexuality.

To me, it’s obscene to lie to a child, to pigeonhole a child into a narrow stereotypical box and to put a child on powerful, damaging drugs with irreversible side effects.

Supportive watch and wait is the ethical pathway. Supportive, but NOT affirmative.

Article in today's Guardian by Hadley Freeman:
(extract)
"As an adolescent, I was terrified of becoming a woman. In part this was because I believed the gender stereotypes. Being a woman, I thought, meant wearing makeup and high heels; men expecting things from me that I in no way wanted to give them. Being a woman seemed limiting and terrifying, and definitely not me. So as soon as I started to go through puberty, I starved myself until I looked safely asexual and boyish again. That was my solution, in 1992, to avoiding being a woman.

I thought about that period of my life this week when I read an interview in the Daily Mirror with a transgender teenager who was born female. At the age of six, he told his mother he wanted to climb trees with boys. “Don’t do that, it’s not what girls do,” his mother replied. According to the report, the six-year-old replied, “Well, I’ll have a sex-change then.”

Trans people to be able to register new identities more easily
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“I never fitted in with the girls at school. I didn’t like makeup, or dresses, and I never wanted to shave my legs or armpits, like everyone else. I really wanted to do all the things boys did, and wear masculine clothes. I think even that young, deep down, I knew I wanted to be a man,” he told the Mirror.

Whether somebody really decided to change sex because of climbing trees and makeup or, as is far more likely, this was oversimplified reporting on the Mirror’s part, nowhere in the article is there any suggestion that an aversion to feminine clothing doesn’t prove you’re a man. This interview was strikingly reminiscent of an interview on BBC Radio 4’s iPM programme, aired in 2016, in which a mother said she realised her three-year-old daughter wasn’t really a girl because she played with Wolverine toys instead of baby dolls. The interviewer did not challenge her. CBBC screened a documentary in the same year, I Am Leo, about a trans boy, in which transgenderism was explained with the help of pink brains for girls and blue brains for boys." (continues)

www.theguardian.com/commentisfree/2018/jul/05/dolls-dresses-no-proof-not-girl-pink-v-blue?

I have heard parents of trans-identifying teenagers say that the only people NOT denying the existence of their child is the parents. The parents are the only ones who accept them unconditionally for who they are, who always will, who don't think they need to be cosmetically altered to be accepted by society.

As is so often the case, focusing on semantics obfuscates the key underlying issues.
Whether it is labelled a condition , a disorder or a natural occurrence, experiencing distress about aspects of ourselves to the extent that it impacts on well being and everyday functioning is a problem.
There are a range of interventions available aimed at alleviating the distress and it is easy to create a hierarchy. Those with the fewest contraindications being the highest ranking.
Therefore, it is preferable to help people feel at peace with their physical bodies without resorting to physical intervention. Much of the time this is achievable, sometimes it isn’t. I cannot fathom why any well intentioned person or medical professional would not seek to exhaust non invasive approaches before resorting to invasive ones.

The comparison with homosexuality needs to be clarified - for a starter are they saying transgender is a sexual orientation? Then this needs to be made clear - that men are dressing in women’s clothes and entering women’s spaces as that is their sexual preference and the changes they want in law is to require women to enable this.

Alternatively (and purposely mixed up with the above) is it a body dysphoria? In which case it needs active intervention. We can argue whether this would be psychotherapy/counselling or drugs/surgery but both of these are interventions. A comparison with homosexuality would be to do nothing at all - which is fine for the middle aged men for whom it is a sexual orientation but not for kids with gender dysphoria.

FloralBunting Can I just look at that last point you made, Hilary?

Would it not be possible to allow and indeed support a child's 'gender identity', however that may be expressed, but draw the line firmly at any form of hormone intervention or body modification, including slightly less invasive measures like binders?

Currently in the UK young people diagnosed with gender incongruence (Gender Dysphoria) are not offered any surgery, body modification until they reach 18 years of age and attend an Adult Gender Clinic.

(Gender incongruence of adolescence and adulthood is characterized by a marked and persistent incongruence between an individual´s experienced gender and the assigned sex, as manifested "by at least two of the following:

1. a strong dislike or discomfort with the one’s primary or secondary sex characteristics (in adolescents, anticipated secondary sex characteristics) due to their incongruity with the experienced gender;
2. a strong desire to be rid of some or all of one’s primary and/or secondary sex characteristics (in adolescents, anticipated secondary sex characteristics) due to their incongruity with the experienced gender;
3. a strong desire to have the primary and/or secondary sex characteristics of the experienced gender. The individual experiences a strong desire to be treated (to live and be accepted) as a person of the experienced gender. The experienced gender incongruence must have been continuously present for at least several months. The diagnosis cannot be assigned prior the onset of puberty. Gender variant behaviour and preferences alone are not a basis for assigning the diagnosis).

We are not talking about people with gender variant behaviour here, like preferring to play with boys or girls or types of toys or games. We are talking about people who are insistent about their gender identity with the understanding that it differs from the sex/gender assigned at birth.

For those with the above diagnosis taking no action is not preventing harm.

Harm can be caused by development of secondary sex characteristics, harm can also be caused by not accepting a persons sense of their gender identity. This harm manifests itself through anxiety, isolation, depression, self harm and suicidal thoughts. These are the physical symptoms of someone with gender incongruence if they are not given the support they need. This support can be in the form of social transition, use of prefered name and pronouns.

For a young person to access medical support they need a referral from a professional GP, Psychologist, etc. The wait time to see a specialist gender development at GIDS is currently 14 months. This process is not fast and the professionals involved only take action to prescribe treatment where necessary.

It is not the case that all individuals attending a gender clinic are automatically offered treatment to put puberty on hold, or hormone treatment. This course of action is only offered when a clinician and the individual involved feel it is appropriate.

Placing puberty on hold prevents the bodily changes that can cause harm to individuals with gender incongruence, it also gives the individual time to investigate their feelings and options before taking any decisions about their future.

The above action would prevent the need for additional surgery should the individual decide to live as the gender they say they are.

We are not talking about people with gender variant behaviour here, like preferring to play with boys or girls or types of toys or games. We are talking about people who are insistent about their gender identity with the understanding that it differs from the sex/gender assigned at birth.

Firstly nobody is assigned a gender at birth. Nobody is assigned a sex at birth either. Sex is assessed and observed. If there is any ambiguity, there is a mechanism for a time delay to the usual registration while medical investigation including genetic testing is carried out.

Secondly: the first part of your comment here is contradictory. We ARE talking about gender variant behaviour. Because there is no gender variant anything else.

‘The above would prevent the need for additional surgery.’

No, sorry. This is absolutely not an ethical position to take. ‘We treat everyone just in case to avoid the ‘need’ for surgery later.’ Absolutely not. Pre emptive surgery or seriously invasive treatment is restricted to life threatening conditions. And even then it’s not a given. Even women who have certain Brca variants for example don’t have this as a default option, and these are women who have an 80%+ risk of ovarian/breast malignancies (which tend to be very aggressive.)

The very idea of such a dramatic intervention as puberty blockers unless there is a serious and compelling reason like very early precious puberty is unethical in the extreme. they are not a harmless pause. They are not totally reversible. They have lifelong, negative consequences across many systems. In some cases they result in permanent sterility. This cannot be done ‘just in case to avoid surgery down he line.’

I am horrified, and shocked, that this is even considered as an option.

For a young person to access medical support they need a referral from a professional GP, Psychologist, etc. The wait time to see a specialist gender development at GIDS is currently 14 months. This process is not fast and the professionals involved only take action to prescribe treatment where necessary.

Are you aware of the push by GenderGP, some from the charity Mermaids and other prominant TRAs to enable GPs to issue a 'bridging prescription' (this would I understand require that the child/young person identified three key points) . Associated with this would be referral to alternative private clinics (such as GenderGP) rather than to GIDS due to waiting times (though of course it widely recognised that there is a difference in approach)

R0wantrees

The recognised care pathway for treatment advises that GPs and other specialists with knowledge of the treatment protocols for gender reassignment should be aloud to prescribe bridging treatment to those who self medicate to prevent harm, whilst they wait for treatment from a gender clinic. Its about preventing harm

I do understand the harm reduction treatment model.

HilaryMGSDC

Where do you stand on considering other MH conditions that may present with gender dysphoria/ gender incongruence?

Its about preventing harm

I’m not convinced that the risk: benefit calaculation is correct. The harm done by puberty blockers is significant.

The suicide stats for example - these have (in my opinion) been inflated precisely for this reason. The only way you can justify the harm done by blockers and surgery is if the alternative is death.

I have grave reservations about affirmative treatment, puberty blockers, cross sex hormones and surgical treatment for young people. I do not personally believe this is in the young persons best interests. I also don’t believe that parents (who I have no doubt are trying to do the best for their kids and are navigating unknown waters) are being given the correct information to make informed choices.

It's not best practice to intervene and harm the healthy body of a child. Kids should be shown and helped to be happy in the body they have. Anything else is abuse.

The medical ethics around some of what's suggested around transing children are a steaming pile of dingo's doings. Some of the clinicians must be completely off their meds. Trolleys too.

fractalplimsoll

Where do you stand on considering other MH conditions that may present with gender dysphoria/ gender incongruence?

I have no personal stand or view on other MH conditions as diagnosis of MH conditions is the preserve of MH specialists who work in diagnosing MH conditions.

My posts in this thread are stating the professional expert advice for the treatment of gender incongruence (gender dysphoria) WPATH / GIDS, as apposed to some form of harmful conversion therapy.

My personal experience is based on work with individuals who work in the field of support services for people with gender incongruence (gender dysphoria) or those questioning their gender identity. Psychologists, Counsellors, GP's Other Specialists who follow the accepted care pathway agreed by professional experts after reviewing all other treatment paths to prevent harm.

My posts on this thread are not based on my personal view. They are based on the evidence that led the professional experts working in this field to design a care pathway the prevents harm.

Historically the care pathway for those with Gender Incongruence could have been likened to conversion therapy. Like the treatment of homosexuality it consisted of psychotherapy to make the individuals feel bad about themselves for being trans. It included psychoactive drugs and electroshock treatment. Individuals could end up in asylums for being trans. The results of this treatment were harmful to the patients.

Thankfully through pioneering research and the knowledge learned, new treatments affirming a patients gender identity were found to relieve the feelings of gender incongruence which has led to the development of the current care pathway.

HilaryMGSDC

Thankfully through pioneering research and the knowledge learned, new treatments affirming a patients gender identity were found to relieve the feelings of gender incongruence which has led to the development of the current care pathway.

My understanding is that people who suffer from gender dysphoria believe that their body is "wrong" in terms of their sex characteristics. Are you suggesting that affirming that a patient is actually "born in the wrong body" is the most appropriate treatment?

Is this affirmation approach also used in other disorders in which a person believes that a part of their body is "wrong" or doesn't belong to them?

They are based on the evidence that led the professional experts working in this field to design a care pathway the prevents harm.

What about the co-morbidity with NPD? Lots of professionals either avoid PD people completely or just give them what they want to avoid litigation.

Historically the care pathway for those with Gender Incongruence could have been likened to conversion therapy

That is a very dangerous, political statement. How can trying to change someone's sexual orientation be anything like treating someone with a disorder? The first is a natural orientation, the second is mental incongruence and disorder which requires intervention when it is acute.

Gender itself and it's social enforcement is the lifelong 'conversion therapy' into rigid sex stereotypes. 'Affirming' a person''s sexist belief they need to switch sex stereotypes is also gender conversion therapy.

Encouraging self acceptance grounded in reality is the opposite of 'conversion'.

/\ This

the Swedish ethics/medical board has just been challenged on this. They recommended that no such affirmative procedures are done on anyone under 18, due to irreversible nature of procedures

www.aftonbladet.se/nyheter/a/dd2epw/statens-medicinsk-etiska-rad-inga-konskorrigerande-ingrepp-for-ungdo

A departmental memo was submitted requesting that children as young as 15 be treated, however the ethics board felt that this was not ethical (my translation apologies for any errors) - “"We are united in the Council most of the time but this was a matter where we didnt agree. In general, we have been restrained in surgical procedures that provide permanent changes. We are not against legal gender substitution, but we are against surgical procedures and drug treatment under 18 years”