Woman's hour today (29 October) 10 am

[ScienceRoar]

There will be a discussion of gender dysphoria. The Twitter grapevine says that Transgender Trend will be represented.

twitter link to discussion about the program:
twitter.com/BBCWomansHour/status/1056803331098714114

Interview with Stephanie Arai Davies:

Lecture by Dr Polly Carmichael: 'Developments and dilemmas'
soundcloud.com/user-664361280/dr-polly-carmichael-developments-and-dilemmas

Discussed by James Kirkup: 'Why are some MPs trying to shut down the transgender debate?'
(extract)
"In her thoughtful hour-long lecture, Dr Carmichael said this:

“The rapid rise in the number of assigned females…. exemplifies the importance of keeping discourse open and allowing different voices to be heard.

“You might say the increase in the numbers of assigned females coming forward is [because] that it’s easier for females to talk about their gender-diverse feelings so what we are seeing is an increase in awareness getting towards a better representation of the true prevalence of this among females.

“A converse explanation, a question: are there issues for young women around how they perceive their gender? There has been a worry by some that people who would previously have had an outcome around sexuality are now having an outcome around gender.”

(In other words, these are girls who do not readily identify with the predominant idea of femininity and are sexually attracted to biological females, and who would, a decade or two ago, have grown up to consider themselves lesbians.) Dr Carmichael’s conclusion:

“The truth is we don’t know, but we need discussion in order to be thinking about what this could mean.”

Just in case that’s not clear, let me sum it up: the country’s leading centre for the care of gender-variant children says its caseload has risen more than twentyfold (35 times for girls) in less than a decade. The head of that centre doesn’t know why that’s happened and says the question needs further discussion." (continues)

Despite its influence, it is worth noting what Mermaids is not. It is not a research body. Its activities are support (for families) and advocacy: based on its contacts with those families, it argues for what it sees are better policies and practices by the NHS and others. It does not carry out or commission clinical or academic research. Its most recent annual report lists among its charitable activities “campaigning and advocacy” and says: “Mermaids has also become more active in lobbying”.

There is regular dialogue between Mermaids and the GIDS, but the two sides do not always agree. An example is on the time the GIDS team take to give referred children the hormone-blocking drugs that stop their bodies developing the physical characteristics associated with their birth sex.

In evidence to another Commons inquiry in 2015, Mermaids argued that GIDS should make such drugs available much more quickly. The GIDS team has generally resisted that call, more than once saying that “any decision around hormone treatment needs time and considered thought.”

And in evidence to that earlier committee, Dr Bernadette Wren of the GIDS said this:

“I know that Susie and Mermaids would like a fast track so that young people who are already well into puberty and feel that they know that they want to move forward into physical intervention would bypass our assessment process and move straight into physical intervention. We feel that is not an ethical way to practise.”

Here’s another summary. A transgender charity that says it is engaged in lobbying lobbied politicians and doctors to change the way children are treated by doctors. The doctors declined to make that change because it would be not be ethical to do so." (continues)

blogs.spectator.co.uk/2018/05/why-are-some-mps-trying-to-shut-down-the-transgender-debate/

Its worth being aware that GIDS is currently under considerable attack by parents from Mermaids and many prominant TRAs for its 'watchful waiting' approach.

This has become quite intense recently.

I think Woman's Hour is to be applauded for hosting the discussion and for not allowing the discourse to be dominated by accusations of transphobia and general wokeness.

Polly Carmichael was a bit patronising. She could have emphasised more the difficulty that rigid stereotypes cause - she said we need to be tolerant of diverse gender expression - this is NOT what is being preached in schools by Allsorts etc.

All three of them said that rigid gender stereotypes were a problem. How hard is it to get from there to see that the solution is more tolerance of diversity, rather than medical transition so that people fit in their gendered boxes?

I agree. That was far better than I was expecting.

The reasons for the huge increase in girls with gender confusion/dysphoria are obviously very complex. A few obvious areas to investigate:

1. Ten years ago when there were 40 or 50 girls a year being referred to GIDS at the Tavistock, were there hundreds more being looked after by their local CAMHS? In other words, is part of the increase in numbers a result of extra funding for this area, making it possible for more children to get specialist treatment?

1. There's been a huge increase in recent years in the number of children diagnosed as being on the autistic spectrum. It took a long time for clinicians to start diagnosing girls because it presents differently but the numbers there are rising too. Given the link between being on the spectrum and experienced gender confusion, what's behind the increase in diagnoses? Is it a case of giving a name to something that went undiagnosed before, or got a different label, which would imply there always were this number of people on the spectrum, we just didn't have that label? Or is it the case that there has been a genuine increase in incidence of the condition? If the latter were to be true, you'd expect an increase in the incidence of gender dysphoria too.

1. Effect of the internet - social media and online porn. We know young people, and especially girls, have a higher rate of mental health problems than used to be the case. (Although there again, is that true or is just that there's less stigma/more awareness so more come forward?) Given the highly gendered nature of much of what girls are exposed to on social media (Instagram filters, horrific stuff done to women, sexting etc etc) is there any way of demonstrating a causal link with the huge increase in girls reporting gender dysphoria?

1. Social contagion. We know it exists. It's always existed. I can't see why it couldn't have a role here, especially now it's so easy for ideas and images to spread all across the world via the internet.

1. Lack of role models for girls just starting to think they might be lesbians. I'm not a lesbian or an expert on this by any means, but I've seen it stated often by people who are that there used to be more in the way of local groups a young woman could go to.

1. Increased gender stereotyping, affecting children from birth onwards - clothes (colour, style, slogans, fabric choice), hairstyles, shoes, toys, books, expectations of how they will behave and about their likely life path, gendered language etc etc etc. In some ways it's worse now than it was when I was young. There wasn't anything like as much expectation of immaculate grooming back then (thank god).

Probably lots more, but that's where I'd start.

I thought this was bloody fantastic! Both in comparison to the mainstream coverage we've had before, and as a piece that took its time, gave everyone fair time to speak, and largely was a civil and sane discussion.

I think Jane Garvey is deffo GC.

Polly Carmichael didn't come across as especially extreme, but I did feel she was being very dismissive of perfectly justifiable concerns. I did think, as others have pointed out, that her points were riddled with contradictions. She is not joining up the dots, indeed.

Stephanie A-D did well. And yes, it was good to hear from Lewis (Luis?). One thing I kept on muttering about was that even if the Tavistock are balanced in their approach with the children they see, those children have often already been exposed to very unbalanced views and organisations at a local level.

Lack of role models for girls just starting to think they might be lesbians. I'm not a lesbian or an expert on this by any means, but I've seen it stated often by people who are that there used to be more in the way of local groups a young woman could go to.

If the local lesbian society included loud shouty males, that would have put me off as a shy teenager.

I can well imagine, ARose.

So 'balance' means interrupting Davis-Arai before she is able to complete any point, then letting Carmichael (Tavistock) or Lewis (from transsexual summer) go on until they exhausted everything they want to say.

ABitCrapper - There was a study about puberty blockers linked to in the tweets - and it did seem to confirm that puberty blockers aren't the sterilising risk I've seen claimed on here. But the study did recommend stopping at age 12 for optimal adult height and bone density.
When used for trans kids - is the difference the age used, dosage or what?

The sterilisation risk is because almost all who start puberty blockers then progress to cross sex hormones. They never develop mature gametes so can't even store eggs or sperm.

The age makes a huge difference too. Children placed on puberty blockers for gender dysphoria start at around the age of 12 and stay on until 16 - it's one thing delaying a very early puberty, quite another not going through puberty at all.

There are a lot of reports from women who have taken these drugs for precocious puberty or endometriosis of serious, long term side effects including osteoporosis, joint problems and mental health issues.

Just NCd.
My Twitter comment was read out! I shall listen after work.

You can contact Woman's Hour here:

www.bbc.co.uk/programmes/b007qlvb/contact

If they get a load of messages telling them well done it'll help support the GC women who've probably had to fight like hell to get this aired.

Using puberty blockers to delay early onset puberty is a totally different use to using them to avoid going through puberty altogether which is how they are used for children who believe they have dysphoria.

It was irresponsible of Carmichael to keep saying they are reversible because no one stops the process once they go on them. So we don't know what happens if you take them until 18 and never go onto sex hormones.

The thing that's rarely discussed is the effect of testosterone on female bodies. Many transmen are self medicating - which is really dangerous.

They will all have vaginal atrophy, which usually happens after menopause. It's sore, itchy and very uncomfortable, so, those transmen who seek help will get a local oestrogen pessary.

Buck Angel, the front page buff transman nearly died because his vaginal atrophy meant the whole thing sealed up. He was still producing stuff from his cervix, so that got infected, he went septic and nearly died.

There's also an icreased risk of heart disease and the bone health issues.

It's just doesn't seem sensible to swap your long term health for a bit of wispy beard to me.

These people need proper advice, but, the specialist clinicians are thin on the ground (Hardly surprising, who'd want to work in this hot potato of a field with no definitive diagnosis or objectivity? See that GP who was prescribing online and has just been convicted of being a bit silly, forget her name, woman in Wales) and waiting lists are long. So, they are advising each other.

There's going to be a real health crisis in this population in 15 years.

It's really bloody scary.

I also listened to Polly Carmichael with a sense of disquiet. She did not seem to be especially frank and her approach to the discussion was to shoot down points raised by her opponent. One thing missing from her was a sense of "we need to push for high quality objective research into these areas". I can't help but feel that she is content for her organisation to operate in a grey area of inconclusive research and to be balanced between competing pressures. It just seems very passive to me.

The discussion around puberty blockers never fails to annoy me. Apparently, they are supposed to buy time to decide. But if just about everyone on puberty blockers goes onto cross sex hormones, supposedly because they've all been correctly diagnosed, then this bought time doesn't seem to have much point.

Poll is on record at the Westminster Forum on Trans Equality on June 4 that media and social media have had an impact on gender waiting lists. 'We try to remain neutral and its hard'. Also on record acknowledging high comorbidity with ASD. 'Less than half those presenting at Tavi go for physical interventions'.

'Some will express themselves differently over time'. 'We should support gender diverse people so we give them more timr'.

Poll not poll

Polly not poll
Fuqsake

The thing that's rarely discussed is the effect of testosterone on female bodies.

Your comments are so important Vivarium. No where in today's discussion did they get to grips with the actual physical reality of life as a transitioned female to male.

But if we can't discuss that then people just won't understand what is at stake.

It's just doesn't seem sensible to swap your long term health for a bit of wispy beard to me.

I think that just about sums it up.

So much is obscured by language.

Talk of 'T' or HRT (its not replacing hormones) prevents people from acknowledging that we know the impact of people taking testosterone over a period of time.

In other situations this would be discussed as steroid abuse.
Anyone who has done drug training is aware of the associated long term side-effects.

I did wonder how, with having a FtM person involved in the discussion, they could frankly discuss matters that could be considered to be critical of their choice/journey. But on the other hand, that would suggest discussions being had that exclude trans people which doesn't feel right. Part of the difficulty is that there are people in that community who come across as vulnerable and people are nervous about saying things that could cause them to be upset.

HRT is deliberately misleading (ie you are replacing the hormones you body was supposed to get at birth), and sounds benign, when it is not.

There was a poster on here a few months ago. Her child was prescribed puberty blockers by the Tavi. However, she was then sent on her way for something like 18 months, with no support, no therapy - just advice to contact the local CAMHS which had no resource to help her. Exactly how does that buy time?

However, she was then sent on her way for something like 18 months, with no support, no therapy - just advice to contact the local CAMHS which had no resource to help her.

Which is when naturally parents and children seek out support from groups such as Mermaids or look online.

I really don't get how preventing a child from maturing can be expected to help them make a more mature decision.

(I do realise how little I know about this subject from the medical end.)

Nauticant: that's incredibly important. Can't discuss trans frankly without trans people present as that is 'exclusive'. Can't discuss trans frankly with a trans person with a trans person present because that's upsetting for them. Catch 22. I think it's been exploited. Not today so much. But previously.