Susie Green

[SlowlyShrinking]

Is the implication that she supports this? I suppose I shouldn’t be surprised, but fucking hell!!

She’s made a lot of decisions that most people find utterly shocking.

She’s probably struggling with the fact that people don’t seem willing to validate her choices.

Jeez that’s awful. She’s saying Puberty blockers have bad effects so start kids on cross sex hormones earlier and everything will be much better! WTAF!!
I’m not sure what she means by sterilisation clause but on reading the first link there is a bit which says to wait till child old enough to consent so maybe that’s what she wants to do away with. Then we will end up with parents who have sterilised their children even younger than her and maybe she won’t feel so bad about herself

Women have to have psychological assessments to have a CS if they want one. A notable percentage of women who are actively opting for CS by choice have a history of abuse / rape and this is one of the main reasons for their request.

That wasn't my reasoning. I didn't like being assessed in this way at the time, but actually I was lucky and it was done in a sensitive manner and was about helping me long term. They emphasised the point that you focus on the birth not on what happens after that, and actually that's just as important. It was about your long term mental health. They recognised that being fixated only on the birth was unhealthy.

My experience was good, but I know others have had poor experience. The way my case was handled was about centring my personal needs rather than just putting me on a care pathway which everyone in the same situation follows to the letter.

Susie Green is firmly fixated on the transition point. The refusal to acknowledge the existence of desistance is a huge red flag in that regard.

She does not view it as there being more than one way to handle. In truth as humans, we all have unique responses and medical needs. Narrow prescriptive, care pathways which fail to treat patients as being complex, with a range of needs of varying depths are harmful for this reason alone. Conveyer belt health has a track record of poor side effects, particularly in relation to mental health.

There is not necessarily a 'right way' to treat children identifying as trans, but there sure as hell is a wrong way. If your mind is closed to the possibility of multiple needs, causes and outcomes, you are already on the path to doing harm.

Susie Green's personal fixation is harmful for this reason alone.

There is no proper research on this, and that's what should be being strives for more than anything else. As it stands this is experimentation on children. Nothing less.

How can we be arguing that CHILDREN are able to consent to this on the basis of simply being gillick competent when the adults around them haven't done proper good quality research (and aren't framing current care as experimental) which includes desistance as part of that? The kids don't know the risks, because the adults around them sure as hell don't!

Informed consent, requires to be informed. The gillick bit, is actually a red herring in this regard. Those children CAN NOT be making informed decisions whether they are 13, 15, 17 or even an adult because its not being framed in a responsible and ethical manner that is led by evidence rather than lobbying.

This gives me chills. How a not-terribly- intelligent, agenda fuelled woman who committed what would be a crime in the uk (and is now also illegal in Thailand) has become so influential is beyond me.

She knows nothing. She does not value research. She actively wants to PREVENT research. She frame's the asking of questions as transphobic. Medics should be able to explore difficult questions as part of research, because to fail to do say is unethical as it could lead to harm.

Susie Green is anti science. She is anti ethics. She is anti safeguarding. She puts lobbying first and thinks identity politics should come ahead of robust medical framework which have been long established to protect patients, particularly vulnerable ones.

A court has told mermaids to stay the fuck away from one child already because they had serious concerns.

There are a lot of people who have failed to do their jobs and have enabled Susie Green.

I think a really important point that it's easy to kind of forget about is that we are talking about healthy bodies.

I keep on having to jolt myself to remind myself about this when talking about surgical consent.

This is operating on people's healthy and functioning bodies. How can this not require psychological evaluation regardless of the age?

And how can you not want to try different psychological interventions before finally having to reach operating on healthy body parts as your final last resort.

It is extraordinary thinking.

How can this not require psychological evaluation regardless of the age?

Yep.

And in an area where there is a huge absence of research and no plans to do any.

Agree RedToothbrush and FFSFFSFFS .

Gender reassignment surgery on healthy children is child abuse.
Puberty blockers prescribed to healthy children is child abuse.
A child exhibiting suicidal behaviour needs special care and attention, not irreversible surgery or lifelong drugs.
Question: What type of person would say that is ok?
Answer: Susie Green and the charity, Mermaids and they are not medically trained.

Marci Bowers, a male who transed, did Jazz Jennings' "bottom surgery" when Jazz was 17.

Lobbying and medicine = dangerous mix.

NO Exceptions whatsoever. None.

There is always the possibility of side effects or intended consequences no matter how well intensioned or noble peoples ambition.

The road to hell and all that.

You must ALWAYS be mindful of this.

That's the very essence of ethics.

What are the ethics committees doing these days?
The people who keep a close watch on genetic research used to be quite vocal in areas of significant medical development.
They seem strangely silent.

Don't see this thread lasting...

It will be a game changer if it stays up.

In no other situation would adults pander to a child’s insecurities. We don’t give anorexics liposuction, we treat their mind. We don’t give children that self harm free access to razor blades, we give them counselling and support. Children must be supported through puberty, even if they are unsure about their changing body-it is part of growing up and maturing. We know feelings of disphoria desist after puberty in approx 80% of young adults. Why are we encouraging children to mutilate their bodies, most likely becoming sterile and setting them on a path as lifelong medical patients, before their frontal cortex is developed enough for them to truly understand the ramifications of their actions? These drugs are UNTESTED on humans, how is this even legal.

The fallout from this will sadly be huge

This is definitely a subject that benefits from plenty of fresh air and light.

Yes happydappy2 , I think there will be so many legal cases in a decade or so. How can anyone think this is ok? Amputating body parts, removing organs, damaging the bodies of beautiful, healthy children and young people. Children who need support and help to accept their changing bodies, and will then in most cases become happily reconciled to their sex as they enter adulthood.

Discussing a public organisation and comments made by its CEO on social media platforms should not be contentious.

I've seen nothing on this thread that references facts/opinions that have not been publicly disclosed by Susie herself.

Equally, many of the positions she advocates are refuted by a number of respected organisations and/or credible evidence.

Public organisations and their executives should be open to scrutiny. If Susie is uncomfortable with this then the post of CEO of a charity/lobby group is not one she should continue in.

Why should this thread get pulled?

We are talking about the prospect of irreversible medical procedures on healthy children.
Procedures that will result in sterility and and reduced sexual satisfaction throughout their adult lives.

What actual professional qualifications does Susie Green have that means she is suitable to be making these pronouncements on medical treatment and psychological assessment? Or advising the government on policy for that matter?

I personally, don't want to comment on Susie and her child. I don't think its necessarily helpful as it gives a reason for the thread to be taken down. I think its relevant, but unfortunately, the nature of things means that there is a bigger issue at hand here.

I do think, however it is ESSENTIAL, that we are ALL allowed to comment and discuss ANYONE lobbying on health related issues. Especially if they are in a position of influence.

This is a position I have held for many, many years and have talked about.

There is a need to think about mental and physical health as a combined thing. You can not separate them. There is a need to treat each and every person as an individual who have different things that make them tick; what is right for one person is not neccesarily right for another. To be able to make an informed decision, a decision must be made in a bubble of 'freedom' - with no coercisive influence from family, friends or HCPs and with information that is as free from bias as possible. There must be no social contagion. Medical ethics is an area which is vulnerable to lobbying.

I am consistent in this opinion. I have a long posting history on this. It is not singling out Susie Green as an individual. She is simply going against every one of these principles. These principle were established for a reason.

We should be making the point about them and reminding everyone of why they were formed in the first place and why ignoring them risks 'doing harm'.

This is not necessarily about trans issues. If you ignore these frameworks for trans health, we open the whole of medicine in this country to the undermining of ethics. We do not like the American lobby groups for a reason.

This goes way beyond trans health. We need to be able to have conversations about the importance of safeguarding frameworks in medicine and the importance of freedom from political influence in science, research and medicine.

I do not mince my words about calling Susie Green 'a danger' for that reason.

Great posts red
Really really great

A few points on the legal bits around consent for medical treatment....
Patients must consent to any and all medical interventions. This can be implied or explicit consent. For example, if I ask someone if I can check their blood pressure and they hold their arm out, this is implied consent. As a general rule, the more serious or risky the interevntion, the more detailed the process of informed consent needs to be, and although doesn’t necessarily have to be written, it will usually be considered good practice.
In order to give informed consent, a patient must be able to believe, understand and retain the information they are told and then use that to make and communicate a decision. For this reason, a patient with dementia for example may not be able to consent because they are unable to retain the information they have been given.
In adults, only the person concerned can give or refuse consent. It cannot be a decision made by a next of kin, friend or relative. If a patient is unable to consent, then the doctor caring for them must make a decision based on the clinical situation, and act in the patient’s best interests. There will need to be a test of capacity in order to do this, and how that is done will be dependent on the situation. For example, if I am in a car accident and am unconscious and need emergency surgery, it would be legal for the surgeon to perform the surgery without my consent if they were able to demonstrate that the surgery was necessary, could not wait until I regained capacity (i.e. became conscious again) and was done in my best interests. In less urgent circumstances, a doctor may discuss the need for a procedure with a patient’s relatives, friends or caters to see what the patient would likely have wanted in order to inform their decision as to whether something is in the patient’s best interests but in the end, it would be the doctor’s decision.
For children, it is generally accepted that parents can consent on their children’s behalf. Depending on the age of the child and the nature of the treatment intended, a child may be able to consent themselves. This does depend on the child, and crucially on the nature of the treatment. A 3 year old can probably consent to having a plaster put on a cut; A 10 year can probably consent to having a plaster cast applied to a broken arm; A 15 year old can probably consent to taking antibiotics to treat their acne. As a general rule, a parent can not refuse treatment on behalf of a child. Complex cases such as those involving refusal of blood products on the basis of a parent or child’s religious beliefs may well end up in front of the court of protection.
Gillick competence comes from the case of Gillick vs R in which a parent argued she should be informed that her daughter (under age 16) was asking to be prescribed contraception. The ruling was that assuming the child had capacity to consent, then a parent would not automatically have a right to know about treatment. While this can be extended to other circumstances, it’s not necessarily applicable across the board.
For something as fraught, Complex and emotive as having puberty blockers, cross sex hormones or irreversible surgery, best practice must be a careful, open and honest dialogue between doctors, the child involved and the parents including the risks and unknown potential effects of these drugs in the future. I don’t think there would be a child who could consent to this alone, without adult guidance and there will be many adults who would struggle with this too. While the evidence of harm of these drugs becomes increasingly clear, and the evidence of harm from taking a watchful waiting approach is so obviously lacking, the GIDS service for children must not be railroaded into taking a less cautious approach.

RedToothBrush
Your post is a very measured, articulate and helpful response to the debate.

Thankyou

If we can stay measured on this, I believe it makes it more difficult for this thread to be challenged.

Emotion, when it comes to talking about medical ethics, can be very unhelpful. Its a tool to manipulate feelings, but ethics and research are purely about rational and logic. Emotion has a habit of getting in the way of establishing best practice.

It is relevant to mental health to a certain degree, but I do firmly believe you have to work hard to remove yourself from personal feelings and preconcieved ideas of what you should do, and instead be evidence led within the framework of the principles of ethics.

Lobbying actively tries to invoke this emotion to push a particular agenda, over and above that objectivity and rationality. We need to be acutely aware of that.

If we ultimately want what is best for kids or adults who identify as trans, when it comes to consent, research etc, we MUST work to create a culture in which there is the freedom and ability to do that.

There's a time and place for talking about trans issues in an emotional way. There's also times when we need to step back and point out how and why its so problematic.