Whatever ultimately the aim of this article is - catharsis, indictment, awareness raising or rallying cry - it has taken a lot of courage to write this. I hope Jacob will find a path to happiness, whatever that may look like.
It was upsetting to read this because my youngest two are 12 and 16. Where Jacob is and where Jacob should be - all I need to do is look at my two and the enormous difference between them in development. DC3 is Tanner stage 1 to 2, the stage at which development is arrested with puberty blockers. DC2 is Tanner stage 5.
To think that other children aged 12 are denied their adolescence and all of the experimentation with beliefs and identity that happen in puberty but also the socio-sexual experiences that typically occur in these four years (like becoming aware of your sexuality), and remembering the emotional, mental, intellectual growth that DC2 experienced is horrifying.
As the author of one study on this issue concludes:
the treatment risks hindering the individual's development of a free personality, sexuality and identity, thus disconnecting the young person from the typical experiences of her or his age, with no certainty of the long-term effects on physical health.
and
From a psychological perspective, the main dilemma is to understand whether buying time at such a precocious age truly enables children to explore deep personal meanings, or whether it freezes youngsters in a prolonged childhood, secluding them from certain aspects of reality and isolating them from peer groups.
Judging from Jacob's story, this is exactly what seems to have happened in this case.
Furthermore, I find the justification focusing on consent particularly chilling, for two reasons.
- DC3 got an application form for one of those Youth Scotland cards. Because he is 12 already, the form stated he was old enough to give consent to the data collection and privacy policy and did not need parental permission.
Since this wasn't the policy in place with DC 1 and DC2, I phoned my local council to ask what steps they had taken to ascertain that children like mine understood what they were asked to agree to. (None)
And who had decided that 12 was the appropriate age to give informed consent at all (some government move apparently that also includes medical consent). Which brings me to
- Because my GP's practice also gave the kids a slip of paper where they had to confirm that they were happy for the doctors to involve their parents in their medical care, my GP had a chat with me about this issue, sharing his grave concerns that this was endangering underage patients.
This was based in part on his own decades-long experience of treating children with type 1 diabetes, all of whom had reached a rebellious stage in adolescence and many of whom had no understanding of the longterm consequences of their medical non-compliance. (All the way to early death in some cases.)
Now diabetes is a much better understood condition than gender dysphoria. The medical issues are much better understood. And especially the longterm consequences of certain behaviours are well-documented and easy to explain to adolescent patients.
Nonetheless, this made no difference to their ability to truly understand the risks and therefore to their ability to truly give informed consent (or in this case withhold consent and reject treatment).
My GP thought this decision by the government that all 12 year-olds are now assumed to be mature enough to give/withhold informed consent to any kind of medical treatment without parental support was utter madness.
And none of that even applies to puberty blockers because no one knows the longterm consequences. So for the Tavistock to stress that they keep explaining the consequences to kids and they are therefore giving consent all the way suggests a callous disregard for their own responsibility as the medical experts here and a staggering ignorance of the facts and timelines of child development.
12 year-olds, for fucks sake, are just at the tail end of make belief and differentiating between what is real and possible and what is not. Your average kid that age is highly prone to being manipulated because of their lack of life experience, knowledge and maturity. That's why we as parents are still needed to accompany and guide them them through this difficult and confusing time.
And the parents can't give informed consent either because there is not enough data to base a decision on.
And as the author of the above study laid out, puberty blockers were only ever meant to be used as part of an extensive framework of combined approaches including psychotherapy throughout (aka exploring the reasons the child may have come to reject their own sex - such as trauma and abuse - and attempting to find a way to reconcile mind and body. Also known today as "conversion therapy" and banned). Other approaches were social interventions and family support.
But we know from previous Times articles - and Jacob's story once again confirms this - that this is severely lacking in the UK.
Puberty blockers cannot give the child time to consider their options, because according to both patients and health care professionals options other than transitioning are no longer fully explored.