NEW: Grounds in support of intervention in the Bell v Tavistock JR appeal published

[ItsAllGoingToBeFine]

twitter.com/RadFemLawyer/status/1354002497753538562?s=19

This is going to fascinating to follow.

GIRES, Stonewall, Brooks and the Endocrine society are intervening.

I'm quite uncomfortable with judgements that affect the many being based on the few though.

Now that's intriguing to me. Empirical data demonstrates that in the case of children diagnosed with gender dysphoria "the many" represents the vast majority who desist and "the few" being the small minority whose gender dysphoria persists into adulthood. Previous best practice in treating children with gender dysphoria took this fact into consideration - to prevent iatrogenic harm coming to the many who would desist, no medical transition was offered to any of them, including the few who would persist (and who today say they would have benefited from treatment starting before they were adults).

The affirmative approach looked to puberty blockers to help those few without harming the many, assuming that those would offer a harmless pause, at the end of which either puberty would resume as normal by discontinuing the puberty blockers or be permanently suppressed and the body changed with the prescription of cross-sex hormones.

Given what we know now, the well-meaning, rather naive assumptions made back then are quite painful to read now in the papers of those who pioneered the approach.

The most damaging assumptions were that medication used in children entering puberty at too early an age would have the same effects on children entering puberty at a normal age. And that the lifelong consequences of prescribing puberty blockers to children entering puberty at too early an age were well researched, with ample evidence that any negative side effects outweighed by the benefits.

Neither of those assumptions were correct.

And yet a treatment approach that negatively affects the many being based on the few who benefit is nonetheless the favoured approach in the Tavistock now.

Are you at all uncomfortable with that, statsgeek1?

They did not hear from a single trans person out of the hundreds that had gone on to a happy life post blockers.

You seem to have missed my post about paras 85-88 in the judgment (which you don't seem to have read).

@statsgeek1

Datun - Of course, you're right. They did not hear from a single trans person out of the hundreds that had gone on to a happy life post blockers. Alternatively, out of that several hundred we can assume they all desisted?

It'd also be nice to hear a 'proper challenge' as to the veracity of the expert witnesses. Of course, I'm sure you have little to worry about so we'll have to just wait and see.

They did tho.

And the experts were drawn from all over the globe, top notch in their individual fields.

We can quibble about ages but, our voices will be heard. There is little misunderstanding. We struggled, we were offered help, we took it and we now live happier lives. For many of us, our sexual function is wonderful, not that it's any of your business. Personally, I'm always disappointed that GC's are so hooked up on my capability to achieve orgasm. Perhpaps you guys need help.

Now that is disingenuous, statsgeek1 and you know it. IIRC, you transitioned post-puberty, so your situation and that of the children the court decided to protect with this judgment is not comparable.

As for the claim that we are "hooked on your capability to achieve orgasm"

Again, there's a difference between adults and children. If an adult individual who has reached sexual maturity choses to risk having surgery with a 30% chance of losing sexual function (and a whole range of other, disproportionately high complications), all I think is that individual must be terribly distressed to be taking such a risk with such an important part of their life. And I hope that they find peace and have a better quality of life afterwards. In other words, if they are mentally and emotionally able to weigh up the pros and cons and still believe that is the right path for them, then that is their business and theirs alone. And if you're willing to risk never having an orgasm again? Well, that's your choice to make, not mine.

However, in the case of children,

-who cannot at age 11 understand what it means to give up the chance to ever father children,
-who cannot at age 13 understand how that decision will affect every relationship they will have for the rest of their lives,
-who cannot at age 15 truly understand what it means to be a lifelong medical patient with a self-inflicted higher risk of heart attacks or strokes than their peers,
-who cannot at age 17 imagine that they could ever want anything more than the pathway being put in front of them right now at the Tavistock,

Then we all have a duty to make damn sure that these children don't embark on treatment as a result of which long- and short-term harms are certain for a merely probable benefit of a happier life later without taking a good hard look at the evidence (especially not when there's an even higher probability that they won't want that benefit anymore once they've grown up.)

We can quibble about ages but, our voices will be heard. There is little misunderstanding. We struggled, we were offered help, we took it and we now live happier lives. For many of us, our sexual function is wonderful, not that it's any of your business. Personally, I'm always disappointed that GC's are so hooked up on my capability to achieve orgasm. Perhpaps you guys need help

Firstly, it’s not a “quibble” about ages. It’s vitally important to recognise that those children who were put on puberty blockers then cross sex hormones are only just reaching an age where the full implications of what has happened to them. The fact the long term implications aren’t fully known is a vital part of the judgment.

Second, “happier lives”. What does this mean? How do you explain to someone who has had their sexual function taken from them that they could be even happier? What is the measure? And if there are plenty of adults who were on puberty blockers who are living happier lives then there should be evidence of such. The only paper that has looked at this was the woeful Jack Turban paper that was shoddy at best, but even then it showed that adults who had been on puberty blockers were twice as likely to have been hospitalised for a suicide attempt in the prior 12 months. If only the Tavistock had tracked all of their patients into adulthood to provide us with information...

And no one gives a damn about your ability to orgasm. What we care about is children not having vital components of human development taken from them without proper consent when there is no evidence it improves their lives.

@PlantMam

I really hope this gets laughed out of court. That is a ridiculous, evidence-free argument.

Especially since the CQC report mentions that some GIDS kids don’t verbally communicate.

Anyway, more sunlight. Bring it on!

NON VERBAL children? I could cry.

Again the evidence that not even adults are able to acknowledge and be honest in engagement with the negative facts, risks and problems, and therefore are unable to weigh up all the information impartially in order to discuss an informed choice. How can children do it when adults can't?

The Tavistock, as the experts, put forward their evidence including children's voices. Its continually interesting that activists seem to want to tell the Tavistock what to do, seem to feel that they need to make the Tavistock's case for them when they are not the nhs body in question. It rather links with the Tavistock whistleblowing and CQC information that staff are under pressure to follow activist lead instead of properly considered policy with children's best interests. And that the two are not always the same thing.

Absolutely all this needs unpacking very, very thoroughly.

@InvisibleDragon

It seems like the argument is based on some sort of Schrödinger's child - simultaneously so fragile they will attempt suicide and so emotionally sophisticated they can consent to experimental medical procedures that a normal child could not understand.

Yes.

Also, some of these kids are non verbal, whaaaaa?!

And also, what the fuck is up with that RCOG tweet?

@statsgeek1

OldCrone -

We can quibble about ages but, our voices will be heard. There is little misunderstanding. We struggled, we were offered help, we took it and we now live happier lives. For many of us, our sexual function is wonderful, not that it's any of your business. Personally, I'm always disappointed that GC's are so hooked up on my capability to achieve orgasm. Perhpaps you guys need help.

As for dozens of happy adults, I imagine it would prove that the decisions we made at the time, in company with our parents, the Dr's and the Endo's in the main with the odd exception have been beneficial.

Of course, the court has so far only heard from one of us. Maybe you guys will be able to genuinely advise those who have had a positive experience where our experience is all wrong?

It doesn't matter (well to me anyway) if it is 1, 10 or 1000 young people with regret, that is still too many. The children who are felt to fully understand what they are consenting to will still be prescribed PB'S. Why do you want children to not go through puberty when the importance on bone and brain development etc is so well known? Why are you campaigning for children to be life long medical patients?

If the Tavi had done a better job around consent we wouldn't be here, but they didn't, address your ire at them. They are the people who have failed children, not anyone else.

It rather links with the Tavistock whistleblowing and CQC information that staff are under pressure to follow activist lead instead of properly considered policy with children's best interests.

Very much so.

Why are Brook spending their time and charitable funds on this? What on earth has it to do with them? Last time I looked, Brook provide contraception, STI testing and partner notification, and emergency contraception and abortion referral. All brilliant, essential work helping young people. Sex-specific bodily knowledge and emotional support obviously required for that. Why do a charity focused on contraception and safe sex care, then need to get involved in whether and how NHS GIDS services are expecting children to be able to foresee and consider their own permanent reproductive and sexual loss of function as part of consent? That is not what Gillick covers at all.
Serious question.

The legitimacy of Brook’s own work completely turns on the acceptance of Gillick as the legal legitimiser for them giving contraceptive advice and treatment without parental consent or knowledge. Because the child is deemed to be Gillick competent on a specific issue by a medical professional.

So why would Brook OF ALL PEOPLE want to muddy the water by publicly apparently believing that the Bell case has anything to do with Gillick?
It doesn’t. That’s a lie put around social media by TRAs trying to confect a problem to gather support for their own politics.

Brook will have their own access to legal counsel. Their legal counsel will know and admit (if they aren’t just hobbyist lobbyists) that the Bell case does not affect Gillick. Its there in black and white.

Why do they think this is in their own remit to spend money on, or give their name to? I don’t get it at all.

So why would Brook OF ALL PEOPLE want to muddy the water by publicly apparently believing that the Bell case has anything to do with Gillick?

Yes, this is very confusing.

It seems much more damaging to the concept of Gillick competence to imply that it is a blanket ruling that a child can agree to any medical treatment.

I suspect they have had no separate legal advice and have just accepted what they have been told by the Good Law Project.

It never surprises me that a large portion of the posters we have posting about how they are all fine after transitioning are not only adults when they medically transition. But are also males. Female transitioners do seem to have a slew of health issues on cross sex hormones and it is usually ignored by the mtf transitioners (and from the stories of the ftm detransitioners not discussed as it seems to be discouraged).

And as usual some posters here ignore the change in the demographics in the current group of people seeking transition away from mtf. So they are advocating pathways that suit their own purpose as males but misses many requirements for the teenagers and children today who are in the majority female.

Well what do you know

One of stonewalls trustees is former Chief executive of Brook www.stonewall.org.uk/people/simon-blake-obe

And Laura Russell trustee of Brook
Is former director of campaigns, policy & research at Stonewall

And suddenly it becomes obvious why Brook are involved....

"Oh what a tangled web we weave, when first we practice to deceive."

@TheGreatWave

I have said this before, but if they are so absolutely certain that PB and then CSH are the right path then surely having to go to court to gain the consent for this shouldn't be an issue. No one is depriving children of healthcare (or whatever is claimed in tweets) just ensuring that the treatment is the correct one.

Why would people be against this?

This is a good point.

One of the criticisms that the clinic are getting from trans advocates is that they don't seem be be doing this. And it's a fair criticism I think. I would have expected the clinic to start applying to the courts for patients already having the treatment at least, but (unless they are wrong) that isn't happening. Perhaps because they haven't got any good evidence that the child was able to consent when they started the treatment because of the terrible record keeping? Or just because they are reeling from the ruling?

I think the appeal intervenors and other lobby groups are probably trying to persuade that the entire problem was with the clinic. That the treatment & principle is fine, but Gids were a disaster. I assume the endocrine society will be submitting whatever international evidence exists. It will be good to have it all put before a court.

So they are advocating pathways that suit their own purpose as males but misses many requirements for the teenagers and children today who are in the majority female

This is a point made very clearly by Keira in her recent interview with Kellie-Jay. It's well worth a listen:

Keira Bell interviewed by Kellie-Jay http://www.mumsnet.com/Talk/womens_rights/4143358-Keira-Bell-interviewed-by-Kellie-Jay

It doesn't matter (well to me anyway) if it is 1, 10 or 1000 young people with regret, that is still too many.
Exactly this. These are people, not just the ‘odd exception’ so pleasantly put by stats. Every ‘wrong diagnosis’ is a child put onto strong medication that makes permanent changes to their body and has a huge potential to damage their long term health.

Every clinician involved in this should be extremely worried about the existence of any detransitioners (let alone the hundreds or possibly thousands around the world).

I remember reading about that poor child in America who had insurance funded ‘top surgery’ age 15, then suffered huge regret and now can’t get insurance funding for any assistance with reconstructive surgery. Unbelievable!

Every detranistioner who has had life changing surgery and body alteration represents a failure in the part of the clinics and people who prescribe the drugs and perform the surgery. This should not be happening at all!!

It is interesting that people who would have been the welcoming ‘glitter family’ for these young people transitioning. However, if they detransition, reject them and their welfare so completely with no concern as to the damage caused but only concern as to how it might affect them.

It seems bizarre that personal bonds in the trans community seem to be so dependant on the trans status of a person.

@Biscuitsanddoombar

Well what do you know

One of stonewalls trustees is former Chief executive of Brook www.stonewall.org.uk/people/simon-blake-obe

And Laura Russell trustee of Brook
Is former director of campaigns, policy & research at Stonewall

And suddenly it becomes obvious why Brook are involved....

Dear lord. There really is no end to the connections beneath all this. Time after time there are links between all the people involved.

Now that is disingenuous, statsgeek1 and you know it. IIRC, you transitioned post-puberty, so your situation and that of the children the court decided to protect with this judgment is not comparable

And this? Ffs. I thought stats was speaking from relevant experience. Adult males who have never taken the pathway they are fiercely advocating for children seem to be a prominent feature.

"So why would Brook OF ALL PEOPLE want to muddy the water by publicly apparently believing that the Bell case has anything to do with Gillick?"

Yes this is such an important point. When the scourge of foxes was going on about how Bell undermines Gillick he tried to get abortion charities to say so publicly, and claimed they wouldn't because of the scary gender criticals on twitter. One did tweet something, but they started getting replies from anti-abortion ppl saying - yes you are right. The regret rate for abortion is much higher than for transition - and they deleted.
What do they get out of it? I suppose if the appeal fails they get a ruling from the appeal court saying that this case has no implications for abortion - but they already have that in the high court's rejection of the appeal. Why don't they want that to stand?

If they are successful they will get a ruling that means children can consent even to a controversial and possibly experimental treatment. That quite young children can consent to things to do with their future adult body and sex lives. Maybe they think that entrenches the child's right to consent to abortion and contraception even more?

Well, it's also clear from the documents and statements from Foxy & co. that the aim is some sort of strengthening of parental consent too, so that if the argument that gender dysphoric kids are indigo child savants themselves doesn't work, the parents can be said to always know exactly what is best for their children, no questions asked. This particular prong of the argument is obviously never going to be able to get past The Children Act, but I think the fact that these are the kind of arguments being made show, at best, that this is an amateurish, ill thought-through action that has completely lost sight of the welfare of children. The dissenting interventions on this thread only underline that aspect.

May I just say that it's great to see the word Bunting on these pages again.

xx

Brook are aimed at supporting young people in relationships so it falls under their remit to discuss this with their service users.

Cynically however, I can’t help wondering if they have one eye on Planned Parenthood in the US who are providing hormone treatment (18+)

I remember reading about that poor child in America who had insurance funded ‘top surgery’ age 15, then suffered huge regret and now can’t get insurance funding for any assistance with reconstructive surgery. Unbelievable!

I was reading the detrans subreddit yesterday. I haven't looked at it in about a year. I was quite shocked at how it's grown and the number of people who had treatment and surgeries in their early teens and were now late teens or early twenties wanting to reverse much of it.

A lot of these cases are in the US where there is even less (no?) caution regarding minors. Insurance paid thousands enabling them to transition but when it comes to detransition insurance won't cover even the basics.

One young person went to the same surgeon for detrans surgery who performed the original transition procedure. Insurance paid this surgeon the first time then the patient paid $$$ of their own money to get it fixed. When you have a model like that it's not going to matter if their patients have regrets because it just means more money for more surgeries.

For all the issues we have here I'm grateful we aren't trying to tackle a medical system like the US.

I suspect eventually detransition surgeries will be covered by insurance over there because it's yet another lucrative income stream.

And suddenly it becomes obvious why Brook are involved....

This seems to be one of the very major problems with many large charities and organisations: that it's a small and extremely incestuous pool of people who all periodically swap jobs.

It would appear from what I've heard from people who have worked in the system, that no one not of the type or group seems to get near top jobs, and those who rock the boat and say things like "Hang on a minute" seem to be quickly made unwelcome and managed out, or quickly vanish to other jobs. As a result it would appear you have a small group who all think the same very extreme end liberal type beliefs although sometimes these are in direct conflict with their core responsibilities (rubber pants man for one), and have no stronger grip on reality that they are completely out of touch with people in the street. These groups seem to liaise together a lot and spend a lot of time reinforcing each other, it can be surprising to see a lack of many basic trained skills you would expect at that level for decision makers, and awareness of things like realistic, practical safeguarding can be much less than those of low paid people at the coal face. Lots of money, trusted names, lots of justifying of expensive posts some of which might be termed as chocolate teapots. I hear it's quite eyebrow raising if you spend a few hours in their offices.

And as periodically they all change seats, the same culture moves through them all. Which of course is not at all helpful to them in ensuring best practice, staying in touch, not losing sight of core brief and falling prey to mission creep and many other things that you'd expect an organisation handling so much public money would take seriously.

Just what I hear.