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Feminism: Sex and gender discussions

The judgment in Keira Bell's case will be given tomorrow

999 replies

MaudTheInvincible · 16/09/2021 19:19

The judgment of the Tavistock's appeal of the case will be given at 2pm.

www.gov.uk/government/publications/royal-courts-of-justice-cause-list/royal-courts-of-justice-daily-cause-list

Brave Keira. You have done so much to protect children from ideologically driven healthcare around the world. Your integrity and courage is inspiring and rare in this ridiculous day and age. 💚🤍💜

The judgment in Keira Bell's case will be given tomorrow
OP posts:
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7
crunchermuncher · 20/09/2021 11:00

I may have got the wrong end of the stick, but wasn't the original Bell judgement that a court order was need only in cases where the Dr, patient and parents didn't all agree to the treatment? In cases where they did, it wasn't necessary, even for young teens? Or am I mistaken?

I don't see how that undermines Gillick competence, as some are fond of arguing.

ChattyLion · 20/09/2021 11:03

If you look up NHS information under gender dysphoria under treatment you’ll see the lies still being told.

www.nhs.uk/conditions/gender-dysphoria/treatment/

I’m not exaggerating. It’s lying.
It says, under ‘treatment’, that you can construct a penis or vagina.
Not worded in quote marks.
Not ‘neo’ anything or ‘cosmetic approximation of’ or anything like that.
It’s misleading vulnerable patients. Considering how dangerous these procedures are and ineffective at achieving their end result aim (because obviously you can’t ‘make’ functional organs…) it’s unacceptable that even the NHS politicises its own language in this way and shame on all the lobby groups will have told them to do this.
Why do adult gender non conforming people also get less good consent and healthcare provision than other patients? It’s a scandal.
RIP that poor young man.

ButterflyHatched · 20/09/2021 15:37

@SusannaM

The thing that bothers me is, the idea that blocking puberty gives the child time to think through their options. But puberty isn't just about growing breasts, wet dreams, deepening voices etc. It's also about developing mental, emotional maturity and the development and maturation of the prefrontal cortex. If we block or delay puberty then that won't happen, so of course these children go straight to CSH they haven't developed enough to have the maturity to move on from their dysphoria.
I can't speak in the general sense for everyone, but can at least provide a personal data point on this subject!

As one of the early GIDS trans kids who went on blockers for several years in her mid teens back at the turn of the millennium and then went on to complete university and embark on a successful industry career, having lived a happy and fulfilling 22 years so far since transitioning, I've certainly never felt that my development was stunted.

Quite the opposite, in fact - I'm far happier, stable and successful than the majority of my friends and my transness is such a minor factor in my general life that I rarely need to factor it into my everyday considerations. I was generally known as 'the sane one' at university within my friendship group, and others frequently commented on how I seemed mature for my age.

Blockers were absolutely the lifeline I needed. I was, however, one of the more stable kids to turn up to GIDS, especially back in those early days - a matter that was frequently pointed out by staff. I knew exactly what I needed, and there was no question as to whether it was the right choice for me - though the staff were diligent, cautious and professional throughout my time with them. There was never any pressure to move on to any other treatment - quite the contrary in fact. Everything seemed so agonisingly slow, and I wasn't allowed to start HRT for several years, despite my desperate pleading to the contrary. The only regret I have is not starting Blockers earlier - my voice has that distinctive mid-teen crackle to it when I sing, so I'll always sound like a 15 year old boy trying to hit a high note! Just a reminder of where I came from, I suppose. It doesn't factor into daily life, but it does occasionally come back to haunt me, like the ghost of dysphoria past.

I've never known what it's like to live in society as a man - I experienced a boyhood that was being forced on me up to my early teens with a huge and very palpable awareness of how I was walking the wrong path, and then lived mid and late teenage girlhood and have experienced over twenty years of womanhood since. I have thankfully been spared a bunch of really unpleasant learned behaviours while being mindful of a whole bunch of others that are burned into people perceived male from a young age. I'd certainly never claim that my early life experiences give me remit to claim something that is not mine to claim, but I'm also acutely aware that I have no claim on manhood either. I don't know how to be one, I've never acted as one, have never experienced being perceived as one, and don't think I could if I tried!

Just a single datapoint, of course. Who knows, maybe blockers did stunt my development and I might have turned out to have been a nobel peace prize winner otherwise. I have very much felt, however, like I have been living my best life.

If blockers had been banned? Well, I'd have ended up in the same place, but the journey would have been harder and more miserable, would have taken longer, and my everyday existence would be marked by gender dysphoria rather than largely just getting on with my life. Not least because instead of being completely invisible, I'd have spent every day being subjected to transphobic abuse, like most trans people are.

Blockers saved me from that fate. They buy you time, if you are uncertain, they stop hugely distressing and unwanted changes from occurring to your body, and they hopefully buy the adults in your life time to get over the worst of their own prejudices.

It is extremely difficult to articulate quite how important they are to an early-mid teenager struggling with trans issues.

I'm so sad that Kiera Bell has had such a rough ride, but it was her ride to have and her decisions were hers to make. She's living proof that gender is complicated and people can make decisions they later come to regret even despite the best efforts of healthcare providers to protect them. Even back at the turn of the millennium we knew about the tiny proportion of people who experience regret after transition - and this was very much a subject of active discussion at every appointment, and likewise at Mermaids meetings back when we were a tiny little bunch operating out of a small conference centre. It was pretty clear that someone like Kiera Bell was going to somehow manage to make it through the system and screw their life up one day, and we'd been bracing ourselves for the resultant hand-wringing moral panic for years. Seeing her case used as an attack platform was disappointing, but not unexpected.

Hopefully now that we've gotten the reactionary backlash out of the way, we'll be able to open up more frank and honest discussions on the subject. Gender is certainly complicated - more complicated than it might seem for those who experience it as a singular point or a straight line, and for everyone who has a relatively clear-cut journey, there will be someone who doesn't.

It would be really, really nice if we could have these conversations openly - as while the data might not exist, the people absolutely do - but most of us can't afford to come out of the woodwork and risk having our lives exploded and subject to harassment. The workplace is often still incredibly hostile, and people get creepy, intrusive and obsessive about our existence when they find out that we used to walk a different road.

We escaped all that decades ago. Why would we want to go back to having an easily attackable, visible presence now, just to provide a counter point to something that we know shouldn't even have to be said?

Of course, that's rather the point, isn't it? If we can't talk for fear of attracting abuse, then what we have to say doesn't get said. Which is awfully convenient for those with a vested interest in making sure we remain silent on the subject of the narrative of our own lives.

So I applaud Kiera Bell for talking about her experiences - they need to be known and discussed, and it is devastatingly important that she did so. However, the way her story has been hijacked as a wholesale attack on the treatment lifeline for trans kids - the singular point of salvation; the critical factor that lets us escape a lifetime of abuse - is, while entirely predictable, also hugely disappointing. Especially as she didn't even start blockers until she was 16. The original ruling, thus, doesn't even cover cases like hers anyway. The entire premise was always flawed, and it isn't remotely surprising that the appeal was successful.

Fitt · 20/09/2021 15:57

Interesting contrast there. The 18 year old who died is only useful to people wanting to complain his death provides for "hand wringing moral panic".

ButterflyHatched · 20/09/2021 16:17

I almost died while skiing when I was 15, and a sizeable number of 15 year olds do every year. I have a lifelong knee injury from it, due to a damaged ligament, and have had to have repeated physiotherapy due to it. I don't think we should ban 15 year olds from skiing, however. Rather, we should be seeing what we can do to make it safer.

EdgeOfACoin · 20/09/2021 16:27

Butterfly, what would you have had to worry about from the original Keira Bell ruling? It sounds as though you would have been a suitable candidate for transition.

Are cases like Keira Bell's unfortunate but acceptable, in your eyes?

ditalini · 20/09/2021 16:41

Butterflyhatched what do you think that people like Kiera, ie females with gender dysphoria, have to benefit from blockers?

You benefited from not being exposed to testosterone which as we all know is a hell of a hormone with all sorts of irreversible effects on the body.

Females are generally more successful at "passing" because of the effect of testosterone on their bodies at any age. Due to the earlier start of puberty in girls, they often still need mastectomies whether they have blockers or not.

Kiera has been irreversibly masculinised by testosterone. She could just have easily had that virilisation 10 years later.

Do you think, especially with the spike in female referrals in adolescence to GIDS that more caution should be exercised in females due to the fact that treatment does not have the same risk/benefit ratio?

Fitt · 20/09/2021 16:54

So if it's the equivalent of ski deaths why do you choose to describe people who would rather their children did not take the risk of surgery as "moral" panic? You mentioned earlier that it's prejudiced, but I agree with you that it's simply a high risk thing to do, I don't think that because of prejudice, I think it because it clearly causes, deaths, complications, and lifelong physical impacts which parents recognise.

What's "moral" or "prejudiced" about being able to assess risk?

I think you reveal your own prejudice about people that don't want their children taking these risks.

FlyingOink · 20/09/2021 17:07

@ditalini

Butterflyhatched what do you think that people like Kiera, ie females with gender dysphoria, have to benefit from blockers?

You benefited from not being exposed to testosterone which as we all know is a hell of a hormone with all sorts of irreversible effects on the body.

Females are generally more successful at "passing" because of the effect of testosterone on their bodies at any age. Due to the earlier start of puberty in girls, they often still need mastectomies whether they have blockers or not.

Kiera has been irreversibly masculinised by testosterone. She could just have easily had that virilisation 10 years later.

Do you think, especially with the spike in female referrals in adolescence to GIDS that more caution should be exercised in females due to the fact that treatment does not have the same risk/benefit ratio?

Bloody good question
ButterflyHatched · 20/09/2021 17:19

There's nothing acceptable about people suffering gender dysphoria, for whatever reason. It's horrible.

To go through that journey and then find you still experience it, or that it actually made it worse? Yeah, that's mind-screaming levels of horror that are very tough to even imagine.

I'm so sorry for her - hers is an incredibly difficult position to be in. One we desperately need to better understand.

There is no such thing as 'acceptable' here, to be clear. She isn't some kind of necessary sacrifice placed upon the altar of gender ideology.

It is important to have a sense of perspective, however, and I can only speak for my own experiences and those of others who were going through the same journey at the same time, but we were all acutely cognizant of the stark reality of our situation, caught as it was between the ever advancing misery of an unwanted puberty and the knowledge that getting it wrong - pursuing an experimental line of treatment with unknown long term effects that, if not immediately, then eventually would have severe and irreversible consequences - would be a monumentally awful place to be in if it turned out to be the wrong one.

It's an enormous amount of pressure to put on a child, but kids are smarter than we give them credit for, and we ask them to make several similarly life-changing, monumental decisions at around the same time.

We were under no illusions as to the nature of the decision we were making. We weren't hurried off down some experimental treatment pathway at the behest of irresponsible medical staff - it was up to us to request treatment and, broadly, their job to say no until they were convinced we were capable of making an informed decision. From there, we were allowed to proceed to see an endocrinologist in conjunction with the psychiatric staff, and discuss our options. Every step of the way was measured, cautious, careful and responsible.

It was a known quantity even back then that it was possible for confused and unsettled kids to arrive in the same place as us. You could often tell they were unsure; that they were struggling with all sorts of other issues that could superficially present as gender dysphoria. Sadness isn't exactly a uniquely trans experience, after all. Some of them seem to have later decided to transition, and now desperately wish they had done so earlier. Others seem glad they didn't. The numbers, however, were so small to begin with and we are living in a world that fundamentally understands and handles transness differently.

I don't envy the task of the GIDS team nowadays in trying to navigate that world while fighting against the background noise of an internet full of the decades-old strata of what has at times been quite a poisonous community, especially when their capacity to actually provide a useful service to the people who need it is severely impacted by funding and resourcing constraints. Cries to defund or dissolve GIDS are utterly perplexing to me; I'm honestly not sure what reality the people baying for blood think we live in, but it certainly isn't one where what we need is less support for young people in this situation.

Awiltu · 20/09/2021 17:30

ButterflyHatched
I'm so sad that Kiera Bell has had such a rough ride, but it was her ride to have and her decisions were hers to make. She's living proof that gender is complicated and people can make decisions they later come to regret even despite the best efforts of healthcare providers to protect them.

I think what people are querying is whether the healthcare currently being provided really meets the criteria of "best efforts".

FlyingOink · 20/09/2021 17:35

kids are smarter than we give them credit for, and we ask them to make several similarly life-changing, monumental decisions at around the same time
No we don't?

FlyingOink · 20/09/2021 17:36

"Which GCSEs do you want to pick" is not the same as "are you OK never having sex your whole life". Ffs

FlyingOink · 20/09/2021 17:38

As one of the early GIDS trans kids who went on blockers for several years in her mid teens back at the turn of the millennium
And this was definitely prior to the massive explosion in numbers.

OvaHere · 20/09/2021 17:50

I don't think we can compare twenty years ago with now.

It was before the internet was in every household, before social media, before smart phones, before the explosion of internet porn, before Susie Green took over Mermaids and threw out the watchful waiting approach, before Reddit subs existed to convince vulnerable people they are 'eggs' waiting to be hatched.

I could go on but that's the gist. Even having gender dysphoria is considered gatekeeping and unnecessary by some activists.

An increase of several thousand percent in girls presenting at gender clinics almost certainly means that down the line the percentage of regret is going to vastly increase.

I think very few of the old clinical guidelines are up to handling what is currently going on, especially with girls.

ButterflyHatched · 20/09/2021 17:58

@Fitt

So if it's the equivalent of ski deaths why do you choose to describe people who would rather their children did not take the risk of surgery as "moral" panic? You mentioned earlier that it's prejudiced, but I agree with you that it's simply a high risk thing to do, I don't think that because of prejudice, I think it because it clearly causes, deaths, complications, and lifelong physical impacts which parents recognise.

What's "moral" or "prejudiced" about being able to assess risk?

I think you reveal your own prejudice about people that don't want their children taking these risks.

Fundamentally, it's -never- your decision. Nobody gets surgery prior to 18. Realistically, due to the grotesque state of waiting lists, nobody gets it until they're at least 21 via the NHS, and generally much, much later. I had mine at 24, and even this was as a 'straight line, no messing about' patient who was seamlessly handed off from Middlesex to Charing Cross at 18. Navigating university with male genitalia in an explicitly lethally hostile world was an experience I wouldn't wish on anyone, but there was no other option.

I was ace at uni, but largely as a survival mechanism. You're stuck in an awful place where creepy people fetishise you and everyone else assumes you are a creep. I hated it on levels and ways that are difficult to articulate. It's just awful. It was always clear that this was a half and half affair, however. Dysphoria is an internal journey as well as an external one, and much of my misery at that time came from existing completely alone in a world that didn't care to understand and kept asking me why I wasn't behaving 'normally'.

You can't 'protect' your child from pursuing surgical transition, even if you wanted to. Entirely aside from whether you should try or not, by the time they are 18, it isn't a matter you get to make the decision on. They do.

What you can do, however, is help serve as their guide before this point.

I think it's important to interrogate feelings as monumental as these and ensure they are coming from a healthy place of self-awareness and informed and competent consent, but your child -cannot- get surgery before 18.

FlyingOink · 20/09/2021 18:07

ButterflyHatched is any of that relevant then, seeing as you rightly point out surgery isn't available and you aren't talking about blockers and the health issues that come with them, or why girls are put on blockers at all, as a previous poster asked?

Waitwhat23 · 20/09/2021 18:10

Some pp's have made a good point. Is early transitioning primarily for the benefit of males? Are there different considerations for females who wish to transition and is early transitioning in their best interest? Given the huge spike in girls wishing to transition, one would hope that this is being considered closely (particularly given the seemingly easy accessibility to puberty blockers).

Tibtom · 20/09/2021 18:11

but your child -cannot- get surgery before 18.

And yet it seems in Scotland you can. The Sandyford clinic has refered 16 year olds for bilateral mastectomies.

FlyingOink · 20/09/2021 18:14

Navigating university with male genitalia in an explicitly lethally hostile world was an experience I wouldn't wish on anyone, but there was no other option.

I was ace at uni, but largely as a survival mechanism. You're stuck in an awful place where creepy people fetishise you and everyone else assumes you are a creep.

And I realise this is very personal, but as you have shared it, presumably you didn't pass at 18? Had you been on blockers? With regard to university being "explicitly lethally hostile", did you get any support from the university re death threats?
If you hadn't been on blockers, do you think they might have helped? If you were on blockers, and presumably then oestrogen as part of the seamless handover, do you believe that the wait for genital surgery was the main problem for you there?

ButterflyHatched · 20/09/2021 18:22

@FlyingOink

"Which GCSEs do you want to pick" is not the same as "are you OK never having sex your whole life". Ffs
Absolutely! One of these decisions has a potentially significant impact on your happiness and future prospects and you'll regret making stupid decisions about later.

The other is about surgical complications. Which can and do happen. And it's horrible that this is the case, but this isn't an issue peculiar to GRS, so much as a general issue with major surgery.

It's important to be realistic and honest about the potential for these things, and communicate them clearly. I've seen some of the language used on here, however, and it is very clear that this is not an environment conductive to that.

FlyingOink · 20/09/2021 18:23

Absolutely! One of these decisions has a potentially significant impact on your happiness and future prospects and you'll regret making stupid decisions about later.

The other is about surgical complications.

Is that supposed to be funny?

Helleofabore · 20/09/2021 18:30

I, too, keep noticing the deflection from the question and it’s relevance to females.

To be fair, I had seen this deflection many times from male transitioners who post on MN. I wonder if maybe it is because they don’t quite understand the unique health risks for female transitioners. Maybe they assume it is the same health risks, I would hate to think that the unique needs of female transitioners are ignored after all.

Waitwhat23 · 20/09/2021 18:33

Lots of hyperbole, lots of deflection...

CharlieParley · 20/09/2021 18:41

Thank you for sharing your perspective with us, ButterflyHatched, and I certainly appreciate the insight into your own journey.

What interests me on reading your posts is the issue that underlies Keira's case. As the pioneers of the Dutch Approach are increasingly at pains to point out, they did not develop the puberty blockers->cross-sex hormones->surgery pathway for children who presented with gender dysphoria in adolescence or as post-adolescents.

From your description, it sounds very much like you were diagnosed before you hit your teens. Keira and the vast majority of girls now presenting in such large numbers at GIDS were not. The Dutch experts are very much saying that those like Keira belong to a different cohort of children with gender dysphoria, and that they never medicalise those children. The same observations about the differences between your group and Keira's were made by the specialist doctors working at the Karolinska Institute in Sweden. And yet, you say this:

"Even back at the turn of the millennium we knew about the tiny proportion of people who experience regret after transition - and this was very much a subject of active discussion at every appointment, and likewise at Mermaids meetings back when we were a tiny little bunch operating out of a small conference centre. It was pretty clear that someone like Kiera Bell was going to somehow manage to make it through the system and screw their life up one day, and we'd been bracing ourselves for the resultant hand-wringing moral panic for years."

Are you unaware of this difference or do you not believe there is a meaningful difference between children who first present in early childhood and those who present after puberty has already started?

Don't get me wrong, I don't believe the Dutch Protocol should be used with your cohort either. But in any case, there is an issue with how it has been implemented in the UK anyway, given that the Dutch protocol places a much higher emphasis on psychological assessment and treatment than is the case here. This is intended to avoid medicalising those who would desist. Keira reports having had neither a thorough psychological assessment nor treatment, which she has come to believe would have prevented her being medicalise in the first place.

Do you believe GIDS should place more emphasis on this part of the Dutch Protocol?

Until recently the Dutch experts believed they had found the magic bullet, but a new understanding of puberty itself being the mechanism that allows desistance has seen them - very tentatively - starting to question their whole approach.

What is your view on the advisability of blocking puberty if it is confirmed that doing so prevents desistance?