Tavistock clinic to close as not safe for children

[GettingMarriedAgain]

Breaking news in the Times and Telegraph:

www.thetimes.co.uk/article/e1ed2bea-0e63-11ed-93cf-b011fa7fe86b?shareToken=4fa557c3083dee141defde72e0e53d54

Sorry, crossposted.

And those lawsuits represent 1000 damaged young people and potentially ruined young lives, not to mention 1000 heartbroken, traumatised families, and we know that's the tip of the iceberg. That's hit home for me in a way it never has before, how the hell has this been allowed to happen?

'How the hell has this been allowed to happen?'

Yes, this is a question that I would very much like those involved to answer. hopefully the class action will unearth this.

Yes, just saw Glinner had posted this. Thanks to Keira, David Bell, Sonia Appleby, and everyone else who helped this moment to arrive.

I agree, it is the thinking I that you have autism/Tourette/s/wrong gender, that is the key. However I don’t think services are robust enough not to valid these, as there is so much pressure. The autism diagnosis is now so stretched, with many new cases presenting as teenagers. Many who have watched TikTok influencers, and now think they have tourettes’ are overwhelming services who do not feel that they can just turn them away so it now has a new name, functional tics.

I agree very much that so called ‘classic’ autism or ‘classic’ tics, are nothing to do with social contagion. They develop before social media is even accessed in earlier childhood.

My point is that we have not looked squarely at this relatively new phenomenon, teenagers, mainly girls, who are now presenting at clinics wanting diagnosis or wanting specific medical treatments. Wanting validation. It is very interesting that in Dr Cass’s report, the huge explosion of numbers is teenage girls.

Wow is that really 1000 families?

Because that is a very high percentage of unhappy families, as it’s around 1,500 a year isn’t it? (I might be wrong). Anyhow that really shows a very worrying number of distressed and unhappy kids.

I agree with what you're saying to some extent, that there are lots of people "identifying into" ASD, Tourette's, and also ADHD and a few other things.

However, I think they differ from some other conditions in that while you can actually to some extent "think yourself into" psychological difficulties like disordered eating, body hatred, low mood, anxiety, gender discomfort, self harm, functional tics, and various other psychological problems which may or may not reach a diagnostic threshold for a mental disorder, you can only either be right or wrong about having neurological or neurodevelopmental disorders like ASD or Tourette's (disregarding controversies about diagnostic thresholds and categorisation) — you can't think yourself into having them.

That makes the issue slightly less complex for ASD and Tourette's — you only need to look at the stringency, thoroughness and accuracy of diagnostic services, make sure they are capable of distinguishing genuine neurological or neurodevelopmental cases from those where something else (psychological or social) is going on instead, and talk about whether thresholds should be made higher or lower or kept the same. Whereas with things which you can, to some extent, "think yourself into", it gets more difficult to distinguish between cases on the basis of etiology, and may not be as important as distinguishing between, say, Tourette's and functional tics, where the treatment should be quite different.

@ClumpingBambooIsALie I don't think there is such a clearcut difference. You can talk yourself into the symptoms of just about anything. All these conditions are determined by observing patterns of symptoms, there is no physical neurological test for ASC or ADHD (I don't know about Tourette's)

One significant reason why it's so hard to diagnose "genuine" gender dysphoria versus social contagion or other distress, is a political dimension that doesn't exist with these other conditions. There has been effective lobbying to stop parents and clinicians from organisations that are ferociously determined to stop them from considering alternatives.

There is no equivalent accusation for "transphobia" to throw at a parent or a clinician who questions whether a child who has meltdowns really has autism. Though ironically it's even more critical to get the diagnosis for gender dysphoria right. There is no medical intervention for autism, and certainly not one that can destroy a young person's reproductive and sexual capacities for life.

I am not so sure you can say there is not a political dimension to autism and ADHD. The online 'autism community' acts very similarly to the TRA one in response to criticism with accusations of 'ablism' instead of transphobia and condemning 'autism moms' (nearly always moms - who ironically may be autistic themselves). I suspect there is a large overlap between the online autism community and TRA's.

Several autistic people have commented that self-identified autistics are skewing research and research priorities.

@AmaryllisNightAndDay I understand what you're saying, in that it's not totally clear-cut and you can develop symptoms that look like all kinds of disorders, but I'm making the distinction between disorders where social contagion can actually cause more genuine cases, and disorders where social contagion or other social factors can only cause the impression that there are more cases.

There are disorders where genuine cases of the disorder become more common due to social contagion, such as bulimia.

But there's no way that social contagion can cause genuine cases of autism or Tourette's to become more common via the same mechanisms. It can cause more people to show symptoms that appear similar, but those aren't genuine cases — with tics, those would, if correctly assessed, be diagnosed as functional tics rather than Tourette's. I don't know how you'd define it with somebody showing autism-like traits due to social factors, but there are doubtless ways a skilled assessor would pick it up. I'm sure there are less-skilled assessors incorrectly diagnosing Tourette's, ASD and ADHD in people who are displaying their symptoms due to social contagion, but those are incorrect diagnoses, not social contagion causing autism/Tourette's. Social factors can also result in genuine cases being identified that might have previously flown under the radar.

It's an open question, I think, what category gender dysphoria fits into (or whether it fits an in-between category, or both things are going on, or another thing altogether).

Also, I agree with @Lovelyricepudding — five minutes in the #actuallyautistic community would disabuse you of the "lack of a political dimension" idea. And there's basically a whole parallel self-ID thing going on there which is a bloody nightmare.

You don't need to spend much time in child mental health services to realise the idea of skilled assessors, looking holistically at children, with a range of interventions for differing presentations is just a mirage the general public still hold about what mental health services can do.

Waiting lists are long, clinicians are under huge pressure from many different groups, assessments are brief, there are different pathways for different difficulties, not holistic services, interventions are minimal, discharge is rapid, the range of options open is limited, impact of involvement with mental health services is often negative and reinforcing.

We need to wake up to the reality of what mental health services can do and look further upstream at why so many children are distressed.

The answer (for many) is the culture not in medical professionals.

Yes but this is a case of different opinions, not 'pretending', which is something TRAs would, and have said.

Seems an odd leap to make. Assuming would have been better but hey ho. The rest of her post made sense and put her into the GC camp. Personally, I am more for encouraging like-minded sisters than slapping them down for poor word choice.

There is also a ferocious attempt to avoid any way to focus on autistic individuals with higher levels of need. A bit like TRA's false teaming of T and LGB - though easier as there isn't a clear cut line. People who have lived independent lives, family, kids, careers, houses shout down anyone who attempts to distinguish those with higher levels of need (unable to self care, needing 2:1 support to leave the house, non verbal, maybe learning disability, lack of danger awareness, etc). 'Low functioning'/'classic'/'high level of need'/'profound' are all condemned because, as a clip of an autistic comedian doing a one woman tour to full houses declares 'she can be low functioning too'.

Language is also policed 'autistic' vs 'with autism'. A few years ago NAS reported a survey on language use. It asked what language was preferred - the most popular response was 'autistic' reported as such. What they failed to report was only 22% of autistic respondents chose this - 78% chose a different response with 'with autism' getting 19% (other responses were at similar levels including 'Aspie' and 'on the spectrum'). Since them there has been an ongoing push for identity-first language as opposed to person-first with just a flimsy nod to 'if that is what they want to call themselves but they are wrong So like transideology it is a focus on identity.

There is also a ferocious attempt to avoid any way to focus on autistic individuals with higher levels of need. A bit like TRA's false teaming of T and LGB - though easier as there isn't a clear cut line.
…
Language is also policed 'autistic' vs 'with autism'. A few years ago NAS reported a survey on language use. It asked what language was preferred - the most popular response was 'autistic' reported as such. What they failed to report was only 22% of autistic respondents chose this

Gah, I was in a meeting recently with several people who policed language like this and told us that it must be "autistic" as that was the term preferred by the 'real community' (to which they reported that they belonged).

Absolutely.

Many of the children I've taught over the last decade and a half don't know they have autism.

Their needs are profound.

The scrum over language is irrelevant and actually, privileged.

There is also a ferocious attempt to avoid any way to focus on autistic individuals with higher levels of need. A bit like TRA's false teaming of T and LGB - though easier as there isn't a clear cut line.

A good recent article on this topic by Freddie de Boer that got a lot of attention.

The Gentrification of Disability

More, though, I cannot comprehend the arrogance of the woman who led the charge against the panel at Harvard, Kris King, to sit on her perch at the most exclusive university in the world and declare for the entire autistic community what autism is and means. It’s unsurprising that she’s disdainful of the need for treatment, given that she’s so high-functioning that she’s flourishing at an Ivy League university. She will never live the life that mother I knew lived. She will likely never care for someone whose autism has devastated them, robbed them of their ability to have conventional human relationships, to have a career, to be in love. Such debilitated people and their families will never have the cultural influence of a self-promoting Harvard student and so they’re simply read out of the conversation. Meanwhile autism activists and advocates make sweeping pronouncements about the lives of people they don’t know and could never understand.

[...]

This is a dynamic I now cannot stop seeing: once a human attribute like autism or mental illness becomes seen as an identity marker that is useful for social positioning among the chattering class, the conversation about that attribute inevitably becomes fixated on those among that chattering class. It becomes impossible to escape their immense social gravity. The culture of that attribute becomes distorted and bent towards the interests and biases of those who enjoy the privilege of holding society’s microphone. Because you must be able to effectively communicate to take part in the conversation, and because all of the usual privileges of class and circumstance influence whose voice sounds the loudest, the discussion becomes just another playground for college-educated urbanites. To speak you must be able to speak, literally, and you must also enjoy the privileges of communicative competence and educated-class signaling mechanisms. So we will always tend toward a conversation that defaults to the interests of the least afflicted. This is inevitable; it’s baked into the system.

And I guess the mechanism Freddie describes:

So we will always tend toward a conversation that defaults to the interests of the least afflicted. This is inevitable; it’s baked into the system.

also perfectly describes the LGBTQ failure. LGBTQ will automatically default to the interests of the least afflicted in that group - the straight males.

@MalagaNights — I've been under NHS mental health services since I was 15; I'm only too aware from my own experience and the experiences of many other fellow travellers that they're utterly shit an awful lot of the time.

I'm only trying to make a distinction between conditions that can be caused by social contagion, and conditions that can only be mimicked by social contagion (possibly successfully enough to fool a less-skilled or very stretched clinician — I know only too well how fallible psychiatric diagnosis is). Eating disorders or self-harming or functional tics or a self-identification as "autistic" or non-binary can rip through, say, a girls' boarding school. Social contagion can cause people to develop genuine bulimia who wouldn't otherwise have developed bulimia. Actual genuine cases of autism can't be caused by social contagion, unless it can somehow reach back in time and create the signs of neurodevelopmental disorder in those girls when they were younger.

I have done a few of the online autism tests and find I am somewhere between borderline and 'in the ballpark'.

I don't think I have autism. I think I am just an extreme introvert with anti-social tendencies and a keen curiosity about 'things' as well as a dogged determinism to prove I am right (and I care more about this than being popular). Also, I rarely trust popular people (based on experience).

It seems to me that the tests are written with an 'ideal human' in mind who is out of some glowing magazine; they are social, love company, the life of the party, empathetic, have a zillion friends but really don't think terribly deeply.

Maybe they are the friendly puppy to my grumpy old cat.

It seems to me that the tests are written with an 'ideal human' in mind who is out of some glowing magazine; they are social, love company, the life of the party, empathetic, have a zillion friends but really don't think terribly deeply.

And who also buy computers and cars without being interested in their technical capabilities.

I mean seriously. Is there a human being on the planet who buys a car and doesn't want to know its engine capacity?

(Admittedly, these are from the EQ/SQ test, not specifically an autism screening test, though EQ/SQ came out of autism research as part of the extreme male brain theory of autism.)

I'm making the distinction between disorders where social contagion can actually cause more genuine cases, and disorders where social contagion or other social factors can only cause the impression that there are more cases.

Hm I think see what you mean, if you decide not to eat you can permanently affect your appetite. Whereas it would be hard to give yourself autism or ADHD.

There's a separate question about social contagion. I don't know why behaviour associated with autism and indeed homosexuality doesn't seem to be subject to social contagion (or at least it hasn't been so far!) whereas behaviour associated with gender dysphoria (and anorexia) does.

I do think that the insistence that gender dysphoria can't be the result of social contagion is partly because fears about social contagion for homosexuality were unfounded and were mostly based on prejudice. When peple say "isn't it just like Section 28?" I want to answer that the rhetoric may sound the same, the facts aren't!

I am not so sure you can say there is not a political dimension to autism and ADHD

I am not trying to say that. I know that there is a political dimension but it is not on the same scale and doesn't have the same power to affect careers and government policies and professional attitudes to parents.

Parents who don't instantly accept an ASC diagnosis don't get the same attacks from professionals (the internet is a different story). It's assumed that parents need time to accept and to grieve, it's accepted that they are going to be doing the care, and they're expected to worry about the effects of interventions and to question whether they're right for their child. They are not told by people in authority well you have transphobia so we'll carry on without you and if you make too much fuss there's always the care system.

I could definitely see a situation where in a society which sees homosexual behaviour as unacceptable, some homosexual people but especially bisexual people might choose not to act on their same-sex attraction or perhaps even acknowledge that it exists, whereas in a society where homosexual behaviour is fine, homosexual and bisexual people wouldn't suppress that attraction or behaviour, so it could look like there's a lot more homosexuality about.

And especially with the bisexual people, that could look like social contagion, because in the former society, they may well be in perfectly happy heterosexual relationships and never have any homosexual relationships, while in the latter they're also/instead having homosexual relationships.

So it's hard to say that just because a behaviour is increasing, it must be social contagion — in this situation, it's an underlying change in social acceptability that's causing the increase in (or increase in visibility of) the behaviour, rather than a strict social contagion thing. Which is of course what the trans activists are trying to argue is happening with the huge increase in teenage girls being referred to gender clinics.