Public Consultation - Interim Service Spec for Specialist Gender Dysphoria Services for Children/Young People

[rogdmum]

This is what was leaked by Reuters last week and is now live:

www.engage.england.nhs.uk/specialised-commissioning/gender-dysphoria-services/

There’s a fair chunk on social transition on pages 15/16:

”Not all adolescents will want or benefit from social transition. The provision of approaches to support social transition may be considered in cases where:
• Gender dysphoria has been diagnosed, is consistent and persistent; AND
• Associated needs and risks have been considered and are being addressed
or supported; AND
• The young person expresses a clear wish to affirm their gender transition and fully understands the implications of affirming a social transition (informed consent); AND
• The proposed clinical approach is necessary for the alleviation, or prevention of, clinically significant distress or impairment in social functioning in the individual.

In these cases the clinical approach will involve a focus on exploring or supporting (as appropriate to the individual) social transition through psychological support and interventions, family work/therapy and guidance for the local professional network”

And what Reuters reported on accessing prescriptions from online/unregulated providers is included (page 16)

”Prescribing from unregulated sources and unregulated providers
Children, young people and their families are strongly discouraged from sourcing GnRHa and masculinising / feminising hormone drugs from unregulated sources or from on-line providers that are not regulated by UK regulatory bodies. In such cases The Service will make the child or young person and their family aware of the risks, contraindications and any irreversible or partly reversible effects of the drugs and will advise the GP to initiate local safeguarding protocols.”

Yes. I've seen school policies which make the Equality Act do a lot of heavy lifting to say that schools must sociall transition children because gender reassignment is a protected characteristic. This blows that out of the water.

That very interesting.

I'm starting to think that it's the nhs getting their house in order first and then guidance, including strict, clear safeguarding rules, can be set out for schools.

Education is terrible for hashing up evidenced research and misinterpreting / diluting it down so that it actually does the opposite (eg; mindfulness, mindset).

Get it set in stone in clinical practice and both SS and schools are duty bound to follow.

Schools have become notoriously bad at "diagnosing" children with all sorts of things and this is one area where they do it a lot.

I was told in my first ever school over 20 years ago we should never mention potential diagnoses with parents and really between ourselves, discuss the behaviour / symptoms and strategies first and then refer on to the actual professionals.

But that's gender identity for you. Self diagnosed (narcissism.)

Yes, especially around toilets/changing/residentials etc.

Really good to see this so explicitly laid out. By being clear that this is not a 'no go' area legally, schools and parents can have much more open conversations around accomodating conflicting needs.

Valancy I’ll be interested to see the EHRC’s response (if any) to NHSE’s statement. It is often their Technical Guidance to Schools that schools fall back in as justification for immediately and unquestioningly supporting a child’s social transition regardless of age or whether their parents know.

www.equalityhumanrights.com/en/publication-download/technical-guidance-schools-england

I know the DfE are working on their new guidelines with the EHRC providing input. Will be interesting to see how the NHSE information is incorporated. If the EHRC alters their stance to acknowledge NHSE concerns, I hope they also withdraw the GR sections within their Scottish Technical Guidance to Schools as at the moment, Scottish children are being left well behind their English/Welsh counterparts.

The thing is that it so obviously ties into the other aspects of school safeguarding, particularly around child on child abuse (Single sex facilities being a necessary biggie there), online harms, extremism and self harm.

This is an interesting response. Apologies if already posted ourduty.group/2022/10/23/response-to-proposed-nhs-interim-service-specification/

OP, thought this might be of interest, wrt Scotland in case you hadn't seen it (from a Conservative MSP):

'The Scottish Conservatives have called for a public inquiry to be held into the increase in children being referred to the Sandyford Sexual Health Service for gender dysphoria. Almost 1,000 children are on the waiting list for their first appointment with this service, including 86 pre-pubescent children. In addition, child referrals to the service increased fifteen-fold from 2013 to 2019. It is essential that an inquiry is taken forward to ensure that the appropriate safeguards for vulnerable children are in place.'

In today's Times:

Most trans children just going through a phase, advises NHS

www.thetimes.co.uk/article/c15dc8da-53d2-11ed-b965-3a5f647316f8?shareToken=bf4a15aa84709162649cb9b0d36bd1ba

Magnolia The Scottish Conservatives are good at grand public statements, showing up at rallies to get their photo taken and posting on Twitter. They are hopeless at any practical help and have either completely ignored my specific requests for help or brushed me off until I called them out on Twitter (and then the help has been limited to a couple of letters sent to ministers with obvious irritation/reluctance). I’ve spent several years now trying to get them to engage on a practical level with no success. Murdo Fraser genuinely cares about the issue, I think (as does one other but who I don’t think would thank me for naming him!) but the rest are just in it for show.

(oops wrong thread, sorry!)

Ah. That's disappointing, rogdmum.

Bumping to remind everyone to fill in the consultation.

Also, I'm concerned it's actually quite woolly on social transition of adolescents. I think Transgender Trend's interpretation is overly optimistic:

"for adolescents the provision of approaches for social transition should only be
considered where the approach is necessary for the alleviation of, or prevention of, clinically significant distress or significant impairment in social functioning and the young person is able to fully comprehend the implications of affirming a social transition."

Most trans identifying teens and scared parents/teachers (having read the suicide 'stats') would probably argue strongly that they/their child meet this criteria and therefore should be socially transitioned.

Oh my goodness rogdmum. That document is awful. Full on self-id for children. Thanks for alerting me to it. I feel quite scared now that my school will cast it up to me. I was feeling pretty confident the law was on my side but not in that document!

What's crazy is we now have utterly conflicting definitions of the characteristic of gender reassignment. Aaarrrgh.

How about building in an opportunity for detransitioners who've been through this process and know what really happens to minds and bodies on hormones and blockers to be a part of the process. Perhaps there need to be group meetings where they can talk about their experience to young people considering proceeding — not to put them off, but to talk peer-to-peer about the reality. Because they know better than the clinicians what happens.

Mermaids "aren't happy with some of the changes that have been proposed and will be sharing our concerns with the NHS." See this thread:

https://twitter.com/mermaidsgender/status/1588511777154662402?s=46&t=aa_MWySxSwaspxDekrWXSlw

Bumpety bump now today's thread has gone to chat. Please everyone respond to this before 4th December.

I've just heard from OurDuty that their guidance for responding is being finalised and will be out this weekend. I'll post the link here when I get it.

Thanks, Valancy.

Transgender Trend just put up their response:

www.transgendertrend.com/nhs-interim-service-specification-consultation/

twitter.com/transgendertrd/status/1593994755708710912?s=46&t=FKYhmwfHR3wMr60G0e2Stg

Thanks Rex. It's spot on. Very clear and thorough- as expected.
Did mine a while ago. Wish I'd waited for this, although I got most of the broad points I think

Agreed - that's an outstanding response (as you'd expect) from TT.
Informed, articulate and nuanced - and insisting that the middle aged male activists who have had so much success in using children (especially teenage girls) for their own ends, should have no business in determining the future of the new services for children.

These responses are so helpful. Thanks for the share.

Thanks for sharing TT's response. It's imperative that as many of us as possible respond before 3rd December. I'm concerned this isn't getting the traction it deserves on this board.

It's also imperative to answer disagree to Q4 if you are concerned about the social transition of teenagers.