NHS Gender Medicine: Gay Men's network response - please support if you can

[DennisNoelKavanaghOffTwitter]

Dear Mums,

I hope it's ok for me to post here, as I published the GMN Crown Prosecution Service sex by deception consultation response here and many supported it I want to publish our newest consultation response - this is to the "proposed interim service specifications" for gender care in the UK following the closure of the Tavistock on the basis Dr. Hilary Cass found it to be "not safe". We have long had concerns based on evidence we set out in appendix 1 to our response that the service is institutionally homophobic.

The consultation is available here and it closes 4th December:

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

Our twitter thread is here:

twitter.com/MensNetwork1/status/1596987024611086338?s=20&t=iqarQZVxzz-qUDyqdyUN6A

Our response is here:

static1.squarespace.com/static/6200252604e9795287de2ada/t/6383d9a527b35315f2b2bfaf/1669585318479/GMN+NHS+Consultation+Response.docx.pdf

Our exec summary is this:

Executive Summary

The Gay Men’s Network is a not-for-profit grassroots organisation dedicated to fighting homophobia in all its forms and advocating for the interests of male homosexuals. We have developed this response from the perspective of these primary objectives. We generally welcome the proposed ISS which moves to a multi-disciplinary team approach, medical leadership, and a clear acknowledgement that “watchful waiting”, and not a rush to medicalisation will be the right response for the vast majority of patients. We welcome safeguarding referrals where potentially dangerous drugs like puberty blockers and cross sex hormones are obtained online. We welcome the general move back to a standardised NHS service with normal follow up, record keeping and awareness of the serious ethical issues at play.

We are, however, dismayed that the proposed ISS makes no mention of the serious and malign influence of homophobia in this area. We say lessons must be learned from the past. NHS staff should never be briefing newspapers that their service “feels like gay conversion therapy”. We argue that the proposed ISS should include specific reference to this serious safeguarding and ethical concern. It is apparent that internalised and external homophobia was and is a safeguarding risk in the field of paediatric gender medicine.

The interim Cass review highlighted problems with this field of medicine so serious that the Tavistock was ordered to close. Inappropriate influence by lobby groups, poor record keeping, inadequate general and safeguarding assessment of patients, medicalisation of patients while ignoring co-morbidities were among the many issues addressed. We take the view this was a medical scandal which must never be repeated.

Thank you. I must sit down and write my response

Dear Mr Kavanagh, your response is very clear, polite and utterly damning. I am very interested in the response you receive to publicising your views. May I ask:
Do you keep records of the response/abuse you receive?
Have members of your network suffered negative consequences from speaking publicly on these topics?

This information would be quite useful if it proved that women are indeed punished more than men for speaking out on the issue.

Thank you.

We get nothing like women do to be honest, my mate who runs a lesbian group showed me her DMs on twitter once, all horrible rape threats and porn, I get nothing apart from a few cranks making videos and stuff - so that's anecdotal (but in my experience not unusual) so my impression generally is women get way way more appalling abuse than I do or the lads in GMN (though it may be because people see I'm a lawyer and think twice perhaps)

Dear Mr. Kavanagh,

I'm going to embarrass myself a bit here.

I'm informed enough to realise that I agree with your standpoint, but I can't wade through all your links.

I would very much like to support you.

Can you please make it more clear how I can do that.

Thank you very much for your reply. This is fascinating - I would love to do some in-depth comparisons between your and your lesbian friends experiences.

I'm no Coleen Rooney but it would be interesting for both accounts to tweet the same thing and compare the response. You could even add in a non-lawyer male account to compensate for the lawyer vibes and compare.

People might find the difference quite jaw-dropping - headlines like "Lesbian receives 90% more abuse than gay man for same tweet " can be quite eye-opening!

That's a great idea!

Lesbians getting more abuse than gay men online is a strange one.

There are lesbian footballers in the England team and no-one bats an eyelid (likewise the England women’s cricket team, and tennis down the years with Navratilova, Billie Jean King etc.) In complete contrast, not a single male top division footballer in England (and pretty much anywhere) has ever come out.

A lesbian footballer, Jill Scott, has just won IACGMOOH, and her sexuality is not news. A hint that an anonymous male Premier League footballer is gay (without even disclosing his name) instantly makes the headlines...remember one in last the year which was met with “oh wonder who it is”.

Perhaps an explanation for this difference is the focus on homosexuality is predominantly on males (the coverage tends to be very lopsided, although it must also be taken into account there are double the number of gay men to lesbians) so the greater spotlight makes it a more daunting prospect for males to come out. This greater attention on males and the campaigns against homophobia (rainbow laces/armbands etc.) may also explain why gay men receive less abuse than lesbians online.

So it’s harder for men to come out, but those who are receive less abuse (seems counter intuitive that).

Gender stereotypes around sport and stereotypes about being gay and toxic ideas of masculinity probably also have a lot to do with the sporting examples.

Sport perceived as masculine (because of higher male participation?)
Lesbian women perceived as butch/masculine therefore not challenging the expectations of good sportswomen.
Whereas gay men historically being perceived as more effeminate which may harm perception of their ability at sport (because sexism and homophobia).
Add in how vile abuse directed at footballers over the years WRT racism etc and the lack of role models you can understand how difficult it is for gay footballers to be out.

Historically female sport being a place where gender non-conforming women are expected but male sport doubles down on ideas about heteronormative masculinity conformity. Whereas something like theatre seen more of a safe space for out gay men.

Sorry this is dripping with stereotypes - of course real gay people have the whole range of personalities and gender conformity/non conformity!

Whereas online abuse directed at women with opinions in general is huge so lesbians are getting that plus homophobia, whereas men are expected to have opinions and get a certain level of respect, even if they are also getting some homophobic response too.

Lawyer effect probably also strong on twitter!

Sticking with the point of the original post, that's a fantastic response and sums up a lot of concerns I have.

Hi @DennisNoelKavanaghOffTwitter I don't yet know how to bookmark here so am posting briefly to say hi and solidarity. I'll PM you my real name on FB where we are friends. Best wishes and best of luck with it.

Placemarking to remind myself to respond to the consultation.

I'm supportive of your aims.

I'm shocked but entirely unsurprised to read that your lesbian colleagues get more abuse, of a worse nature. Women in public life do get far, far more abuse; look at Diane Abbot, or JK Rowling, for example.

Abbot gets by far and away the most abuse of all MPs.

I’m really glad that you included this paragraph:

We note with some concern the proposal in the ISS for a research programme into the outcomes of treating gender incongruence/dysphoria with GnRHa hormone analogues and other masculinising/feminising drugs. We feel that this proposal should be subject to public consultation as to how such an exercise could possibly be ethical. It is our view that it cannot be (for further details about the harms of puberty blockers, see Appendix 2).

I totally agree that this cannot be ethical.

My own response to the consultation focused much more on age as a protected characteristic (because that is my area of expertise), and children and young people’s developmental needs. I’m aghast that anyone thinks that interrupting, disrupting or eliminating the important developmental process of puberty could possibly be acceptable (other than where the intervention is to address problems with puberty).

I would write in cases where the child’s life is at risk or physical health are compromised (by issues that can only be addressed through such drugs), but that concept has been so muddied by the spectre of suicide in support of gender medical intervention. Mental distress related to gender dysphoria is a different issue and there are far more
appropriate ways of addressing this that do not deny young people the experience of puberty.

The idea that important parts of human development can or should just be deferred or opted out of is terrifying. It’s the stuff of dystopian novels.

Just a reminder that the closing date for submissions for this consultation is December 4th.
Transgender Trend have a good submission that you can use as a basis:
www.transgendertrend.com/nhs-interim-service-specification-consultation/

I will be emphasising that lobby groups AND clinicians with a 'vested interest' (such as parents with 'transitioning' kids, etc) should not be anywhere near the new service. Also, that Puberty Blockers should not be used AT ALL, not even as part of a 'trial'.

sex-matters.org/posts/updates/response-to-the-nhs-spec/

Sex matters up now too. Between all 3 responses, all key points that need raising are covered well.