Times gender laws article removed

[BonfireLady]

Did anyone see this article before it got removed? Normally the Times has been great at covering gender related topics so I was surprised to see it had been pulled. Is it available anywhere else?

I just searched for it in the times app but no joy. Did you get to read any of it?

Sadly not. This is the field I'm particularly interested in (teenage girls with autism who present with gender incongruence/ROGD to be more specific) and this looks like it would have been an interesting read.

I found it had been archived here. Curious that it was removed from The Times website.

@Genesis1v27 thank you!
Yes, very odd. It makes me wonder what's in it?! I shall have a read with a cup of coffee before work.

A very interesting read. I wonder if it was just ahead of its time in the challenges it throws up? Perhaps we're close, but not close enough, to gender dysphoria being recognised by the medical profession as a mental health condition?
I've been doing a lot of research in this subject and what is being called out in the article makes a lot of sense from what I have seen.

Thank you for the archive, odd it was pulled. Is about Irish laws though so perhaps something sensitive was said? It may come in a later edition?

Is there a difference between dysmorphia and dysphoria, I always assumed the former was a typo., but she seems to use them interchangeably.

I wonder if the article was pulled because of the second part, concerning the death of the baby. It seems that is litigation that is ongoing. I can't see anything in the first bit that I haven't recently read elsewhere.

Is everyone able to open the 'archive' link because I am not?

I can. I'm on the iPhone App.

I think that dysmorphia is a sense of unease with one's physical shape, whereas dysphoria is a sense of unease with an intangible attribute. So a gender dysmorphic girl might be deeply troubled by the physical changes in her body during puberty, whereas a gender dysphoric girl might be deeply troubled by the fact that she loves engines and does not know how to wear makeup and is judged for being like this.

@JellySaurus and @IcakethereforeIam I agree it's very similar to other previous articles but I thought the use of dysmorphia was interesting. Particularly as the Cass Review talks about the important distinction between gender incongruence (more on the dysmorphia end of things) and gender dysphoria. Perhaps it's a prising open of nuances that allow for better discussion?
An adolescent who is presenting gender incongruous could be given access to talking therapy to understand why, without (I hope) the "conversion therapy" accusation.
Then maybe gender dysphoria can be looked at separately.

I still think both are mental illnesses and deserve compassion. I guess the logical goal of therapy for gender incongruence/dysmorphia is to help the person accept their body (e.g. puberty distress following trauma or linked to autism reaction to body changing).

Whereas the "goal" for the treatment of gender dysphoria is more open: from a "first do no harm" angle, it would be acceptance as above but if that's not possible then next would be "living as the opposite sex" (we're lucky as women that we can wear trousers etc without that even being necessary but sadly men who wear dresses don't get that acceptance), then as a last resort, hormones and surgery.

If it can be broken apart like this, the debate may be easier. Perhaps. It's clearly a charged subject no matter how you look at it.

Urrgh. Terrible grammar. Multi-tasking while cooking dinner. Hopefully intelligible 😬🙃

A very interesting article. Is there any news on the models that the new regional centres will be ran on once the Tavistock closes? Are we seeing the end of the affirmation model?

Regarding the difference between body dysmorphia and dysphoria: I think the former is the anorexic looking in the mirror and seeing a fat person looking back at them: their perception of their physical self is faulty.

Whereas someone with dysphoria looks in the mirror, sees what is really there and is extremely distressed by it.

Have you seen the Interim Service Specification document? This sets out what the new service will look like at a high level. Does this link work?

It was briefly in the public domain but it got pulled down because of feedback from existing front line services like CAMHS and GPs saying that they couldn't understand how they fitted in to it (the response to consultation on draft interim service specification Response to the NHS from the Cass Review provides the context for why it got pulled back), so my understanding is that this shaping is still in progress. But priority 1 is research in to puberty blockers.

This sounds like a great explanation to me. Minor disclaimer: I'm no expert, I have just read a LOT of stuff in this whole field.

Thank you for that link. It is very helpful and encouraging that there appears to be a recognition that dysphoria/dysmorphia may not be something that appears in isolation and there may be other factors which need to be explored too.

The Interim Service Specifications are currently under consultation. They were open to the public for comment between 20 October and 4 December. Full details are here:

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

We’re now waiting for the final specs following the consultation.

People with Body Dysmorphic Disorder also experience body dysmorphia. With BDD the person focuses on on small "defects" in appearance. These can either be real or imagined. The defects are often not noticeable or barely noticeable to others. But to the person with BDD they cause significant distress which is disproportionate to the "defect" in question.

So almost a mix of the two as you describe there. Interestingly in BDD, researching cosmetic surgery can be a symptom ie an obsession and is discouraged. As is any cosmetic/surgical treatment which usually worsens the condition (and so anyone seeking cosmetic surgery is usually screened for BDD).

BDD has a high rate of suicide. But noone is suggesting surgery is the answer for people with BDD (in fact they know it isn't as weight loss isn't the answer for people with an eating disorder).

The symptoms seem very similar. Significant distress - anxiety and depression - caused by the way you view your body and appearance - imagined or real.

I do wonder why the treatment pathways are so very different.

Good point. Hopefully this is the only reason that the document is no longer in the public domain.

Very interesting, thank you.

Totally agree re the strange deviation from the standard pathway. It just doesn't seem to make any sense. I can only conclude that it's because gender dysphoria has been classed as not being a mental illness.

I can still see a case for surgery and hormones in cases of dysphoria where all therapeutic pathways that lean towards acceptance of the person's body are exhausted. So separating it out from dysmorphia would still make sense in that respect.

The document is in the public domain. It is in the link I posted above.

You are possibly getting confused by the fact that it was very briefly published (and reported on by Reuters) the week before the consultation opened and then taken down from the NHSE website.

*taken down and then republished on 20 October

”in BDD, researching cosmetic surgery can be a symptom ie an obsession and is discouraged. As is any cosmetic/surgical treatment which usually worsens the condition”

I have periodically read accounts from men who had transitioned, who seemed to be continually worrying about whether they’d be misgendered and said their day/evening/social event could be entirely ruined when it happened. I thought that it would have been much healthier if they could have been encouraged to wear whatever they liked and given support in dealing with any reactions they faced.

Pretending to be female when they were acutely aware the entire time that they were not and that others might “notice” (or more realistically, mention the obvious) seemed like a very uncomfortable experience where they had exchanged discomfort with wearing clothes that others might scorn with something that was actually worse. The paranoia this seemed to create surely represented a worsening of the condition.

👍👍