Politicised trans groups put children at risk, says expert

https://www.theguardian.com/society/2019/jul/27/trans-lobby-pressure-pushing-young-people-to-transition

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School counsellors and mental health service providers are bowing to pressures from ‘highly politicised’ transgender groups to affirm children’s beliefs that they were born the wrong sex, a leading expert has warned.

Marcus Evans, a psychotherapist and ex-governor of the Tavistock and Portman NHS Foundation Trust, whose Gender Identity Development Service (GIDS) is the only NHS clinic to provide gender counselling and transitioning, said many experts were living in fear of being labelled transphobic, which was having an impact on their objectivity.

“I believe the trans political agenda has encroached on the clinical environment surrounding and within the Gender Identity Development Service,” Evans told the Observer. “Young people need an independent clinical service that has the long-term interests of the patient at heart. To some extent, this requires a capacity to stand up to pressure coming from various sources: from the young person, their family, peer groups, online and social networking pressures and from highly politicised pro-trans groups.”

The number of children referred annually to GIDS has risen from 468 in 2013 to 2,519 in 2018. Some claim social media is a factor in the increase.In a hard-hitting paper, presented at a conference earlier this year and shared with the Observer, Evans quoted the experience of “Dagny”, a woman who identified as a trans man in her teens, has now detransitioned and says she was influenced by views expressed on the social network, Tumblr.

“One of these unhealthy beliefs I held was the belief that if you have gender dysphoria, you must transition,” Dagny has said. “And anyone that appeared to stand in my way was a transphobe – an alt-right bigot.”

Evans resigned as a governor of the trust in February in protest at its response to criticism from a former member of its council of governors, David Bell, who had raised concerns from 10 members of staff.

“They reported inadequate assessments, patients pushed through for early medical interventions and an inability to stand up to pressure from trans lobbies,” Evans said.

A review of Bell’s concerns by the trust did not “identify any immediate issues in relation to patient safety or failings in the overall approach … in responding to the needs of young people.”

Evans said that since his resignation he had become concerned that the debate around transitioning had been shut down by a vocal minority. “The mind that is free to think or ask difficult questions is treated as a real threat; TV producers and journalists continually report that while people are willing to speak in confidence to them about their reservations about treatment in these areas, they shy away from being named, for fear of being accused of being bigoted and transphobic and sometimes either disciplined or even sacked for speaking their mind.”

Since his high-profile resignation, Evans’s concerns have broadened as parents approach him for advice about their children.

“They confirm that a gender-affirmative approach is being adopted by many school counsellors and CAMHS (Children and Adolescent Mental Health Services),” Evans notes.

“These parents all expressed alarm that, after their children suddenly announced they believed they were the wrong sex, practitioners were immediately endorsing the belief that this was the cause of the child’s distress, rather than offering time to explore perhaps long-standing psychological/developmental issues.”

With waiting times for a consultation taking up to two years, some critics accuse the Tavistock of being too slow to meet demand for its services.

But others accuse it of fast-tracking children on to hormone blockers, a pathway to transitioning, a claim the trust rejects. It said that fewer than half of patients who present to it go on to its endocrine (hormone) clinics. Yesterday, the Times reported that the Royal College of Paediatricians and Child Health has asked its ethics and law advisory committee to look at the ethics surrounding the rapid increase in the use of blockers to treat under 16s who identify as transgender.

In April, it emerged that five clinicians had resigned over concerns that some children had been sent for life-changing medical intervention without a thorough assessment of their options.

Last week BBC Newsnight reported that the trust had data showing that children who took hormone blockers had reported an increase in thoughts of suicide and self-harm.

The trust said the data, involving 44 children, was too small to draw final conclusions. It said the data suggested the positive outcomes were likely to outweigh the negative .

The Newsnight expose followed an open letter posted online by a former clinician at the Leeds branch of GIDS, Dr Kirsty Entwistle, who warned that “traumatic early experiences”, which might be a factor in a young person’s desire to transition, were not being investigated by medical staff out of fear of being labelled transphobic.

In a statement the trust said: “GIDS is a thoughtful and safe service. It cares for young people at a vulnerable time in their lives. Our experience with this group of patients, which is a highly diverse group, indicates that the choice to do nothing is not neutral and may lead to significant harm.

“The service is thorough and systematic in its approach to exploring with the young people and families the best way of dealing with their distress and the implications of different choices.”

It added: “We believe the opinions described are misinformed and based on a limited view, both of the clinical work undertaken within the service and of the experience of young people seeking help from the Gender Identity Development Service.”