August 9, 2022

For my day job, I interview celebrities, and here’s what you do if you want to interview a celebrity: you call up their press officer and pitch the piece you have in mind. The press officer checks if you have ever written anything negative about that celebrity. If you have, you are firmly rejected, and usually given a telling off to boot. If you haven’t, you are granted an interview. This is because celebrity interviews are largely seen as a form of advertising: you are advertising the celebrity’s brand. (Although obviously, that is not how I do it. I write searing, incisive takes that will be studied by future generations. Pulitzer to the usual address, please.)

After more than 20 years of this, I’m pretty well-accustomed to the rigamarole. But even I was surprised last summer when I called up the Gender Identity Development Service (Gids) at the Tavistock & Portman Trust for research, and realised they expected to be treated like a celebrity. Because I’d once made a cheap crack about them on Twitter, they said, they would not talk to me. In other words, they didn’t want journalism; they wanted advertising. This is a line I can just about choke down from Angelina Jolie; it’s a little tougher to swallow from an NHS trust.

At the time, I was writing a non-fiction book about why adolescent girls have, for centuries, expressed their anxiety by harming their bodies. (Title to be announced, but that jolly little beach read will be available from all good bookshops early next year.) Several doctors I spoke to said that the disproportionate number of adolescent girl patients at Gids — 70% girls to 30% boys — suggested that, in some cases, adolescent female gender dysphoria was a new form of this peculiarly female form of self-hatred. It wasn’t that suddenly, out of the blue, so many girls were actually trans boys; rather, they’d found a new way to express a hatred of their bodies “This could be the new anorexia,” one doctor said to me.

These were all unbiased, non-ideological doctors I spoke to; in many cases, they had once worked at Gids. But I wanted an alternative perspective for balance, so I called multiple charities that work with LGBT youth — Stonewall, Mosaic, Mermaids — to ask if I could talk them. None called me back. I then left a message at Gids, explaining the book I was writing and why I wanted to talk. A few hours later, I received a message telling me that a man, who I’ll call James and who worked in the communications department of the Tavistock, was willing to speak with me that afternoon. Pleased, I called him at the set time and took notes, as I always do for work. The following is a summary of the conversation that ensued:

Me: I’m writing a book about unhappy teenage girls and I’d love to talk to someone at the Tavistock about it.
James: The thing is, quite a few of our clinicians saw a comment you made on 5 December where you mentioned the Nazis and our clinicians in the same tweet
Me: Really?
James: Yes, Jo Maugham said something, then [Times columnist] Janice Turner said something, then you replied to that. You said: “The Nazis performed medical experiments on children whereas the judges are trying to stop that.”

Brief interruption here for some context. This particular Twitter conversation was about the Keira Bell case, in which a young woman sued the Tavistock for prescribing her puberty blockers when she was 16. Bell has since detransitioned and says she should never have been given blockers so young. She won that case, but it was quashed on appeal. Jolyon Maugham is a lawyer who is probably best known for once boasting on Twitter about clubbing a fox to death while wearing his wife’s kimono. He is also a fervent gender ideologist.

I can’t quote him exactly because he long ago blocked me, but Jolyon had paraphrased the famous Pastor Niemoller poem: “First they came for the trans people, and I did not speak out, because I was not trans…” Implying, in other words, that the judges who had found in favour of Bell were analogous to Nazis. I responded pointing out that it wasn’t the judges who were giving children untested medical treatments, implying that Gids was.

James: I see that you did it within a context, and you have since deleted the tweet, but we have it.
Me: Do you often keep tweets?
James (laughing): We keep the ones that refer to us as Nazis!
Me: Fine, so shall I say “No comment” from you?
James: Yes, well, this obviously puts us in a bit of a pickle. We’re not interested in saying publicly: “You used these terms about our clinicians, who are incredibly hard-working, caring people.” The discourse around this subject is so toxic, and we do believe in transparency and want journalists to describe how we work. Would you be willing to… well, you deleted the tweet.
Me: All my tweets delete automatically.
James: Well, you never apologised for that or said: “Maybe they shouldn’t be linked to Nazis.” So that’s your last word about clinicians.
Me: If you’re asking me to make a public apology in order to talk to one of your clinicians, I think that would just draw more attention to the tweet. I also don’t do things in return for an interview.
James: Sure. We’re not trying to extract a cost from you. But you have been quite outspoken about gender identity issues.
Me: So let’s talk. If you don’t talk to me, I can’t present your side.
James: But if this ugly thing that happened means we can’t work with you, then it feels unjust for you to be like: “I approached these guys and they said they couldn’t speak to me.”
Me: So what am I supposed to say? That you say it’s unfair for me to say you wouldn’t speak to me, but that’s what’s happening? If you don’t want to talk, that’s cool. I don’t think it’s healthy to have books that just present one side, but here we are.
James: I think this bridge is a little too burned. But I do think it’s a subject worth exploring.
Me: This whole argument is not going to get less toxic if the two sides don’t talk to each other. I’m still trying to learn more, but that is not going to happen if public services are keeping secret files of people’s tweets and we’re told “No, that bridge is burned.”
James: It’s an interesting point, but ummm…
Me: Fine, you’re not available to comment. Bye.

I want to say a couple of things about this conversation. Like so many of the things I’ve tweeted in my life, I regret what I said to Janice Turner about medical treatments — but not because it was incorrect. In fact, it’s looking even more correct today than it did when I wrote it. In her letter last month to the NHS advocating for a complete overhaul in this country’s treatment of gender dysphoric children and young people, Dr Cass wrote that “there has been very limited research on the short, medium or longer-term impact of puberty blockers on neurocognitive development”. Blockers are medical unknowns, and I was right to say that the judges believed children shouldn’t be subjected to experiments. But I regret it because there’s no excuse for comparing anything, whether it’s judges or Gids, to the Nazis; I lowered myself to the level of Jolyon Maugham. For that — let the record show — I apologise.

But I want to say a couple of other things, too. First, I’d love to know how much money the Tavistock & Portman Trust allocated towards overseeing what people said about them on Twitter. Was it a one-person job? An entire call centre? And where did they file away the offending tweets? I’m picturing the final scene of Indiana Jones and Raiders of the Lost Ark, with a lone NHS worker, wearily pushing into the archive another giant box of incriminating tweets with “JULIE BINDEL” stamped across one side. I’d also like to know if all NHS trusts do this or just the Tavistock, or even just Gids. I have a very sexy foot operation booked in for next January. If I have a moan online afterwards about how crap the food is, will my doctors, like Gids, refuse to speak to me? Eject me from my bed?

I wasn’t surprised that people at the Tavistock & Portman didn’t like me. As John rightly said, I have been very open about my scepticism about gender ideology, particularly in its application to children and young people. But the only other time I’ve encountered an institution (as opposed to a celebrity) that expected to be able to control media coverage, it was the Church of Scientology, and that is not publicly funded.

I have had extensive experience of doctors in my life. Several close relatives are doctors and, more relevantly, I spent several years as an in-patient in multiple hospitals when I was a teenager. The first psychiatrist I had was arrogant, absolute in his opinions, certain that he always knew best. When I dared — as a deeply insecure and unwell 14-year-old — to question any of his treatment for me, he brushed me aside, as if I were as irrelevant as a moth. Well, I did not get better, and, in fact, he ended up getting struck off for serious misconduct. His refusal to question himself was, ultimately, his downfall, and it came at a serious cost to his patients, including me.

Then I had another doctor. She was very different. When I got angry at her and told her she was ruining my life, she didn’t agree, but she listened, trying to understand my thinking. When I recovered enough to speak logically, and tentatively suggested ways I thought my treatment needed to be tailored to me, she agreed. She genuinely wanted her patients to recover, so she was willing to listen to all sides, because it wasn’t about her — it was about what was best for those who were ill.

Good people worked at Gids. I know, because I’ve met some of them. But it does seem that too many inside it were more focused on validating a certain ideology instead of looking at what was right for its patients. Fine, don’t talk to the crappy journalist who made some cheap Nazi crack on social media, but why didn’t Gids do long-term tests on puberty blockers? Why did it take them so long to keep records on the long-term outcomes of its patients? Maybe it was for the same reason they refused to talk to gender-critical journalists: because they didn’t want to know.

When Gids shuts next year, treatment for gender dysphoric young people will be decentralised: instead of there being one place myopically focused on gender, there will instead be multiple regional hubs around the country. This is partly to reduce long waiting times. But it is also, Dr Cass stressed in her letter, so children and young people can have “competent local multi-disciplinary assessment and remain under active holistic local management until they are seen at a specialist centre”.

In other words, their gender dysphoria will first be seen within the context of multiple potential factors — eating disorders, depression, anxiety, etc — instead of doctors hurriedly validating their gender identity. Some people from Gids will be involved at the regional specialist centres, but the young people will receive broader psychological assessments before they get there. It will also, I think and hope, be harder for anyone to operate without transparency because they’ll be coordinating with other NHS services. As Dr Cass wrote: “The support of wider services is vital.” Ideologues and fox-murderers can block out those they disagree with, but for healthcare services, that time is up.

Sign up to UnHerd's new weekly email, in which Will Lloyd selects the best (and occasionally worst) writing from around the web.

Free, every Friday morning.