October 25, 2022 - 3:30pm

It wouldn’t have happened even a couple of years ago. Until very recently, most of our institutions appeared to have been captured by an extreme ideology that insisted on the existence of something called a ‘trans child’. Now, in a welcome return to common sense, the NHS has acknowledged that this approach has scant clinical basis.

A report from NHS England says that most children who think they’re transgender are going through a ‘transient phase’ and will grow out of it. It recommends a ‘watchful approach’, rather than rushing into medical treatment, and suggests that doctors should consider the possibility of autism and other mental health conditions.

This is so obviously right that it’s hard to believe anyone ever thought otherwise. At the age of seven, I desperately wanted to be a cowboy, something that earned me the label ‘tomboy’. My parents responded by buying me a cowboy hat, but these days trans activists would advise them to change my pronouns and seek treatment for ‘gender dysphoria’. I grew out of it, but now there is an industry pushing the notion that a child who rejects gender stereotypes needs ‘treatment’.

The dire effects are visible in the heart-breaking testimonies of detransitioners, who bitterly regret embarking on irreversible courses of drugs when they were too young to understand the likely outcome. Teenage girls have been encouraged to bind their breasts or take puberty blockers, supposedly a loving, ‘affirmative’ approach to something that for most children isn’t actually an illness. A small number may be diagnosed with gender dysphoria but even then there are serious questions about this course of action. We don’t ‘affirm’ teenagers who present with anorexia, telling them they’re right to starve themselves, yet some parents have encouraged their kids to believe they were ‘born in the wrong body’.

We are our bodies. We may not like them, especially in the hormonally tumultuous teenage years, and we may reject conventional notions of masculinity and femininity. But the likelihood of contagion, of confused teenagers seeking each other out and getting advice via proselytising organisations like Mermaids — now under investigation by the Charity Commission for allegedly sending out binders against parents’ wishes — is painfully obvious. It could explain the huge rise in referrals to the NHS gender identity service, from fewer than 250 in 2011-12 to more than 5,000 last year.

There is also a risk that parents who can’t cope with a gay or lesbian child might decide that their son or daughter is trans. That, I suspect, is where the idea of the ‘trans child’ came from, reflecting the possibly unconscious wishes of the parents. It’s a thoroughly ideological invention, vital to the arguments of trans activists who misuse suicide statistics to scare families into going along with it. Not to mention schools, where children are being coerced into calling boys ‘she’ and using ‘gender neutral’ toilets. 

Now we have official advice confirming that ‘trans’, in the context of children who question their sex, most likely means ‘transient’. The fact that so many kids have been encouraged into social and even medical transition is fast turning into one of the major scandals of the 21st century.


Joan Smith is a novelist and columnist. She has been Chair of the Mayor of London’s Violence Against Women and Girls Board since 2013. Her book Homegrown: How Domestic Violence Turns Men Into Terrorists was published in 2019.

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