May 11, 2023 - 10:15am

The Care Inspectorate, the body responsible for regulating and inspecting care services across Scotland, has published guidance for children and young people’s services on “the inclusion of transgender including non-binary young people”. It has provoked a strong backlash from groups concerned about the impact of gender identity theory within the caring profession.

The document, drafted with controversial group LGBT Youth Scotland and issued to bodies that look after highly vulnerable children, demands an uncritical approach to those questioning their identity. Care staff are advised not to discuss youngsters’ feelings or suggest they might be going through “a phase”. Instead, they are told to immediately adopt preferred pronouns and “be supportive”.

The care watchdog makes clear that the perceived reality of a child must always be endorsed. One paragraph in the guidance says kids aged 12 and above can be “presumed to have sufficient capacity to make decisions about medical treatment”, and advises that they can be sent to the Sandyford Gender Service in Glasgow, which provides hormones and sex change surgery.

The guidance includes cases of young people who have already been helped to transition by care staff. One example positively portrays a young woman who had her breasts removed via “chest reconstruction surgery”. In a wider context where detransitioners are describing their deep regret and trauma after opting for irreversible surgeries, many will find this alarming.

Another example involves a teenager supported through “transition” by professionals, despite family members being “unsure” about it. Similar to controversial schools’ guidance produced by the Scottish Government, the Care Inspectorate tells professionals they can keep a child or young person’s new identity secret, and even choose not to document information.

Dissent doesn’t appear to be an option. The guidance states that staff must be “proactive in developing an inclusive culture and practice” by displaying posters and celebrating Trans Awareness Week. They are advised to wear rainbow lanyards, introduce themselves with “their own pronouns”, and adopt “gender-inclusive language” that erases sex. Conscientious objection isn’t mentioned once.

Care professionals have expressed alarm. Maggie Mellon, an independent social worker and chair of the Evidence-Based Social Work Alliance, told me that her organisation will be lodging a formal complaint. 

“The Care Inspectorate has failed to gather or consider evidence that did not support the views and practices it is now promoting,” she warned. “Children cannot give informed consent to treatment and processes that have lifelong consequences, including infertility and lack of sexual function. The Care Inspectorate exists to protect the vulnerable and promote the highest standards of practice, not promote harmful ideology. It must scrap this dangerous, un-evidenced guidance.”

Other experts have also hit out at the Care Inspectorate for endorsing the “affirmation model” decried in the Cass Review of England’s gender identity clinic, the Tavistock, last year. David Bell, a consultant psychiatrist who became a whistleblower at Tavistock, described the watchdog’s guidance as a “significant failure of safeguarding”.

Bell told the Telegraph there is “now considerable evidence that just affirming children is harmful”, and raised particular concerns about the impact of children in the care system who can “have a history of abuse, trauma, depression and major family issues”. He went on, “Just referring to them as trans and sending them off down a medical pathway risks causing them more harm”.

Earlier in the week Dr Antony Latham, Chair of the Scottish Council on Human Bioethics, also expressed concerns about trans treatments, stressing that at least 80% of young people who present with dysphoria will, in time, “become comfortable with their biological sex”. He added, “We are seeing more young people de-transitioning […] This is a medical scandal”.

With growing alarm about the impact of ideology being promoted in Scotland’s institutions, especially on vulnerable children, the silence from the country’s political class is deafening.

Jamie Gillies is a commentator on politics and culture