Doctors must be free to express their concerns about premature transitioning
In 2005 I received a call from a medical practitioner at a clinic in the UK that treats children and young people with ‘gender dysphoria’. This person, who I will refer to as Nic*, told me that they had attempted to raise concerns with senior management regarding the speed and ease at which young people were diagnosed as transgender.
Yesterday it was revealed that doctors at the Gender Identity Development Service (GIDS), part of the Tavistock and Portman NHS Foundation Trust, raised concerns about the use of puberty blockers 15 years ago. That was the same year that Nic asked me to help expose bad practice, saying that they often felt pressured to refer patients for treatment too quickly.
What Nic told me in 2005 was that young people seemed to come to the service with a set of very similar stories: Girls would say they like climbing trees and ‘boys toys’; and boys would say they love Barbie and pink. Many would say they were same-sex attracted, which, to Nic’s mind meant it was very likely they would be lesbian or gay in later life as opposed to transgender.
Nic had seen my investigation, published in the Sunday Telegraph Magazine in 2003 into what was then referred to as ‘transsexuality’. For my article, I interviewed Claudia who had undergone hormone treatment and sex reassignment surgery in 1985. Claudia told me that the psychiatrist, who in 2007 was found guilty by the GMC of Serious Professional Misconduct after it was found he ‘rushed patients’ towards a diagnosis of gender dysphoria, took 45 minutes before referring her for irreversible surgery and hormone treatment.
Since that 2003 piece I have written several other articles about individuals regretting transition, including one for these pages which exposed the shocking numbers of young women, mostly lesbians, offered hormones and surgery such as double mastectomy and hysterectomy. They now recognise that they needed psychological support to live as women and not sex-change surgery.
As I write this, I receive an email from Kate* who tells me that growing up in the 1960s she faced painful family disapproval for being a ‘tomboy’. Had there been such a thing as GID clinics and puberty blockers available, she probably would have transitioned.
“When I look back now at my childhood, I can link my perceived lack of femininity to a sexual assault”, wrote Kate, “a traumatic ‘body shock’ aged four that had profound effects on my subsequent behaviour and development.”
It would appear that the silencing of whistle-blowers continues. Last year it was revealed that several members of staff were ‘shut down’ when, 14 years since Nic called me, they raised similar concerns about treatment of children and young people at the clinic.
Last month, after pressure from clinicians, parents, and young people who regretted transitioning, it was announced that the NHS has ordered an independent review into gender identity services for children and young people. Let’s hope the silencing will end and accountability begins.