I’ve long since passed the point when I thought posting anything political on the internet made any difference, and what I’m about to say is on an issue where questioning a particular orthodoxy often results in abuse.
But I don’t actually want to look back in a year or two and think I kept my head down on this issue for fear of some aggro on social media. Or even for fear of losing friends who had once been good friends.
The Tavistock and Portman NHS Trust’s lead for safeguarding children, Sonia Appleby, is taking her own employer to court as a whistleblower, claiming that she was victimised after bringing forward concerns from clinical psychiatrists working on the Gender Identity Development Service (GIDS), the only adolescent gender clinic in England, which also receives referrals from Wales and both jurisdictions in Ireland.
The Trust is bringing forward disciplinary action against another clinician, David Bell, who had been approached by GIDS staff with concerns because he was a staff governor on the Trust, and who then wrote an internal report critical of GIDS.
It has been reported that 40 clinicians resigned from GIDS in just three years to early 2020.
The Tavistock has just lost a court case brought by one of its own former clients who claimed she was encouraged to start puberty blockers, then cross-sex hormones, and then have a double mastectomy after only minimal counselling when it turns out she wasn’t actually trans in the first place. The woman, Keira Bell, is a working-class Black lesbian who is, in a particularly maddening way, being memory holed in the social media breast-beating of high-powered, privileged cishet and cisgay men shouting support for the Tavistock. People who like name dropping their commitment to “intersectionality” while refusing to live it out in practice.
Something has clearly gone badly wrong at the Tavi. This may be due to its resources being overwhelmed by the 40-fold increase in self-reported gender dysphoria among teenage girls in the last decade. It may also be something to do with the toxic quality of the debate about gender and transition on social media with every shout of “TERF” being matched by one of “child mutilator”; a ‘debate’ where everybody seems to forget about how vulnerable the frightened, self-loathing, teens presenting at GIDS’ door are.
Absent too is any sense that the young people seeking treatment may be doing so for different reasons, experiencing dysphoria rooted in very different causes from one another. It might be that social media is helping more trans people connect with one another and understand who they really are at an earlier age; it might be that some of the ways that young women are have long been driven into hating their own bodies, that used to express themselves through anorexia and cutting, are migrating into a new modality of self-harm; it may be that gender transition is more socially or culturally acceptable than homosexuality in some cultural contexts; probably there’s a bit of all of these factors in play and some others nobody has noticed yet.
What is clear though is that the Tavistock can no longer cope with internal questioning of radical experimental treatments which by their very nature need to be open to radical questioning, and hasn’t even been collating data that you might reasonably expect it to be collating. So, for example, it wasn’t able to tell the High Court what proportion of its service users on puberty blockers were autistic, even though the high proportion of autistic service users was flagged up internally at least three years ago.
Central government needs to step in at this point and:
- a. urgently set up an ad hoc management structure which can take GIDS out of the control of the Tavistock and Portman Trust, where it is clearly not working;
- b. set up an independent investigation into adolescent gender dysphoria treatment and transition at the Tavi at least over the past 5 years and probably over the past 20. The latter needs to be tasked with reporting on a very tight timescale, possibly as quickly as six months, because time marches on quickly with adolescents and damage occurs quickly.
And the question of correctly diagnosing and treating gender dysphoria among adolescents needs to be taken out of the debates about amending the GRA, trans prisoners, female-sex only spaces, etc., which can only make it even more toxic and less clear-headed than it already is. We are talking about minors here, vulnerable minors, who all desperately need us adults to start acting like adults.
