C of E Anti-Bullying Guidance – Send us your reckons!

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Today the Church of England released a much needed update to their guidance on tackling homophobic and transphobic bullying in schools:

https://www.churchofengland.org/sites/default/files/2017-11/Valuing%20All%20God%27s%20Children%27s%20Report_0.pdf

Here’s a quote from the introduction:

“All bullying, including homophobic, biphobic and transphobic bullying causes profound damage, leading to higher levels of mental health disorders,self-harm, depression and suicide.

Central to Christian theology is the truth that every single one of us is made in the image of God. Every one of us is loved unconditionally by God.

Church of England schools offer a community where everyone is a person known and loved by God, supported to know their intrinsic value. This guidance helps schools to offer the Christian message of love, joy and the celebration of our humanity without
exception or exclusion.

Church schools must do all they can to ensure that all children, particularly those who may identify as, or are perceived to be, gay, lesbian, bisexual or transgender are kept safe and can flourish.”

A number of Christian commentators have responded with opinion pieces criticising the Church of England for welcoming and caring for transgender children. Sadly many of these opinion pieces are deeply misinformed of the facts.

There is much misinformation on the subject of transgender children and everyone has a view –  I’m reminded of ‘Send us your reckons’ from Mitchell and Webb.

Sadly this misinformation has led to very real consequences for families with transgender children. We know Christian grandparents who have stopped all contact with transgender grandchildren. We know vulnerable families with transgender children who do not feel welcome in their place of worship.

Positive examples of church acceptance, kindness and inclusion (and thankfully in the UK there are many more good stories than bad) are included at the end of this post.

Any Christians commentating in this area, particularly those with a platform and a following, have a moral responsibility to make themselves familiar with the facts, not simply regurgitate  the propaganda of anti-transgender lobby groups, (unless they are part of those groups which seek to restrict the rights of LGBT youth).

I’ve taken as an example a recent article by Ian Paul, expressing deep concern about a move towards “unthinking and unqualified affirmation of those asking for recognition of their transgender status, even if motivated by kindness”. I chose to focus on this article as Ian apparently is open to learning and hearing additional information on this subject. I am happy to share in good faith information with anyone open minded enough to listen. Here therefore is a detailed response to his post (quoted at length in the blue boxes):

“then what of the far more complex question of gender identity?

The famous obstetrician Robert Winston was drawn into the controversy around this question on Radio 4 last week. He pointed out the serious harm that can arise from medical intervention to effect gender ‘transition’.

Speaking on the Today Programme on BBC Radio 4, he said that “results are horrendous in such a big proportion of cases”. He said 40 per cent of people who undergo vaginal reconstruction surgery experience complications as a result, and many need further surgery, and 23 per cent of people who have their breasts removed “feel uncomfortable with what they’ve done”.

He added: “What I’ve been seeing in a fertility clinic are the long-term results of often very unhappy people who now feel quite badly damaged. One has to consider when you’re doing any kind of medicine where you’re trying to do good not harm, and looking at the long-term effects of what you might be doing, and for me that is really a very important warning sign.”

The ‘famous obstetrician’. You are quoting the views of someone who has no experience in treating, much less in performing surgery on, transgender people. The statistics he provides do not accord with the evidence based views of specialists who are clear that transgender surgery has one of the best outcomes of all types of surgery:

This is from those with real expertise treating transgender people, the Endocrine Society:

“Medical intervention for transgender individuals (including both hormone therapy and medically indicated surgery) is effective, relatively safe (when appropriately monitored), and has been established as the standard of care.”

https://www.endocrine.org/advocacy/priorities-and-positions/transgender-health

And here’s an overview of the misleading statistics quoted about transition regret:

https://www.huffingtonpost.com/brynn-tannehill/myths-about-transition-regrets_b_6160626.html

Winston refers to two references which do not appear to support his assertions:

  1. Complications of the Neovagina in Male-To-Female Transgender Surgery: A Systematic Review and Meta-Analysis With Discussion of Management PC Dreher et al. Clin Anat. 2017 Oct 23
  2. Postoperative Complications Following Primary Penile Inversion Vaginoplasty Among 330 Male-To-Female Transgender Patients TW Gaither et al. J Urol. 2017 Oct 11

Here are two quotes from the first paper:

“Wagner et al. (2010) describe that gender reassignment surgery (GRS) has proven to be the best solution for patients with discordant gender and contributes significantly to psychosocial stability in these patients”

“An increasing number of patients appear to be seeking this surgery, likely due in part to increasing acceptance by medical and reimbursement communities, high satisfaction rates and improved quality-of-life reports according to Gooren (2011).”

This first paper (Dreher et al) covers surgery worldwide since 1995 and produces an average of 21% of patients requiring additional procedures. It notes that rates of complication are very significantly lower (nearing 0%) in surgeons who have conducted more than 40 surgeries. This suggests improved surgical guidance and training is key to improved outcomes.

The second paper (Wagner et al) looks at the work of an experienced surgeon, and notes 9% required a follow on procedure, almost all of these were conducted as an outpatient and none were severe complications (none graded IV or V). It concludes it is a relatively safe procedure.

It should be recognised that talking about surgery in relation to children is a common tactic used by transphobic groups to misinform and provoke fear. No children in the UK NHS have surgical interventions (the minimum age for surgery is 18).

“For expressing his informed medical opinion, Winston received a torrent of hate mail from transgender activists.”

There is a climate of fear mongering and misinformation in the media about transgender people and transgender children, fuelled by lobbyists such as Christian Concern. I do not condone any hate mail. I do however, understand people expressing their deep frustration at a respected professor using their voice to spout misinformation on a public platform.

Winston’s Daily Mail article follow up is titled “Trolls call me homophobic” which suggests some really basic misunderstanding of the difference between homophobia and transphobia.

You could read this humorous blog post which provided some light relief for those of us who have seen this all before.

https://sexdrugsmh.wordpress.com/2017/11/01/every-trans-media-piece-ever/

You could read this poem to get a sense of how us parents feel every time someone appears on radio or tv and gets their basic facts wrong:

https://growinguptransgender.wordpress.com/2017/11/01/finding-my-fierce/

“But he was expressing from a medical point of view similar reservations expressed by the feminist Camille Paglia:

Although I describe myself as transgender (I was donning flamboyant male costumes from early childhood on),”

Camille here is describing gender expression (what clothing they like) rather than gender identity (who they are). Clothing does not make a person transgender. This is someone who has a history of  appropriating a transgender identity as a rhetorical device with the goal of curtailing the rights of transgender people.

Along with Prof Winston, Camille Paglia also has no known expertise in supporting transgender people

“I am highly sceptical about the current transgender wave, which I think has been produced by far more complicated psychological and sociological factors than current gender discourse allows.”

The phrase ‘transgender wave’ is distorted and dehumanising language. The increase in people seeking support means less people are struggling on their own. Here are the words of experts from the Australian Standards of Care and Treatment:

“with increasing visibility and social acceptance of gender diversity in Australia, more children and adolescents are presenting [….and ] requesting support, advice, and gender affirmative psychological and medical treatment”. They note that with “approximately 1.2% of adolescents identifying as trans […] it is likely that referrals will continue to rise in the future”.

https://www.rch.org.au/uploadedFiles/Main/Content/adolescent-medicine/Australian%20Standards%20of%20Care%20and%20Treatment%20Guidelines%20for%20Trans%20and%20Gender%20Diverse%20Children%20and%20Adolescents.pdf

See this thread on twitter which makes a comparison between the current increase in numbers of out transgender people (and referrals to youth gender services) with the rise in prevalence of left handed people last century: https://twitter.com/DadTrans/status/929081990107881472

(In short – in 1900 there was significant social prejudice against left handed people – left handed children were forced to write with their right hand – and only 2% of the population was openly left handed. With increased acceptance of left-handed children, numbers of openly left-handed people rose sharply in the early twentieth century and have remained constant at about 12% of the population since then. Speculators in the 1930s could have expressed concern about the sharp increase in left-handedness. But the phenomenon was clearly related to increasing levels of acceptance leading to left-handed people being more open and not having to pretend to be right-handed. Interestingly, in Japan where there is still stigma and left-handed children are still forced to use their left hand, the prevalence is still 2%).

“Furthermore, I condemn the escalating prescription of puberty blockers (whose long-term effects are unknown) for children. I regard this practice as a criminal violation of human rights.”

This is the ideologically based opinion of someone with no qualifications in this topic. Puberty blockers are safe and reversible.  They have been prescribed for precocious puberty since the 1970’s and continue to be prescribed for this purpose (delaying the puberty of children who begin puberty too young).

For a thorough review of the ethics of hormone blockers see the following article: Gender Atypical Organisation in Children and Adolescents: Ethico-legal Issues and a Proposal for New Guidelines, Simona Giordano http://booksandjournals.brillonline.com/content/journals/10.1163/092755607×262793

“Puberty delaying hormones …have the following benefits:
a. The main benefit of early physical treatment is arrest of pubertal development,
and, consequently, arrest of the suffering of the patient (CohenKettenis
et al., 2003, p. 171).
b. Arresting the progress of puberty gives adolescents more time in which to achieve greater certainty about their innate gender identity.
c. The administration of blockers will prevent the development of secondary sexual characteristics of the undesired sex. In turn, future treatment would be less invasive and painful (for example, breast removal in female-to-male patients and painful and expensive treatment for facial hair in male-to female patients will be prevented; the voice will not deepen, and nose jaw and crico-cartilage (Adam’s apple) will be less developed)) (Cohen-Kettenis et al., 2003, p. 171).
d. Successful adaptation is associated with early start of physical treatment (Cohen-Kettenis et al., 2003, p. 171)”.

The safety and reversibility of puberty blockers are looked at in the recent Australian national medical guidance (published September 2017) which states:

“Puberty suppression is most effective in preventing the development of secondary sexual characteristics when commenced at Tanner stage 2”. ”reduction in the duration of use of puberty suppression by earlier commencement of stage 2 treatment must be considered in adolescents with reduced bone density to minimise negative effects.”

Further, this month the Endocrine Society (published new guidance: “Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline,” (published online and  in the November 2017 print issue of the Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of the Endocrine Society).

Recommend puberty blockers

“We suggest that adolescents who meet diagnostic criteria for GD/gender incongruence, fulfil criteria for treatment, and are requesting treatment should initially undergo treatment to suppress pubertal development

These recommendations place a high value on avoiding an unsatisfactory physical outcome when secondary sex characteristics have become manifest and irreversible, a higher value on psychological well-being, and a lower value on avoiding potential harm from early pubertal suppression.”

Start puberty before blockers

“We suggest that clinicians begin pubertal hormone suppression after girls and boys first exhibit physical changes of puberty.

We recommend treating gender-dysphoric/gender-incongruent adolescents who have entered puberty at Tanner Stage G2/B2 by suppression with gonadotropin-releasing hormone agonists.”

Here’s the criteria for blockers, which are not handed out on a whim:

Criteria for blockers

“Adolescents are eligible for GnRH agonist treatment if:

  1. A qualified MHP has confirmed that:
  • the adolescent has demonstrated a long-lasting and intense pattern of gender nonconformity or gender dysphoria (whether suppressed or expressed),
  • gender dysphoria worsened with the onset of puberty,
  • any coexisting psychological, medical, or social problems that could interfere with treatment (e.g., that may compromise treatment adherence) have been addressed, such that the adolescent’s situation and functioning are stable enough to start treatment,
  • the adolescent has sufficient mental capacity to give informed consent to this (reversible) treatment,
  1. And the adolescent:
  • has been informed of the effects and side effects of treatment (including potential loss of fertility if the individual subsequently continues with sex hormone treatment) and options to preserve fertility,
  • has given informed consent and (particularly when the adolescent has not reached the age of legal medical consent, depending on applicable legislation) the parents or other caretakers or guardians have consented to the treatment and are involved in supporting the adolescent throughout the treatment process,
  1. And a paediatric endocrinologist or other clinician experienced in pubertal assessment
  • agrees with the indication for GnRH agonist treatment,
  • has confirmed that puberty has started in the adolescent (Tanner stage $G2/B2),
  • has confirmed that there are no medical contraindications to GnRH agonist treatment.”

“The cold biological truth is that sex changes are impossible. Every single cell of the human body remains coded with one’s birth gender for life. Intersex ambiguities can occur, but they are developmental anomalies that represent a tiny proportion of all human births.”

Does this author actually believe that transgender people do not exist? This is a deeply transphobic perspective and the fact that the author describes herself as transgender does not undo the clear transphobia here. Camille also clearly does not understand the difference between sex and gender.

Intersex ambiguities are estimated by WHO to be 1% of births which is hardly a tiny proportion.

Futhermore, the findings of the Endocrine Society note conclusive evidence of ‘a biological underpinning for gender identity’ and list the many scientific studies noting a biological underpinning. Below I’ve provided the cold biological truth about transgender people as written by the global experts in endocrinology

In September 2017 the Endocrine Society published a guideline, entitled “Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline,” (published online and will appear in the November 2017 print issue of the Journal of Clinical Endocrinology & Metabolism (JCEM), a publication of the Endocrine Society). This updated guidance was produced by leading endocrinologists specialising in support to transgender adults and adolescents from the US, Belgium, and the Netherlands. The guidelines are endorsed by the American Association of Clinical Endocrinologists, the American Society of Andrology, the European Society for Pediatric Endocrinology, the European Society of Endocrinology, the Pediatric Endocrine Society, and the World Professional Association for Transgender Health.

Accompanying the guideline is a position statement: https://www.endocrine.org/advocacy/priorities-and-positions/transgender-health

Here’s a longer quote

The medical consensus in the late 20th century was that transgender and gender incongruent individuals suffered a mental health disorder termed “gender identity disorder.” Gender identity was considered malleable and subject to external influences. Today, however, this attitude is no longer considered valid. Considerable scientific evidence has emerged demonstrating a durable biological element underlying gender identity. Individuals may make choices due to other factors in their lives, but there do not seem to be external forces that genuinely cause individuals to change gender identity.

Although the specific mechanisms guiding the biological underpinnings of gender identity are not entirely understood, there is evolving consensus that being transgender is not a mental health disorder. Such evidence stems from scientific studies suggesting that: 1) attempts to change gender identity in intersex patients to match external genitalia or chromosomes are typically unsuccessful; 2) identical twins (who share the exact same genetic background) are more likely to both experience transgender identity as compared to fraternal (non-identical) twins; 3) among individuals with female chromosomes (XX), rates of male gender identity are higher for those exposed to higher levels of androgens in utero relative to those without such exposure, and male (XY)-chromosome individuals with complete androgen insensitivity syndrome typically have female gender identity6; and 4) there are associations of certain brain scan or staining patterns with gender identity rather than external genitalia or chromosomes

In summary, although there is much that is still unknown with respect to gender identity and its expression, compelling studies support the concept that biologic factors, in addition to environmental factors, contribute to this fundamental aspect of human development.”

“Data are strong for a biological underpinning to gender identity”

“All this makes Synod’s passing of a motion on this issue last July look at best naive, at worst very foolish.”

“All of this”. All of what? You have quoted two people with no expertise or experience.

A clearer interpretation is that the General Synod has moved towards being compassionate to transgender people, in line with recent scientific research and expert endorsed best practice.

“Winston is pointing out the (unintended) consequences of hasty and naive action in this area, just as Jon Kuhrt is pointing out the results of hasty and naive action in response to the homeless. There are the consequences of giving an unthinking and unqualified affirmation of those asking for recognition of their transgender status, even if motived by kindness. It is, in any complex situation, quite possible to harm even when intending to do good, if care and love are not shaped by awareness and wisdom. What is true of those asking for money is true of those asking for recognition. These are the facts that the Church needs to take account of; in fact, these are the things any of us needs to take account of if we are to be wise and compassionate pastors.”

To be wise and compassionate pastors you should follow the guidance provided by those who are best qualified in this topic. The actual experts. Transgender people exist. Transgender people have always existed. There is a “durable biological underpinning to gender identity” (Endocrine society).

Here’s several quotes from Australia’s Standards of Care:

“being trans or gender diverse is now largely viewed as being part of the natural spectrum of human diversity”.

“increasing evidence demonstrates that with supportive, gender affirmative care during childhood and adolescence, harms can be ameliorated and mental health and well being outcomes can be significantly improved”.

Avoid causing harm”. “withholding of gender affirming treatment is not considered a neutral option, and may exacerbate distress in a number of ways including depression, anxiety and suicidality, social withdrawal, as well as possibly increasing chances of young people illegally accessing medications”

“for children, family support is associated with more optimal mental health outcomes”

“trans or gender diverse children with good health and wellbeing who are supported and affirmed by their family, community and educational environments may not require any additional psychological support beyond occasional and intermittent contact with relevant professionals in the child’s life such as the family’s general practitioner or school support”.

Australia’s Royal Children’s Hospital Gender Service new “Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents”. These guidelines are compiled by the leading Australian experts, based on the best and most current evidence from around the world. These guidelines are endorsed by ANZPATH (the Australian and New Zealand Professional Association for Transgender Health) and were launched at the recent ANZPATH conference. They are now the official guidelines for all health professionals working with transgender children in Australia.

Transgender trend” are a non-religious group representing parents of children with gender dysphoria who do not agree with the current transgender ideology. They made a presentation to the Government, opposing the planned demedicalisation of the legal process around ‘transition’. I reproduce below some of the facts they set out—facts that the Church of England will need to take into account in anything that it proposes in this area as part of its wider debate on sexuality.”

“Transgender trend” are considered by parents of transgender children like myself as an anti-transgender hate group. Their posts, publications and tweets are deliberately incendiary, malicious and frequently based on an extremely biased review of evidence. They pose as ‘concerned parents’ but constantly attack the rights of transgender people in general and transgender children in particular. Their website is neither neutral, nor concerned for the well-being of transgender children. The key individuals on the site do not have transgender children. The group name “transgender trend” should give you a clue. These are not experts but a small group with the sole agenda of undermining the well being of transgender children. Why not quote from the highly respected charity Mermaids, who has over 1,000 parent members, all parents of transgender children in the UK. Mermaids co-hosted with the NHS the 2017 conference on trans children that you quote in one of your sources. “Transgender trend” meanwhile is a fringe anti-trans lobby group without credibility.

“I also speak to urge caution on behalf of the children of this generation who are caught up in the teaching of a new rigid, anti-science belief system presented to them as fact.”

The Endocrine Society are scientists. Supporting transgender children is evidence based science. Please provide a source that supporting transgender children is anti-science

“If Gender Identity is established in law as a Protected Characteristic, it will apply to children of any age. But a child’s identity is not fixed: it changes over time, and it is shaped by factors like parental approval and societal influences. If all trusted adults are reinforcing daily a little boy’s belief that he is really a girl, this will have an obvious self-fulfilling effect. Puberty blockers supply the ‘answer’ to the created fear of a puberty he now believes to be the ‘wrong’ one.”

You are quoting a transphobic view here that is completely inaccurate. Let me explain:

A) You are suggesting that parents are imposing or reinforcing a child’s gender identity. The Lancet report is clear:

“research has established no clear correlations between parenting and gender incongruence”

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00683-8/fulltext

B) You are suggesting that parental denial of a child’s identity will make them less likely to be trans

Here’s the Endocrine Society:

“The medical consensus in the late 20th century was that transgender and gender incongruent individuals suffered a mental health disorder termed “gender identity disorder.” Gender identity was considered malleable and subject to external influences. Today, however, this attitude is no longer considered valid. Considerable scientific evidence has emerged demonstrating a durable biological element underlying gender identity.1,2 Individuals may make choices due to other factors in their lives, but there do not seem to be external forces that genuinely cause individuals to change gender identity.”

https://www.endocrine.org/advocacy/priorities-and-positions/transgender-health

3) You are claiming that a trans girl is a boy who is deluded and wrong.

The Endocrine Society concludes:

“a durable biological underpinning to gender identity”

The World Professional Association of Transgender Health and ICD are removing the classification as a mental health disorder, acknowledging that it is natural human variation. Note these bodies are slow moving – ICD only de-classified homosexuality as a mental disorder in 1992

https://www.psychologytoday.com/blog/hide-and-seek/201509/when-homosexuality-stopped-being-mental-disorder

See this from the American Academy of Pediatrics:

“While researchers have much to learn about gender-expansive and transgender children, there is evidence that both reparative therapy and delayed transition can have serious negative consequences for children. While some groups promote these strategies in good faith, many use misleading descriptions of research or even outright misinformation.”

https://www.aap.org/en-us/Documents/solgbt_resource_transgenderchildren.pdf

“Almost all children on blockers progress to cross-sex hormones at age 16. [2] Very few come off this path of increasingly invasive medical treatments once they are on it and so-called ‘social transition’ is the first step. This approach clearly works to prevent normal resolution of childhood gender dysphoria and foster persistence of opposite-sex identity.”

The protocols for receiving blockers in the NHS are exceedingly conservative. Families first need to get a referral from a GP, which many GPs are unwilling to provide. Many are sent on a time-consuming detour via the child mental health service CAHMS (until CAHMS confirm gender identity is not a mental health issue and refer on to the Gender Identity service). Once referred to the Gender Identity Service there is a 12 month wait for first appointment. Then a 6 month assessment process. Then prolonged monthly sessions with psychologists talking about identity. Even then blockers are very far from guaranteed – a young person can only get blockers if referred from the NHS Gender Service, and they are extremely conservative. Only the most persistent children, the ones with the most clear cut and long held identity, the ones who insist session after session and show no doubt, who are supported by their parents, who are usually socially transitioned and accepted as their identified gender in their lives – these are the very small number of children who are referred for blockers. It is not surprising to me that the small number of children who jump through all the medicalised hoops for years and years to get blockers, are likely to continue in their identity.

This quote also refers to two myths that are incorrect. One the myth that the majority of prepubescent children will ‘desist’ from a transgender identity at puberty. Please see: https://growinguptransgender.wordpress.com/2017/03/04/a-plea-for-better-transgender-research-on-the-perpetual-myth-of-desistance-and-the-harm-of-social-transitioning/

This analysis concludes thus:

“Certainly the studies listed in the 2016 paper provide no conclusive evidence that consistent, persistent, insistent transgender children are likely to desist. In fact the best of these bad studies does not support desistance at all, but instead clearly showed a 58% persistence rate”.

To talk about it as a ‘path’ is also extremely misleading. Whilst many transgender adolescents (none before the age of 15 years 10 months on the NHS) end up eventually taking hormones, not all will have further interventions such as surgery (and surgery is never available in the NHS before age 18).

“While trans activists call for the de-medicalisation of ‘transgender,’ in the case of children they campaign aggressively for social transition, blockers and cross-sex hormones at ever earlier ages”

Again, this is couched in unnecessarily incendiary language such as “at ever earlier ages”. Advocates for the rights of transgender children understand that puberty blockers should be prescribed at the start of puberty (otherwise they have no purpose – there really is a clue in the name). Concerned parents are conflicted about the advice on the ideal age for cross-sex hormones, with some experts arguing for this to start at around age 16 (as is the current NHS protocol even though for many children it is late in their pubertal developmental) whereas some experts are arguing for the prescription at a younger age. This debate on appropriate age for cross-sex hormones is ongoing and is outlined in the Endocrine Society’s guidance and it is right that this .This debate is not one between transgender activists and concerned parents, it is a debate between competent medical professionals who are currently divided and who take different value judgements when deriving their approach. Your blog post could have presented this in an informed and sensitive way – instead of repeating the material espoused by the group called “transgender trend” who do not believe in the existence of transgender children.

“The surge in sex hormones at puberty triggers the enormous changes in the teenage brain which don’t complete their job until the mid-twenties. [4] The brain /personality is not fully-formed until then. The effects of blockers on adolescent brain development are unknown [5] although studies on adults, including men taking the drug for prostate cancer, indicate risk of memory loss, depression and cognitive impairment. [6] Recent reports from the US indicate long-term serious health effects for women who were administered blockers for precocious puberty, such as excruciating muscle and bone pain, depression, weakness and fatigue.”

The potential dangers of puberty blockers need to be weighed up against the very real and known impacts of a transgender person going through the wrong puberty. People who recognise the existence of transgender people are very aware of this balance. “Transgender trend” does not acknowledge (or care) about transgender people so only presents potential negatives.

Here’s the take from the Australian specialists in their guidance published this year:

Avoid causing harm”. “withholding of gender affirming treatment is not considered a neutral option, and may exacerbate distress in a number of ways including depression, anxiety and suicidality, social withdrawal, as well as possibly increasing chances of young people illegally accessing medications”

“Preventing a child’s sexual development in early puberty, followed at 16 by cross-sex hormones, results in sterility as viable eggs or sperm have not developed”

It is accepted that cross-sex hormones can be a barrier to fertility in many youth, though this is not a reason to withhold necessary treatment. This is a discussion to be had, but it needs to be held much more sensitively based on an understanding of the needs of transgender adolescents and adults. For any individual and any family, difficult discussions around fertility are core to any decision about cross-sex hormones – this is not rushed in to on a whim, and counselling about potential impact on fertility is a requirement before eligibility.

“These children are prevented from ever experiencing puberty: hormones can only superficially feminise or masculinise secondary sex characteristics, they cannot create the puberty of the opposite sex”

This is a non-scientific statement that shows very limited knowledge of endocrinology.

“Risks of cross-sex hormones include cardiac disease, high blood pressure, blood clots, strokes, diabetes and cancers. [9] Some significant effects are irreversible, such as male-pattern baldness and body and facial hair, masculinised voice and compromised fertility.”

All medical treatments have potential side-effects. If I listed the potential side effects of paracetamol without context it would look similarly alarming. This is intentionally inflammatory.

“There have been no clinical research trials into the long-term effects of this treatment on children”

We have over 20 years of data with no ill effects observed in that period. We’d of course like more data and this will come in time. We do conversely have plenty of long term evidence of the poor outcomes (particularly in terms of mental health, depression, wellbeing) for transgender adults who have not been supported and accepted in childhood. Concerned parents are hoping for a better outcome for their own children, and the latest evidence, including from the Netherlands, is very positive.

“this is a non evidence-based practice [10] to treat a non evidence-based diagnosis of being ‘a girl trapped in a boy’s body’ and vice versa [11] and this generation of children are the guinea pigs.”

This is a ‘Straw man argument’. There is no diagnosis of ‘being a girl trapped in a boy’s body’. This is a phrase that some transgender people in the past have used to try to explain in simple terms how they feel. This is not a scientific diagnosis and no one claims this is the situation. What is known is that some children have a clear and consistent gender identity that differs from the sex they were assigned at birth. Experts have found “conclusive evidence that there is a durable biological underpinning for gender identity” – speculated to be due to hormone fluctuations in utero.

As a concerned parent I would much rather be living 40 years in the future when there is better long term data. However, this is not in itself reason for with holding treatment. We have to make the best evidence based decisions we can based on what is currently known. Again here’s a quote from the Australian national health guidelines:

“withholding of gender affirming treatment is not considered a neutral option, and may exacerbate distress in a number of ways including depression, anxiety and suicidality, social withdrawal, as well as possibly increasing chances of young people illegally accessing medications”.

“‘Transgender’ is an ideological label distinct from the clinical diagnosis ‘gender dysphoria.’ To call a child ‘transgender’ is to make both a claim that the child’s feelings represent material reality and a prediction about that child’s future: they will not change.”

Unlike the apparent anti transgender ideology of the author quoted, transgender is not an ideology. Transgender is an adjective to describe people whose gender identity is different to the sex they were assigned at birth from a cursory inspection of their genitals.

“An analysis of all published research studies of children with ‘gender dysphoria’ shows that 80% will naturally come to be happy as the sex they were born and this is true of even some of the most severe cases, we can’t know which children will persist and which will desist.

Opposite-sex identity in childhood is overwhelmingly predictive of gay or lesbian sexual orientation in adulthood, not transsexualism.”

This statement is demonstrably false and shows the people at “Transgender Trend” are intentionally conflating the distinction between children who are gender non-conforming (eg boys who like dolls) and children who are transgender (eg children assigned male at birth who have a consistent, insistent and persistent identity that they are a girl). The research that gave rise to the myth of 80% ‘desistance’ has been comprehensively discredited as deeply flawed and unreliable as it lumped together gender non-conforming and transgender children – In fact:

“Certainly the studies listed in the 2016 paper provide no conclusive evidence that consistent, persistent, insistent transgender children are likely to desist. In fact the best of these bad studies does not support desistance at all, but instead clearly showed a 58% persistence rate).

https://growinguptransgender.wordpress.com/2017/03/04/a-plea-for-better-transgender-research-on-the-perpetual-myth-of-desistance-and-the-harm-of-social-transitioning/

“Affirming a child’s ‘gender identity’ can therefore be seen as gay conversion therapy by another name.”

Gender identity and sexual orientation are two separate things. Some transgender people are homosexual, some are heterosexual, some are bisexual, some are pansexual (attracted to people regardless of gender including non-binary people). The same therapists who attempted ineffectual and harmful conversions of gay people later applied the same techniques to attempt conversion of transgender children.

“There has been an almost 1000% increase in children referred to the Tavistock clinic in London over the past 6 years. [14] These figures are inflated by the unprecedented rise in the number of girls – nearly 70% of the figure overall and over 70% of adolescent referrals last year. [15] By comparison, in the late Sixties 90% of adult transsexuals were male. [16] We are aware that teenagers and young adults are susceptible to indoctrination, brainwashing and social contagion which is why we block online anorexia and self-harm sites. The internet, however, is chock-full of Tumblr bloggers and Youtube vloggers with hundreds of thousands of followers, who are selling vulnerable young people the myth of transformation through cosmetic alteration of their bodies, including amputation of healthy body parts, and a lifetime’s dependency on powerful off label hormones.”

I’ve mentioned prevalence earlier in this response (see above). This increase in numbers referred to the UK Gender Identity Service (GIDS) was not unexpected or unusual but predicted, as was the increase in assigned female referrals (specialists had predicted years ago an increase in assigned female referrals). Yes, it is a fact that there are a few openly trans people on the internet – individuals who are followed by individuals who before the availability of the internet would have been completely on their own. Isn’t it wonderful that now a few trans people are sharing their experiences, offering support to isolated transgender people. The remainder of the quoted section is pure conjecture and hyperbole.

“Recent reports of girls’ mental health indicate that girls and young women in the UK are in crisis. [17] Recently published evidence of the rate of sexual abuse and harassment in schools across the UK is a matter of national shame. [18]

Reports such as the recent Stonewall Schools Report [19] which indicate high suicidal ideation in ‘trans’ youth serve to cover up the fact that the vast majority of these youngsters will be teenage girls, now hidden in the category ‘trans boys.’”

The Stonewall report indeed outlines what a tough time transgender children are having at school. Media hysteria, continual criticism, and trans boys being described as girls is exactly what makes life hard for a trans child or adolescent. The C of E guidance supports acceptance of all people, even those who are different. It encourages schools to be welcoming safe places where transgender children can get an education without harassment or bullying. Who would want more bullying of transgender children? The C of E guidance is extremely sensible and should be welcomed by all who care about children. In the past schools were not welcoming places for children who were different. This did not mean these children didn’t exist– it just left them bullied, depressed, ashamed and needing to hide.

“A PSHE teacher and Head of Year at a large comprehensive told me that in her school the kids who identify as ‘trans’ are, without exception, either lesbian, autism spectrum, have mental health problems or have suffered sexual abuse.”

This kind of rhetorical anecdote is a well worn device familiar to anyone who has watched a political debate. For an easy to digest discussion on this phenomenon see http://www.bbc.co.uk/news/uk-politics-20956126

About 8% of trans children have autism (https://www.theatlantic.com/health/archive/2016/11/the-link-between-autism-and-trans-identity/507509/) but this is seen as co-occurring rather than either autism making them transgender or vice versa.

Sexuality and gender identity are different concepts, something this teacher seems confused about.

Many trans children suffer mental health problems such as depression – this is recognised as ‘minority stress’. Depression, stress and anxiety not because of who they are but because of how they are treated.

This important US study evidences that trans children who are accepted and supported at home and at school have normal levels of mental health. http://pediatrics.aappublications.org/content/pediatrics/early/2016/02/24/peds.2015-3223.full.pdf

Supporting trans children is the best option for those who genuinely care about their wellbeing. I’m glad the Church of England has been informed by experts and those who know trans children.

“Parents are also concerned about the relentless gender identity propaganda their children are subject to today – across the media, [20] the internet and in schools, through organisations such as GIRES, Gendered Intelligence, Mermaids and Educate and Celebrate. The belief that gender is an innate identity is taught to children as truth, with no alternative views offered, in contravention of the UN Rights of the Child.”

Trans children exist. They have always existed. And the few quiet voices speaking up for them are dwarfed by the powerful anti-trans voices that are platformed daily across tv, newspapers and radio. As  I write this, in the last week, The Times alone has published 7 articles attacking trans children. The reality is that anti transgender rhetoric is prominent and inescapable, much to the distress of transgender children, adults and their friends and families.

“The ‘transition or suicide’ trope is repeated endlessly, against all Samaritans guidelines. There is no evidence that children will commit suicide if their parents fail to support them in taking a medical pathway, but of course the threat terrifies parents into feeling they have to.”

I agree that writing about suicide needs to be handled sensitively and in accordance with the Samaritans guidance. Seeing as you raised this, (as anecdote, and without irony, in the same sentence as saying it shouldn’t be mentioned), here’s a statement of evidence from the Endocrine Society:

Transgender individuals who have been denied care show an increased likelihood of committing suicide and self-harm”

https://www.endocrine.org/advocacy/priorities-and-positions/transgender-health

“There are over 260 trans youth support groups across the UK [21], which provide the ‘tribe’ where our most vulnerable young people will be accepted, maybe for the first time, as long as they identify as trans. All transgender organisations advertise their support for ‘gender non-conforming’ youth, sweeping up all children who are ‘different’ and don’t fit in.

These organisations claim to support ‘diversity’ but of course they do the opposite: a girl who rejects feminine stereotypes is transformed into a ‘boy’ who conforms to masculine stereotypes. Gender non-conformity is erased. Regressive and reactionary sex-stereotyping is being sold to young people as a progressive social justice movement.”

This shows very little knowledge of these organisations and their scope. A girl who rejects feminine stereotypes would not be ‘transformed’ by a youth group into a boy who conforms. My transgender daughter is not a cliché or a stereotype of femininity. She likes football and art, wears jeans more than dresses, and is a normal well rounded child with a variety of interests and likes. The majority of transgender children and adults I know are defiantly breaking down gender stereotypes. It is “Transgender Trend”, who seem set on reducing trans children to the regressive stereotypes they claim to be against. At this point I doubt very much whether they have even met any transgender children.

“To teach children that their ‘authentic self’ is something in their heads, split off from and in opposition to, the body, is to create gender dysphoria. Mind-body disassociation is recognised as a state of mental ill-health: in this case uniquely, it is presented as a normal variation and something to be celebrated. Mental health is based on being equipped to accept reality.

Since children have been taught that it is their ‘gender identity’ which makes them a boy or a girl and not their biological sex, calls to Childline from young people confused about their gender have doubled in a year – eight calls are now received every day from children as young as eleven. [22] The concept of ‘gender identity’ is clearly – and inevitably – causing mental health problems for young people.”

Again the author deliberately and falsely presents transgender people as mentally ill, deluded or confused. Throughout the 20th century, methods were applied to trans people to stop them being trans including electroshock and attempted conversion therapies. These techniques, historically used also on gay people, disabled people, and other marginalised groups, did not work. Instead trans people were harmed with resulting depression and shame. All forms of conversion therapy are now seen as both unethical and ineffective.

http://www.rcgp.org.uk/news/2017/january/uk-organisations-unite-against-conversion-therapy.aspx

“Any child who suffers genuine gender dysphoria must of course be sensitively supported in schools and youth organisations. But teachers, professionals and other children cannot be asked to collude in the reinforcement of a child’s belief which contradicts reality. Recognition of biological facts is not bigotry.

When girls are told that a male classmate is now a girl, their sense of their own reality is shattered. If a biological male is a girl, then it is not female biology which makes you a girl, it is something else. Girls must look to a male classmate to find out the invisible magic quality they need, and the boy is given the power to define what a girl is. We cannot predict the long-term practical or psychological effects on girls taught to deny their own biology, without the right to even define themselves correctly as the female sex.”

This is denial that trans people exist. This is extremely disturbing and appears to be advocating for teachers not to work in accordance with the 2010 Equality Act. This damaging bigotry harms children like mine who just want to live their life without prejudice. This also shows no understanding of the complexities of biology.

“If teenage girls must consent to a male classmate using their toilets and changing-rooms they learn that their boundaries may be violated and their consent is unimportant. Girls learn that they are not always allowed to say ‘no.’ This is grooming; lessons on the importance of consent become meaningless.

Girls who are coached at school into ignoring their own discomfort and intuition may go on to put themselves in risky situations with any man who claims to be a woman, out of fear of being seen as transphobic.

In the case of public swimming pool changing rooms a young girl cannot name a male with a penis as a man: voyeurism and indecent exposure cease to exist as crimes if a man claims to be a woman. Normal child protection protocols effectively become unlawful.”

This rhetoric is now moving beyond bigotry towards hate. It reveals what was clear from the start, there is no care for transgender children, but simply hate rooted in fear. These exact same arguments were put forward against gay people in the 1980s and gave rise to Section 28.

I am deeply concerned that we are not learning from the lessons of the past, and that history may repeat itself, with transgender people the latest in a long history of marginalised groups being attacked, stigmatised and othered.

Trans women are women. Trans girls like my daughter are girls. They are not a threat.

For anyone wanting to sensitively address the stance of organised religion to trans issues then the following must be the foundation for any discussion: Trans people exist; Trans people have always existed; Trans children exist.

If you choose to comment on these issues, you can do as this writer has done whether maliciously or through ignorance, and seek to marginalise trans people, present them as mentally deluded or potentially dangerous, encourage others to fear and reject them.

Or, instead, you can choose to embrace them, tell them you love and accept them as they are. My own grandparents were deeply committed Christians and I know they would have loved and supported my daughter. Please open your eyes and your hearts. Tell transgender children and their families that they are welcome in your schools and even in your churches (temples, mosques etc). Commit to protecting vulnerable transgender children from bullies including uniformed writers who spread misinformation, hate and fear.

To the Church of England. I am grateful that The Church of England have bravely ignored media hysteria and stood up for one of the most misunderstood, marginalised and attacked groups of children.

I commend them for caring for my transgender child.

To conclude here (with permission) are positive stories of Church and Christian community acceptance, inclusion and love:

“Our C of E/Methodist church has been very supportive. We often have talks on inclusivity and the love of God. My daughter also goes to a C of E school and the message we’ve had there is one of acceptance and kindness. In fact the head teacher said that as a Christian school they should be the first to show kindness and acceptance, and zero tolerance to any kind of unkindness.”

“We’re so lucky, our C of E church have been wonderful”

“We were at our previous church when our child socially transitioned. My husband was suddenly asked to stop doing sermons in church. We ended up going to another church. Our new church however have been incredible, from day one they used our child’s pronouns, and when he chose a new name a month after we joined the church absolutely everyone began using it immediately. They’ve been nothing but supportive and accepting.”

“The vicar at our c of e place was just calmly accepting and kind when I told her about my child. It’s a Church that does loads of social justice stuff and has a welcoming, un-judgemental attitude in general.”

“A Sunday School teacher was the first one to tell me that my child was using a different name. We attend the Church of Scotland. If you look at who Jesus was actually hanging out with it’s fairly clear to me that Christians are called to support people who are perhaps a little bit different and not accepted by wider society.”

“So far I have been surprised by our religious relatives (Jehova’s Witnesses and Christians), I was expecting some discomfort from them but they have all been supportive and accepting.”

“The poignant words of my eldest daughter’s blog detailing our family’s sad estrangement from the local CofE church. https://bethmackin.wordpress.com/…/may-2017-faithfully…/ We left said church and now attend a inclusive church that is a URC/Methodist church. I feel much safer, loved and cared for but mourn the loss.”

“Many positive examples to be found at Diverse Church – a UK wide organisation with groups for 18-30 LGBTA+, they also have a parents forum that has a specific hub for Christian Parents of Transgender children http://diversechurch.website/

See also OneBodyOneFaith – Great for engagement with current issues as well as networking to find safe and accepting churches. http://www.onebodyonefaith.org.uk/ and OpenTable which is a collection of LGBT inclusive eucharist services. This Sunday Open Table London will hold a special service for Transgender Day of Remembrance https://www.facebook.com/opentablelondon/”

“Here’s an article on inclusive approaches to baptism http://www.independent.co.uk/…/new-chapel-unitarian…

“@JamesMartinSJ is a very vocal supportive priest on twitter”

 

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