The consolidated response from the NHS consultation on adult gender services has just been released. While there is some interesting data, the validity of the public survey method of consultation has been eroded due to the number of responses from organised transphobic lobbying groups. The impact of these responses is particularly pronounced on any questions which touch upon services for trans adolescents.

A great number of the responses from ‘individual members of the general public’ and from those who claimed to be ‘friends and family’, advocated transphobic positions, even arguing in favour of conversion therapy.

The volume of responses from those seemingly without personal knowledge or lived experience, is not surprising to anyone who has observed this lobbying tactic from prior public NHS and Government surveys. During the consultation, transphobic groups wrote and widely disseminated set template responses – alongside guidelines for how to complete. In doing so, they sought to swamp the consultation with their ill informed bigotry.

As usual, these highly organised hate groups prioritised spreading of misinformation about and denial of rights to trans children. This was a consultation on adult services, however the anti trans rights template responses focused their aim on the health care options for older teenagers, aged 17 and above.

Below are the key references to teenagers and youth in the consultation.

While in other areas of the consultation the balance is more pronounced between informed clinicians and the service users themselves, a lack of those voices speaking up for trans adolescents has led to the responses of transphobes being centred and highlighted in the report.

Note how the voices of trans seventeen and eighteen year olds are missing or invisible, note how the voices of trans adults (and allies) do not explicit defend the rights of trans youth, note how the voices of supportive parents of trans teens are missing and note how the dialogue on trans teens continues to be dominated by anti-evidence transphobes.

“2.3.4 Assessment process

Service users felt that the requirement to undergo two core diagnostic assessments before treatment commences is excessive

Other respondents emphasised that the mental health of service users should be assessed in greater detail at the initial assessment. This was particularly emphasised in relation to the assessment of young people

Specialised, specific psychological interventions

Some respondents welcomed the service specification’s explicit rejection of conversion therapy. Others, feared that it would leave counsellors and therapists in a position where they can only ‘affirm’ a young person gender identity without exploring potential psychological causes

Loss of fertility

A few individual members of the public believed that under 18-year olds should not be allowed in law to undergo surgery that could result in infertility since under 18-year olds cannot fully appreciate the life-long implications of such a permanent procedure

Gender dysphoria and mental health

Some respondents from these groups disagreed with the NHS’s stance that gender dysphoria is not a mental health condition. Instead, they regarded gender dysphoria to be a mental health problem of a similar kind to body dysmorphic disorder (BDD).

Many respondents from these groups voiced their concern that the current treatment pathway priorities medical over psycho-social interventions. They believed that therapy and counselling should be mandatory before medical interventions are performed. This was seen to be particularly pertinent for young people who are still undergoing a period of identity formation. The concerns arising during this process of identity information, including those related to the gender, sexuality and body image, should be investigated in talking therapies as opposed to medical interventions.

Young people aged 17 years and above will be referred to an adult Gender Identity Clinic

83% of service users supported the proposal, 71% of clinicians, who are mostly GPs, supported the proposal

14% of individual members of the public supported the proposal, 30% of family and friends of service users supported the proposal

Respondents felt that 17 years is too young to make a decision regarding hormonal replacement therapy or surgery. This was particularly a concern given that many interventions were considered irreversible. Reasons for this were:

– That the brain of a young person is still developing at 17 years old and they are therefore more prone to risk-taking behaviour and imperfect decision making

– That young people are also still developing their personality and through this young people may explore aspects of their gender identity. Respondents were worried that during this period young people hold onto readily available “labels” and groups to satisfy their need of belonging, and they considered the “trans” community to be one such group. Often, however, expressing their (gender) identity in a certain way may just be a “phase” for young people that passes with time.

– That 17 year olds may be too young to make decisions about interventions offered to adults. Respondents were particularly worried that this proposal was seen to “fast track teenagers into the adult clinic where they will be treated like adults”. (Individual Member Of The Public).

Respondents said that the diagnostic assessments at Gender Identity Clinics were insufficient for young people given the specific challenges young people face. Respondents felt that more intensive psychological assessment and ongoing support were required.

Respondents also stated that there was a lack of evidence around hormone replacement therapy and surgery. This concern was primarily expressed by individual members of the public. For example, the affects that puberty blockers can have on a young person’s physical and socio-emotional development. Respondents also suggested that a number of young people want to reverse the transition they have undergone

Social pressures

Many individual members of the public suggested that wider societal factors and trends should be considered when assessing those presenting with gender dysphoria. They suggested that young people, and young women in particular, are subject to “social pressures” which may lead them to identify as trans:

• It was felt that young people may be at risk of “social contagion” and “indoctrination” by trans lobby and peer groups online. It was suggested that young people may identify as trans as it gives them entry into a social network where they feel accepted. Respondents worried that any long-term decisions made as a result of trying to “fit in” as a teenager may lead to future regret.
• Respondents identified a set of social “social pressures” faced by young women in particular. They felt that some teenage girls may be transitioning to “escape” the role of a woman in the context of “misogyny” and “sexism” in society. They suggested that the latter may lead to body dysmorphia in women, which can then be falsely understood as gender dysphoria. The perceived increase in the number of teenage girls attending young people’s gender identity services was seen as evidence that this was a societal phenomenon.

Respondents from these groups wanted more research on what “causes” gender dysphoria. They perceived this to be necessary in the light of the “social pressures” on young people and women outlined above”

Adults and Allies – Please Stand Up For Trans Children and Youth

Transphobic haters incessantly attack the rights of trans children and trans youth. They spread misinformation and fear so successfully that concern about potential abuse of children is their number one asset in their fight against trans equality. Note how Sarah Ditum focused on spreading misinformation and fear mongering about trans children in the recent Channel 4 ‘Gender Quake’ debate.

Anyone who wants to see a social shift in acceptance for trans people needs to speak up and stop letting transphobic hate groups dominate the conversation around trans children and trans youth. The fact that hate groups inundated this adult services consultation with fearmongering and misinformation about trans youth should be a surprise to no-one.

Trans children and trans youth need effective, proven, evidence-based affirmative care. They need protecting from harmful, abusive, conversion therapy, or from rigid age-based denial of medical expert endorsed affirmative care.

Transphobes see how weak trans children and youth are. They see how few allies are willing to speak up for trans children and young people.

Trans allies and advocates need to Stand Up for Trans Children and Young People.

Trans Children Exist.

#SomeKidsAreTrans #StandUpForTransKids #LetThemSoar