GenderCare: London private clinic with a winning business model

by SunMum

The author is a UK academic and mother of a son who experienced sudden onset gender dysphoria. She has attended the Gendered Intelligence parents support group, and her son consulted Stuart Lorimer at GenderCare.  She can be found on Twitter as SunMum@Mum3Sun


The business model of a private gender clinic in the UK looks a dead cert. To start with, you need demand, and the rising demand for gender reassignment services offers that in abundance. The NHS offers a gender reassignment pathway, but demand in recent years has outstripped the resources of a publicly funded health service. Waiting lists at the main adult provider, the Charing Cross Gender Identity Clinic, the UK’s ‘oldest and largest adult clinic’ founded in 1966, are currently about 12 months from the first referral. Referrals have ‘almost quadrupled in 10 years, from 498 in 2006-07 to 1,892 in 2015-16’ according to the Guardian in July 2016.

At the Tavistock and Portman, the only NHS service for children and adolescents with gender dysphoria, referrals have increased ‘about 50% a year since 2010-11.’ In the year leading up to this Guardian report, the rate of change in child referrals showed ‘an unexpected and unprecedented increase of 100%, up from 697 to 1,398 referrals’.

In the same 2016 Guardian article, Charing Cross GIC lead clinician James Barrett comments jocularly on this sudden increase in demand:

‘It obviously can’t continue like that forever because we’d be treating everyone in the country, but there isn’t any sign of that levelling off.’

Now this is a rather strange comment, given that only five years before, in 2011, Barrett stated that rates of gender dysphoria were stable and unchanging. Citing a 1996 study, he presented the condition as vanishingly rare: ‘It seems that the incidence of transsexualism is very roughly 1 in 60000 males and 1 in 100000 females, and it seems to have remained constant’. Given that ‘treatment is drastic and irreversible’, Barrett insisted that diagnosis must be entrusted to the experts of the gender identity clinic:

The least certain diagnosis is that made by the patient, made as it is without any training or objectivity. This uncertainty is not lessened by the patient’s frequently high degree of conviction. Neither does the support of others with gender dysphoria help, since conviction leads people to associate with the like­minded and to discount or fail to seek out disharmonious views. [ James Barrett, Advances in psychiatric treatment (2011), vol. 17, 381–388 doi: 10.1192/apt.bp.109.007484)

 

Pitching the service: Respect and Authority

GenderCare, headed by Stuart Lorimer, is a private London gender clinic mostly staffed by clinicians employed at Charing Cross GIC: endocrinologist Leighton Seal, psychologist Christina Richards and speech therapist Christella Antoni. These are professionals who have reputations at stake.

gendercare-home

And while GenderCare does offer some Skype and email consultations, prospective patients or parents of gender confused young adults can be reassured that this is not an online clinic like that run by Helen Webberley, a Welsh GP whose Online Transgender Medical Clinic displays no more relevant qualifications than a one hour e-course in ‘Gender Variance’ designed by a transactivist organisation for GPs.

Twitter contains some negative reports of Webberley’s outfit: ‘A guy I know was rushed into hospital with liver failure because of Dr W’s incompetence, not having his bloods reviewed meant he was on too high a dosage of testosterone & literally nearly died.’ According to one young person, Webberley ‘has this weird online ‘grooming’ thing going on, contacting young people via social media’. Of course, Twitter testimonials do not constitute actual evidence and should be viewed with caution. Yet it’s clear to anyone who spends time investigating that young people are discerning as they sift through their choices and look for medical help they trust.

weird-online-grooming

The GenderCare website by contrast is reassuringly respectable: these are ‘Specialists in Gender Care’, genuinely experts in their field. The site and FAQ frequently remind us that patients will be seen by a team of medical experts  The FAQ emphasises hormonal treatment,  with assurances that the letter needed for medical transition will be prepared as quickly as possible.

What would be the hurry? It appears that, since 2011 when Lorimer’s Charing Cross colleague James Barrett insisted on the ‘drastic and irreversible’ nature of medical transition and the caution that the ‘least certain diagnosis is that made by the patient’, there has been a sea change in the field. Now Barrett presents gender dysphoria as a condition with no parallel. It simply is what it is, and gender specialists are sui generis: neither psychiatrists, nor endocrinologists, but what it says on the can: ‘gender specialists’. Barrett compares gender dysphoria in a 2016 blog post for the BMJ, to ‘the Australasian Platypus’[full article behind paywall]:

The first specimens were dismissed as a joke of some sort.

But then more came, and alive and kicking at that. There followed a mighty taxonomological struggle. They were reptiles or perhaps some sort of bird, surely, as they were warm blooded, laid eggs and were venomous. On the other hand, the fur argued for mammals, but they didn’t have proper breasts, the defining feature of the mammals, and that business of being venomous is more of a reptile-like thing, is it not? And they do lay eggs…but warm blooded…perhaps a bird of some sort…?

In the end, it was all solved by everyone admitting that the Platypus was real, important, couldn’t be dismissed and didn’t fit any existing category very well. It got its own, special category where it has paddled, very happily, ever since, albeit joined by echidnas and some long-extinct fossilised forebears.

The comparison is witty and memorable, but leaves us no wiser. Lorimer also subscribes to what we might call the Platypus model of gender theory (‘a variety of clinical specialisms might lay reasonable claim to ownership of gender care but, like the platypus, it’s its own creature, distinct and different’. Although trained as a ‘Liaison psych’ he believes that ‘ultimately, it’s about pragmatism – who has the appropriate skill-set to do the work.’

For gender identity, there is no well-founded theoretical model, no objective test: we simply have to believe in the authority of the expert. Believe me because I say so. For the young people who visit GenderCare, diagnosis by a gender specialist offers confirmation and validation of their internal sense of self. YouTube videos about ‘my first visit’ to GenderCare form a genre of their own, revealing the overwhelming power of this validation. One young person reports

‘It were a really positive experience. He were very validating and he shouldn’t have been because I obviously know that someone validating your experience isn’t necessary. But hearing him saying the words saying he’s diagnosed me, he’s signing me off…It’s like all my Christmases come at once.’

There are many transition YouTubes made by young clients of Dr. Lorimer; they are moving videos, in which these young people freely admit they suffer with self harm and sometimes suicidality. A single visit to GenderCare can apparently provide a rapid remedy. The process is quick and simple: when blood tests are in and the letter comes through, a young woman who desires to transition FTM can start testosterone. One has already got ‘syringes through the post’, the ‘sharps bin’ and the needles:

‘I don’t know if you’ll be able to see this. Look at the fucking size of that needle. Look at it compared to the size of my finger. Well clearly I’m not needle-phobic. But fuck, it’s huge. I’d hit myself in the face with a brick if it meant starting on testosterone.’

Pushing at the boundaries

In taking on private work, Lorimer would need to protect his professional reputation and adhere to legal and medical regulations.  This may at times present complications. In 2014, according to a post on ‘The Angels’ (a trans support forum), the UK’s Care Quality Commission (CQC) raised questions about the ‘grey area’ of his private practice, prompting Dr Lorimer to temporarily stop seeing clients.

Lorimer Care quality commission 4.jpg

lorimer-care-quality-commission-3

Leaving aside the question of what may or may not have happened in 2014, the key regulatory boundaries with gender reassignment are to do with time (how quickly hormones are dispensed) and age (those under 18 are treated in a different way from adults). For much of 2016, the GenderCare website warned that hormones are not normally prescribed on a first visit. That is certainly not the belief expressed on Twitter today:

sweetie-one-visit

The burgeoning youth market

GenderCare’s FAQ tells us they primarily treat over-18s, although some exceptions are made. Lorimer confirms this on Twitter:

dr-p-edit

Earlier in this post, we saw that some young people on Twitter were freaked out by what one calls ‘this weird online grooming thing going on’ by Helen Webberley’s outfit. The respectable GenderCare would surely do no such thing. But Lorimer too has a social media presence through which he touts for business, a Twitter voice seemingly designed to speak to the young – especially trans men. Here we find him mythologizing the joys of testosterone:

lorimer-horsemen

Parents know that when young people want something, they want it Now! And for some young women the thing that is needed, and needed quickly, is testosterone, seen by dysphoric adolescent females as a panacea for all ills.

steph-edit

About ‘two thirds’ of his patients, Lorimer explains are ‘trans men’:

lorimer-milkshake

Like the proverbial high court judge, I need to make my way over to the Urban Dictionary . But Lorimer is the doc who talks to young people, who plays knowingly with the idea of ‘A girl’s body and the way she carries it.’ Looking at YouTube or at Twitter, you would think that Stuart Lorimer was an expert on adolescent gender dysphoria. But this apparently is not the case:

lorimer-limited-experience

Lorimer may have ‘extremely limited experience of children/adolescents’. But it takes a very limited dip into the sea of adolescent angst freely available on Twitter and YouTube to realise that GenderCare clients are in the throes of the kinds of relationship and body issues that many adults remember. These are not strange young people, but people suffering from a horribly familiar set of feelings. Of course, we don’t know the age of all those who tweet of vlog about their GenderCare appointments. They might simply be youthful in spirit, but young they certainly appear to be. These don’t sound like people who are approaching ‘drastic and irreversible’ bodily alterations with maturity, discretion or objectivity:

 

Perhaps most troubling is that in 2016 Lorimer arrived on Tumblr, overwhelmingly a place for young people (very popular with ages 13-18), with a GenderCare Tumblr site. Lorimer seems anxious. Why? Is it because he knows he’s rather old to be on Tumblr?

lorimer-tumblr-scare

Tumblr is full of accolades for GenderCare. And whilst one might think a need for hormones and surgery would be necessary only for those who strongly believe themselves to be the opposite sex, evidently even ‘nonbinaries’ are supported in their quest for medical intervention via GenderCare:

tumblr-nonbinary

Lest readers think this nonbinary stuff is hyperbole, Dr Lorimer (aka The MXMaster) confirmed the Tumblrite’s observation on Twitter last August.

lorimer-mxmaster

The market potential for ‘nonbinaries’ must be unlimited.  Who amongst us fully conforms to gender stereotypes? And GenderCare isn’t the only UK gender clinic cashing in on the ‘enbie’  market:

yelland-enbie

Let’s see: Can you spot the difference between ‘non-binary’ and ‘binary’ mastectomy?

But returning to GenderCare, one of the more ironic aspects of all this is that Lorimer himself is certainly old enough and wise enough to see beyond the teenage rush for bodily alteration. A highly flattering image of Lorimer appears on the website of photographer James M. Barrett (not the gender clinician this time but a photographer who specialises in beautiful images of gay men). The photographer’s Facebook page comments sagely on the contemporary rush for bodily alteration:

 ‘In popular culture, there is an extraordinary urgency to take charge of our bodies and minds, and to “become the person that we were always meant to be”! It is as if we can rewrite our lives and give birth to new selves, simply through the power of positive self-belief, and some bloody good cosmetic work on our physical appearance! It is not just a practical idea that looking more attractive might increase our pulling power or lift our spirits. It is the fantasy that if we could just become achingly beautiful, then we will also be unbearably desirable, and our whole lives will be transformed from ordinary to unique. And of course, digital photography plays right into this fantasy, allowing us to perform virtual nick-and-tuck manipulations, and to airbrush a veneer of youthfulness onto our imagined selves. The images in this portrait series have also been heavily worked in post-production, but the effect is meant to suggest something very different: a harsh beauty that resonates with uncertainty, doubt, restlessness, world-weariness, perhaps mid-life crisis…but which also carries a tender intimacy, resilience, ruggedness, and a new-found robustness that comes from surviving a crisis.’

Wise words. And we know that Lorimer subscribes to this aesthetic. Not only has Barrett photographed him but under another image a ‘Stuart Lorimer’ comments: ‘Fantastic portrait!’. In his own photograph, Lorimer looks great: retouched, digitally improved, there is no necessity for cosmetic surgery, drugs, or scalpels.

For professional purposes, simpler photographic techniques suffice:

lorimer-business-cards

Now Lorimer knows, for certain, that Tumblr is for young people:

‘Tumblr, like lycra is probably not for anyone over 30 –yet here I am. Every fibre in my fortysomething being is screaming at me “GO! THIS IS FOR YOUNG PEOPLE!” but I’m resisting that because I think it may be useful for me to tout for lucrative business, as head of GenderCare, to have a presence here.’

Why? Maybe because young people use Tumblr to explore sub cultures of body hatred and body alteration. Lorimer is careful to add a disclaimer that he does not represent his ‘NHS employers or my GenderCare colleagues’.

But there is no escaping the fact that this is the official GenderCare Tumblr. There is no doubt that he is advertising transition services. In this location, Lorimer does not share his wise appreciation of the power of digital photographic enhancement to act out our fantasies. Instead he offers age-appropriate ‘links to things I find diverting that are not especially relevant (cute animals)’:

gendercare-tumblr

Don’t worry, young person about your first trip to get T. You will meet a cuddly gender doc wearing a pink suit.

lorimer-pink-suit

After all, this is all a game, a joke. Fun. Isn’t it?

Well I for one don’t think it is. My son, you see, became seriously depressed in his second year at university and developed sudden onset gender dysphoria. No earlier signs, easily the most ‘boyish’ of my boys. But after a romantic rejection and drug experimentation he developed depersonalization, googled his symptoms, found they were a symptom of trans, stopped washing, seeing his friends, his handwriting changed, he made odd repetitive hand movements, he became angry and he stayed up all night. I thought he was having a breakdown. His GP thinks it is depression or maybe schizophrenia. But, urged on by a counsellor, I in my naivete paid out for an assessment at GenderCare. After all, the clinicians were the real thing, weren’t they? They all worked at Charing Cross GIC in the NHS. They couldn’t be just cynical or stupid, could they?

I was astounded when my son came back telling me that he would be starting hormones in a few weeks. I emailed GenderCare and asked whether I could supply some contextual information. Lorimer contacted my son to ask permission (since he was 22 at the time). Son said yes, so I sent off a timeline of events, including details that I thought might be relevant to a diagnosis, including a series of recent traumatic events. Lorimer duly wrote a report saying he was a bit worried and wanted a second opinion. The second opinion was with his colleague at Charing Cross GIC, James Barrett (not the photographer, who could only have beautified my beautiful son digitally acting out his fantasies). As Barrett had no access to context (this time son said No), he had an avuncular chat with son (cost £200) and advised on choosing a new name and the right to access female toilets. My son, who a family therapy team thought was ‘struggling with his decision to transition’, now repeatedly refers to the fact that he has been ‘diagnosed by two gender experts’. But in this matter, there is no diagnosis: doctors simply echo back to patients their own self-diagnosis. And the first doctor to offer him that external recognition was Stuart Lorimer.

GenderCare combines accessibility to the young through its active presence on social media, with a show of clinical expertise. The recent news that the Charing Cross GIC would be run within the Tavistock and Portman NHS trust led Lorimer to comment on ‘that potentially big plus. Possibilities for great cross-fertilisation between child and adult services.’ He wouldn’t notice the crassness of the metaphor, because what Lorimer is breeding is a business model; the fertility of confused young people is neither here nor there.

cross-sterilisation

Anime culture & teen trans-trending

This morning, after descending into the bowels of the site “Kiwi Farms” (the lair of some of the Internet’s more colorful denizens), we tweet-stormed about the unethical “gender specialists” who profit from the identity confusion of teens addicted to anime and Tumblr-inspired cosplay. The particular Kiwi Farms thread discusses what many of us parents are all too aware of: The impact of hours of pretend-identity play on our kids’ desire to make their Internet fantasies a reality “IRL.”

The question is: Where the hell are the developmental psychologists, sociologists, autism experts, and responsible journalists [more and more an oxymoron] on this issue? It’s not like this stuff is happening in secret.

Here is the “storified” tweet storm, reproduced below.

anime-titleanime-part-1

anime-part-2anime-part-3anime-part-4

 

 

A mum’s voyage through Transtopia: A tale of love and desistance

Lily Maynard lives with her husband and their family in the UK. Her daughter, Jessie, was 15 when she first began identifying as trans.

In this post, Lily chronicles her grueling journey of self education on trans issues, and her determination to share what she learned with Jessie, who at first utterly dismissed her mother’s efforts.  But after 9 months, Jessie, now 16, eventually desisted from trans identification, and, with the support of her mother and another formerly trans-identified friend, came to recognize and embrace herself as a young woman.

Jessie adds her own observations at the end of her mother’s post.

Lily and Jessie are both available to interact with readers in the comments section of this post.


by Lily Maynard

My youngest daughter Jessie was not a ‘girly’ girl. As a small child she was often mistaken for a boy, despite her long hair, because mostly she wore jeans and dinosaur tops. She didn’t care much for the pastel, glitter, hearts and lace that tends to fill the girls’ section of most stores. Growing up, she liked Dora the Explorer and Ben 10; she liked Lego and Bratz dolls. Occasionally, she chose a pink sparkly top, or a crystal ballerina for the Christmas tree.

Once, when she was about 7, a woman in a second-hand shop said to her, “Oh you’re a GIRL! Why are you playing with that dirty old truck? Here’s a nice doll.”

So I bought her the truck to make a point, and on the way home we talked about how silly it was to have different toys for boys and girls. We always applauded the strong women in movies and cartoons. My kids would tell me, “Mum, you’d like this film, there’s a Strong Female Role in it.”

Jessie played with both boys and girls growing up; she had siblings; she was sociable; she had a wide circle of friends. She did ballet for half a term, but tripped over her feet and hated it. She tried football, but tripped over her feet and hated getting up early. She liked jujitsu and roller skating, drawing and writing stories. She hated skirts and dresses and tomatoes.

By age 12, she was spending a lot of time online. She had a Facebook account and loved YouTube, music videos, cat videos; Naruto and Hannah Montana. She hung out mostly with a small group of close girlfriends, but mixed well with anyone. At 13 she had her own iPhone and laptop, and worshipped One Direction. At 14, she began watching videos by lesbian YouTubers Rose and Rosie, and ElloSteph. For the most part, I liked them. These young women were funny, happy and confident, and they gave out good life advice. Their videos were well composed, although there was a bit too much of the obligatory YouTube navel-gazing  for my liking.

Jessie, slightly goth, long dyed dark hair and occasional black eyeliner, always in jeans and a band T shirt, Jessie came out as gay just before her 15th birthday . I wasn’t surprised. She’d briefly ‘dated’ a boy she’d known since she was five but it was obviously no great passion, so I had suspected she was going to tell me weeks before she did. Shortly afterwards she made a ‘coming out’ YouTube video and posted it on her Facebook page. She said she was ‘gay’; she didn’t use the word ‘lesbian’. I did think she was quite young to define her sexuality so suddenly and utterly, and declare it to the world before she had even had a relationship. By this time, I was very aware of the part YouTube youth culture played in the decision to ‘go public’ with a video. I told her that, but I wasn’t shocked or discouraging.  I had a few girlfriends myself when I was younger. If she was a lesbian, so be it. I just wanted her to be happy and healthy.

Soon thereafter, Jessie began watching ‘transitioning’ videos on YouTube with her friends and siblings: cute boys who became girls and cute girls who became boys; endless slideshows of their stories, entitled, ‘My Transition Timeline’.

The girls all had the same sideways smiles and little bum-fluff beards. “I never liked pink,” they declared, “I never liked dresses, I wasn’t attracted to boys. I wore guy clothing.” The boys twisted their long hair as they spoke through heavily lipsticked lips, leaning forward coyly and peering out from over-mascara’ed lashes.  “I always liked pink,” they cooed, “I played with girls’ toys.” I wondered why this generation seemed desperate to put itself into boxes and mark them with labels, but mostly I worried that my kids were spending too much time online.

“Read a book; go outside!” was my mantra. “Turn off the internet and put down your phone.”

Jessie took me to a YouTube convention and we sat at the front during the LGBT discussion. She had a crush on a high-profile teen who identified as a boy. Chris was on hormones and had had a double mastectomy. Chris was kind to Jessie at the ‘meet and greet’ afterwards and posed for a photo. I didn’t see Chris as a boy, but I didn’t think much of it at the time. What I do remember was those eyes, like a frightened rabbit, a frail little thing despite the smiles.

Jessie asked to cut her long hair short. I said, “Of course.” I was surprised how much it suited her. We donated her hair to the Little Princess Trust, to be made into wigs for children with cancer.

Jessie still had her phone 24/7. I ‘trusted’ her, despite knowing that many of her friends were online half the night. I knew some of them self-harmed, or starved themselves, or posted half-naked pictures online. I know now that it isn’t about trust. No one ever thinks their child is doing that stuff. Social media cliques are like a spiral, ever more insular and self-serving. They are more than the sum of the parts of their users. The internet can be a great source of support, but whole online communities have grown up to normalise disturbing behaviours: from the personification of eating disorders with Ana and Mia, through forums where kids discuss who cuts the deepest or most frequently. If my bright, happy child was vulnerable, anybody’s child can be vulnerable. You can’t ‘trust’ your child not to get drawn into a cult, any more than you can trust them not to get run over by a truck.

joolz-pullquote

A month after cutting her hair, Jessie said she had something to tell me. She was distraught, red-faced and bleary-eyed. There was a tiny part of me that knew what she was going to say, although I didn’t realise it until later. After almost an hour of pacing the room she grabbed a pen and wrote on a scrap of paper, ‘I am transgender’.

Despite having half-known what she was going to say, I was shocked. I had heard of people who said they’d always known they were ‘in the wrong body’ but there had never been anything in Jessie’s past to suggest that might be the case with her. She insisted the signs had always been there. She hated wearing dresses, she used male avatars in video games, she didn’t want to flirt with boys. She didn’t ‘feel’ like a girl.

“Do you want to go on hormones?” I asked, at one point during that first conversation. “You’d grow a beard.” I added, pointlessly.

She nodded. She never mentioned surgery, but I saw it looming in her future. The prospect terrified me. I didn’t know what to say.  So I said, “It’ll be ok.”

She seemed much happier after telling me and then went to bed, a million miles away, in her room next to mine. I went to bed too, and the darkness screamed at me. I got up again, and spent the night googling ‘transgender’ and crying. I tried to be open-minded. I wanted to support Jessie more than anything; to do the best thing to help her, but I was sure transition wasn’t the answer she needed. I told myself I was open-minded, but was I really? Was I in denial? I slept very little over the following weeks.

I spoke to a lesbian friend, in a panic.  “What does he want to do next?” she inquired.  I felt as if I’d been punched in the stomach.

One of the first places I looked for information was the National Health Service website, because I presumed there would be impartial advice: something about helping people with the issue of reconciling their bodies with their identity. I thought that thinking you were transgender would be treated as a mental health issue; surely  transition would be recommended as a last resort.

I typed ‘NHS transgender’ into Google, and the first article that appeared was the story of a boxing promoter who came out as transgender  at age 60; about  his ‘dreams, diaries and dress-ups’. A link on that site led to the children’s trans support group, ‘Mermaids’. which is run by parents who believe their children are born in the wrong bodies. Their advice to confused teens, in the section ‘I think I’m trans, what do I do?’ is ‘you can speak to your GP  without your parents being able to know if you are not comfortable with coming out to them yet.’ Next, I flipped through the testimonials from parents. Mermaids receives UK lottery funding and is often the first port of call for concerned parents in the UK.  As far as I could tell, every single child mentioned on the site has transitioned.

Another link on the NHS transgender page led me to a glossy brochure called ‘Living my Life’, featuring studio photos of good-looking transgender people. It struck me as more of an advert for plastic surgery than an information booklet.

A spikey-haired 20-something plays a guitar and shouts into the camera. ’We’re here for a good time, not a long time.’  A coiffed and manicured blonde wears a low-cut salmon pink top, and a pair of surgically enhanced breasts take up most of the bottom half of the picture.  ’I was always me but I just didn’t look like me.’

There was nothing on either of those two links about helping kids to reconcile with their natal sex. Nothing about working through it; nothing about learning to love yourself as you are. I saw nothing stating the obvious: that a healthy natal boy has a penis and testicles and a healthy natal girl has a vulva and vagina, and that both sexes should be able to do all the things they love while wearing whatever damn outfit takes their fancy.

I typed ‘Am I transgender?’ into Google and clicked on the link to amitransgender.com. One word filled the screen: a black YES on a white background.

“I want to change my pronouns,” Jessie announced. “I’m a boy in a girl’s body.”

“How can you know what a boy feels like, when you’re a girl?” I demanded.

She couldn’t or wouldn’t answer.

“You’re a girl,” I insisted. “You can do anything as a girl, achieve anything as a girl that you could if you were a boy, but you can’t just become a boy any more than you can become a cat. It doesn’t work like that.”

“Go away.”

My eyes were opened over the next few weeks. Staying up most of the night, every night, Google led me beyond YouTube, to Reddit, to Tumblr, to Pinterest and Instagram. To posts about pink, clothing, hair and make-up. To seemingly endless pictures and slideshows of men, dressed like pornstars, claiming to be women. Vague explanations about ‘feeling’ different; about ‘being yourself’. It led me to videos of girls in checked shirts with cute quiffs and bound breasts, who genuinely believed they were gay men. They talked of ‘gender identity’ and the sex they’d been ‘assigned at birth’, as if births were attended by a gender fairy who absent-mindedly distributed random gifts of genitalia. A huge amount of importance was attached to public bathroom access and locker rooms of one’s choice. Endless posts claiming, in all seriousness, that ‘misgendering’ transpeople is an act of violence tantamount to trying to kill them, and how the only way to stop the feeling of dysphoria is to embrace transition and start living as your ‘preferred gender’. Immediately. There is no shortage of gender therapists offering to help a child do that, because if you even suspect you might be trans, then you probably are. Type ‘child gender therapist UK’ into Google and you get over 15 million results.

Everywhere I looked, the internet seemed eager to affirm that transition was a simple and marvellous thing, the one and only solution to all the problems of physical and social dysphoria. If you don’t support your child’s transition, parents are warned over and over again, they will probably try to kill themselves.

amitransgender

I learned a lot. I learned that if you don’t believe a man can become a woman; if you are gender critical, you will be called a TERF, transphobic and told to ‘educate yourself’ at best; ‘die in a fire’ at worst. I became familiar with the term ‘die cis scum’ (‘cis’  are non-trans people). I learned that if you are a lesbian who doesn’t want to give fellatio, you are transphobic. You may be called a cisbian and you are responsible for the ‘cotton ceiling’. Men get pregnant  and you should say ‘chestfeeding’ not ‘breastfeeding’. Vulva cupcakes are violent. Women who menstruate should be called ‘menstruators’ so as not to trigger transwomen who cannot menstruate, or transmen who don’t wish to be reminded that they do. The term ‘female genital mutilation’ is ‘cis sexist’. Often, middle-aged people with names like Misty or Crystal will be the ones helpfully explaining this to confused ‘non-binary’ youngsters. If your child thinks they’re trans, there are a host of interested adults out there. They’ll help you select underwear, they’ll advise you to start transition as early as you can. Some will advise you to keep your feelings from your parents because they may become ‘crazy, hateful people’ if you come out to them. Worried siblings are told to keep quiet if they don’t want suicide on their hands. A few clicks will get you tips on how to get a binder without your parents knowing; some sites will even post you a second-hand binder for free. Tips on how to get hold of hormones illegally online and how to get ‘top surgery’ quicker by lying to a therapist are just a few clicks away.

I started taking Jessie’s phone away at night.

Here’s the thing – teenagers are dysphoric. Dysphoria is defined as ‘a state of unease or generalised dissatisfaction with life’ and that just about sums up being a teenager for a lot of kids. Many teenagers feel they aren’t in the right place, the right life, the right time. It is not such a huge leap, especially for a lesbian girl, to conclude that she is in the wrong body. Transkids call the name their parents gave them at birth their ‘deadname’. The appeal is clear. Society demands such impossible things from our youth. Our boychildren are expected to be tough, to ‘man up’, to scorn women yet acquire them, to value money and power above everything else. Is it any wonder if they shirk from what they are told is manhood? And if it is hard for them, it is so much worse for our girls. They are faced with endless images of airbrushed physical perfection in a society where women are told they can ‘have it all’ but are everywhere portrayed as constantly sexually available and intellectually and physically inferior. We are raising our girls in a society where women still earn nearly 20% less than men for the same work hours; where online porn is only a click away; where a third of young women age 18-24 report being sexually abused in childhood and only one in twenty reported rapes ends in a conviction. Is it really any wonder when young women want to cut off not just their hair  but their breasts and fantasise about emerging, as if from a chrysalis, to join men in their position of power and privilege?

“Gender is a social construct.” I repeated. “You are a biological girl. You can have no idea what it feels like to be a boy, because you aren’t a boy. Being a girl doesn’t have to dictate what you like to do, or wear, or who you love.”

She said, “I’m a boy.”

“No, you are a girl.”

“You can’t tell me how I feel.”

I worried myself sick that, at almost 16, my child was only a few months away from being able to visit a doctor privately and start hormone treatment. In fact, as I later learned, some UK children are receiving cross-sex hormones from private doctors as young as 12.

When I first started my research into transgenderism online, I could find nothing that questioned the trans narrative. Everything said transition was the answer, the only answer. Then I found 4thWaveNow, Transgender Trend and Gender Critical Dad. Those websites were saving lights in the blue glow of my laptop on those sleepless nights. From there I was led to others who questioned Transtopia. I read, with a mixture of relief and dismay, articles showing the huge increase in young people identifying as ‘trans’ and presenting to gender clinics in the last few years. Those most likely to be sucked in seemed to be white, middle class girls who spent compulsive amounts of time on social media. I read blog posts by thissoftspace and crashchaoscats. I watched YouTube videos by the inspirational Peachyoghurt. I read Sheila Jeffreys’ ‘Gender Hurts’. I joined online radical feminist groups and met wonderful women full of love and anger who taught me a lot.  I read stories about five year old children transitioning, and about parents discovering their child had ‘changed pronouns’ at school months ago, but the school had a policy not to discuss  the issue with parents. I saw picture books encouraging children to question if they were born the ‘right’ sex. I read about a woman who started a fundraiser for ‘top surgery’ for her disabled daughter who was hospitalised in an intensive care unit. I watched videos where young boys donned false eyelashes and lipstick and curled their long hair, and told the world that they were really girls, while their parents held the cameras that broadcast their lives to the world via their own YouTube channels. Trans-identifying Jazz Jennings stars in a reality TV show. I read about MTT (male to trans) boxers hospitalising women in fights, about MTT golfers who suddenly became world champions, about middle-aged MTT playing on girls’ basketball teams. And I read story upon story about women and girls being assaulted in bathrooms, locker rooms, prisons and refuges, by men who identified as women and used the privilege that gave them to invade women’s spaces.  In all my internet surfing, I never found a single story about an MTT being attacked in a men’s restroom.

I showed Jessie a graph that registered the sweeping rise in girls identifying as trans over the last decade. She seemed somewhat subdued by that.

“A woman can’t become a man, it’s impossible.” I reasoned. “How can your body be wrong but your brain be right?”

She repeated, “I’m in the wrong body.”

We went round in circles. And then, in my Internet wanderings, I discovered ‘Jake’.

Jessie had created an elaborate online persona as a transboy, as Jake. As the story slowly unravelled, I discovered that Jessie hadn’t met her new girlfriend, Beth, at a party, as she had told me. Instead, they had met online, and as far as Beth was concerned, she had a boyfriend, a transboy called Jake. As far as Beth was concerned, Jessie Maynard didn’t exist.

I was devastated, I was lost, I was furious. We’d had a strict ‘no fake profiles online’ rule and she had broken it, and then had lied to me.

“It’s not a fake profile,” she yelled, as she slammed her bedroom door. “It’s me!”

I changed the internet passwords and I bought her a ‘brick phone’, a phone without internet access. She was not impressed.

But I didn’t try to stop Jessie seeing Beth, or any of her other friends. Beth lived two hours away from us, but I paid Jessie’s train fare to visit her fortnightly, and gave her back her old phone to FaceTime most evenings. I was touched when Jessie wanted me to meet Beth, and I took them out for dinner. I had mixed feelings. On one level I felt the relationship was reinforcing her confusion. On another I felt it might help clear it. Yet I was horrified that Jessie had created this online world, slipped so easily inside and pulled it back into reality with her. There were others calling her Jake now, friends she had met online, and a few ‘IRL’ friends. Even some of her friends’ parents, I discovered, used the new name and pronouns.

“Do you think Beth really sees you as a boy?” I questioned, one afternoon.

“Yes.” Jessie didn’t look up from her book.

“Really?”

“She says if that’s how I identify, that’s how she sees me.” Jessie looked up this time, and seemed a little uncertain. “I have wondered about that,” she admitted.

Sometimes I would sit with her, coaxing her to explain how she felt, trying so hard to understand how she thought she really could be a boy; telling her what a talented and creative person she was and what a great life she had ahead of her.

Sometimes I couldn’t bear it any longer.

“Whatever you do to yourself you will always be a woman,” I shouted, exasperated. “Do you want a life where everyone around you creeps about pretending they think you’re something you’re not? Do you want to spend the rest of your life on hormones? Do you want a half-beard, phantom breasts, a life based on a lie?”

Sometimes she would not speak to me at all. And I didn’t blame her.

As I’ve said, the internet told me repeatedly that my child might kill herself if I questioned this new identity or whether transition was the best response to her feelings. I didn’t believe it. Jessie did not seem suicidal. Angry and confused, yes. There seemed to be no space for question, no one out there to tell these kids they might be ok as they are – that it was society’s expectations of what makes a man or a woman that should change, not them. This self-diagnosed condition seemed to be accepted without question by most therapists and health professionals.

I started a Facebook group just for Jessie and me, where I posted blog links, news articles and reports I found online, and checked if she had read them by bringing them up in conversation.

Sometimes I’d say, “You can have your phone to call Beth after you’ve read that article.”

Or, “I’ll wash up, you go and look at that video.”

Many of the links I shared with her explained gender as a social construct. Some unravelled the myth that our brains are gendered; some discussed what makes a woman a woman. Many linked FTT (female to trans) transgenderism to male domination, some discussed internalised misogyny. I made sure she knew that detransition was ‘a thing’ and that detransitioners were rejected by the community that had encouraged them to transition in the first place. Sometimes we read articles or watched videos together. She rolled her eyes a lot but didn’t seem to mind too much.

dolezal

I read everything I could get my hands on. I stayed up most of the night, most nights, reading and copying and pasting appropriate links for Jessie to read. It was easier than lying in the dark, thinking about my perfect child removing her breasts a few years down the line. I learned about breast binders and the problems they can cause. I learned that the facial hair produced by testosterone often remains even if hormones are stopped. I googled pictures that I now wish I could unsee. A pre-op torso sporting breasts and chest hair. Photos of badly scarred, crooked chests; of nipples that looked as if they had been glued or badly stitched back on, reports of nipples that had ‘fallen off’. A photo of bloody breast tissue lying in a silver surgeon’s bowl. I saw pictures of constructed penises that looked like ready-rolled pastry and the raw exposed flesh that was cut away from arms or thighs to build them. I learned about how an artificial vagina can be constructed from a scrotal sack, and how, in the words of one MTT, “some of the tissues get starved of nutrients and oxygen (and) tends to die off”. I learned about ‘phantom penis syndrome’ and how it can affect some post-op MTTs when they become aroused.

It was horrific. It was nothing like the ‘My 2 Year Transition Story’ YouTube videos. I did not make an appointment for Jessie to see the doctor. I did not take her to a gender clinic.

“You’re not a straight boy, Jessie. You’re a lesbian.” I reasoned.

She shouted, furious, “I am not a lesbian!”

Her 16th birthday came and went. She had a party and her friends took over the ground floor. I kept one eye out from upstairs. Some cross-looking little goth girls smoked and drank beer at the bottom of the garden.

“Who were those girls?” I asked the next day.

“Those boys were Ryan and Jake.”

I snorted.

I did try to find Jessie a therapist who would help her reconcile with being female. The only openly gender critical therapist a Google search threw up lived in Texas. No use to us, then. I was put in touch with several people by email, but I could find no-one who worked in our area. Those I did communicate with were wonderfully supportive but asked me not to name them, not to give out their email address or talk about them. The message was clear – publicly questioning Transtopia could be professional suicide.

Jessie talked disparagingly of ‘otherkin’, the world of people who seriously ‘identify’ as animals. Cats, mostly, or wolves, and sometimes dragons. She didn’t take them very seriously. I said I couldn’t see a lot of difference between their beliefs and her own. She scowled–but then she laughed.

I showed Jessie photographs of Danielle Muscato and Alex Drummond: both men who consider themselves to be women.

I showed her a picture of an FTT (female to trans), who claimed she was a gay man, breast-feeding her baby.

“Man or woman?” I pestered her. “What makes a woman? What makes a man?”

We watched a video about Paul Wolscht, a man in his late forties who now ‘identifies’ and ‘lives as’ a 7- year old girl. Jessie was horrified. She said it was gross. I said that if gender really is all about identity, then his identity is surely as valid as any other. She looked at me, incredulous. I shrugged. There was a silence.

I showed her Peachyoghurt’s YouTube channel and we watched the videos together. Peachyoghurt made Jessie laugh. Sometimes I felt like we were getting somewhere, but when I asked her, the answer was always the same.

“Nothing’s changed. I’m still a boy.”

“What about Rachel Dolezal?” I asked one day, in the middle of dinner. “She was born white but honestly feels as if she is black. How is that different?”

“It just is.”

“Why?”

“I’m eating my dinner, mum.”

I taught her about how gender is a hierarchy; I gave her articles that showed that ‘transwomen’ are as likely to be arrested for violent crime against women as men; and that wealthy, older men are investing huge amounts of money in the transitioning of children.

Sigh. “I’m still a boy, mum. Nothing has changed.”

When Jessie was due to register at college at 16, she told me she wanted to register as a boy, as Jake. I had seen this coming and I was not keen at all. I felt that the more she indulged Jake; ascribed the good things in her life to being perceived as a male, the less there would be left of Jessie. The deeper she waded in the waters of Transtopia, the harder it would be to turn back. I worried about the effect on her education, and the damage that would be done by people in authority appearing to buy into her delusion. I was determined to at least find her some time and space to think a while longer before stepping into a life in which her ’transness’ was either the elephant in the room or the main focus of her being. She’d been offered a place at an excellent college an hour away from us. I took a gamble.

“You can do what you like when you are 18,” I told her. “But for now, you register as Jessie- as a girl- or you go to the college two blocks away from our flat.”

To say she was not pleased is an understatement. There were tears and there was shouting.  But she registered at college as Jessie Maynard.

We know that we are supposed to say that transwomen are real women. We know that it upsets them when we don’t. We also know, although we think about it far less, that we are supposed to believe that teenage girls who think they are boys, are actually men. The reason the cry ‘transwomen are real women’ is so important is that the minute we stop buying into that ‘reality’ the whole house of cards collapses.

I talked with Jessie about the way we treat boys and girls differently and how their brains develop differences because of that. I reminded her that in Victorian times, and well into the 20th century, pink was considered to be a boy’s colour and boys wore dresses until they were as old as eight. Gender expectations are different in different cultures. How could your brain be right but your body wrong? Is Caitlin Jenner really a woman, and is the hardest part of being a woman really deciding what to wear? Can sixty years of male privilege be wiped away with surgery and a lipstick? I talked a lot.

After a while I would always ask, “Do you want me to go away?”  Usually she would say, “Yes,” but sometimes she would shake her head. “No, you can stay.”

I told her how angry it made me feel that she had friends whose parents used her ‘preferred pronouns’, because I wouldn’t tell an anorexic girl she looked better thin, or comment on how cool the cutting scars on a boy’s arms looked.

I tried to give her support and let her know that I would always love her, but I never wavered for a minute from the idea that a woman cannot ‘become’ a man. Jessie and I went out for walks, to the cinema; out to lunch. I watched her and thought how clever she was, how compassionate, how thoughtful, how beautiful. I couldn’t bear the thought that she might mutilate herself in pursuit of something she could never really have. I wore sunglasses far too often that summer, but it helped to hide my eyes.

Then, at a party, Jessie met up with a friend she hadn’t seen for a year. Hazel had lived as a boy called Harvey for 8 months and then re-identified as a girl. Unbeknownst to me, they talked a lot over the next few weeks.

“What does Hazel say about it all?” I asked, curious, when Jessie told me. She shrugged. “Pretty much the same as you.”

When she asked if she could stay the weekend at Hazel’s house, obviously I said yes. I began crossing my fingers and hoping for a light at the end of the tunnel.

A week later she said “I’m thinking about it all, mum. I’m not sure what I think anymore.”

Jessie started at college and had never seemed so happy. Slowly, she seemed to begin reconciling with her femaleness. Then she told me she wanted to tell me something ‘later’. I thought I knew, I suspected, I hoped and I hoped. I waited and time passed slowly.

One day she texted me on the way to college,  “I am a girl. I was never a boy.’

She has told the group of friends that called her Jake the same.  Beth has been accepting, saying “Now you’re my preferred gender.” The only friend who is disappointed is a boy.

“You are becoming problematic.” he told her. “You need to educate yourself.”

Jessie saw the irony.

Jessie wrote a respectful but trans-critical post on her Tumblr account, and two of her ‘transboy’ followers messaged her saying they had also been feeling that way for some time and asked her to tell them more. She is currently messaging with several young people who are experiencing gender confusion. I hope she can help them, as her friend Hazel and I helped her, to realise that your potential should not be governed by your genitals; that the problem is gender and the solution is to try to change the system, not yourself.

I realise that it could have all gone horribly wrong: Jessie could have turned her back on our family and bought into the myth that anyone who questions trans ideology is phobic, full of hatred, and should be discarded in the name of liberation and finding yourself. If things had gone that way, I could have lost a child as well as a daughter. Every family is different and I would not presume to tell another parent how to deal with their child’s assertion that they are transgender. It is a minefield. If I had ever felt that Jessie needed to transition to stay alive, I would have acted differently, but I never once felt that she was in danger of taking her own life. Of course, I had never expected my daughter to tell me she was my son, either.

I do not dispute that, for a very small number of people, their gender and body dysmorphia has gone so far that the only comfortable way for them to survive in this culture is to live as the opposite sex. These people should have the same rights as the rest of us, they should not be discriminated against and they should be able to move about their business in safety. Housing and jobs should be open to them, just as they should to any member of society. I don’t want to belittle their suffering and I would not ‘misgender’ someone to their face. But a man is not a woman and a woman is not a man. These are biological differences, and biology is the fundamental basis of female oppression. To claim that being a woman is no more than a feeling is to instigate the erasure of women. The idea that we should buy into the myth that our young people are ‘born in the wrong body’ because they do not want to conform to contemporary gender stereotypes is doublespeak worthy of an Orwellian dystopia. The fact that teenage girls, predominantly young lesbians, are rejecting their womanhood in an attempt to become their oppressors should fill society with horror. Instead we are making ‘being trans’ into the latest fashion and parading these children in newspapers and on reality TV shows. I don’t know where it will end.

What I do know is that if I had let Jessie register at college as a boy and taken her to a gender clinic, we would be looking at a very, very different picture now. My beautiful 16-year-old daughter would have stepped down the road to public transitioning and a lifetime on medication. She would be looking towards a very different future.

Thank you to those of you that gave me support. To the women and men who have written so honestly about their experiences as parents, or as gender questioning young adults. Words cannot describe the strength you gave me when I needed to believe that I was doing the right thing in not supporting Jessie’s immediate transition. One more strong, healthy young woman is growing up a feminist.


Thoughts from Jessie Maynard:

Although at the time I didn’t appreciate it, the constant repetition of “you can’t be a boy” did me good. A lot of good. I had been spending too much time on the internet and I had got it into my head that somehow, biological girls could really be boys, if they “identified” as such (& vice versa).

As someone who’s always had a mostly realistic grip on the world, for some reason I had been pulled into a world where boys could become girls and girls could become boys. I felt that because I said I was a boy, I was a boy.

At the time, I felt that my mum not immediately calling me Jake and using male pronouns was horrible and transphobic. But in the long run, without her resistance, I probably wouldn’t be as happy as I am today, as I would still be thinking I was a boy and trying to “pass” as a boy (which I would never be able to do without body-altering hormones.)

I think that if I had changed my pronouns in September, and registered at my college as a boy I would be a lot more unhappy as I would constantly be trying to “pass” and I wouldn’t be making the friends I wanted to, as I would be trying to fit in with the “male crowd”. When I arrived at my college, making friends wasn’t my primary motive, however the friends I have made are almost all female, and I don’t think I would have those friends if I had been trying to fit in as a boy.

Most of all, understanding gender as a social construct has taken me a long way in my personal life, and in my ideas about feminism and the way women and men are treated, especially women by the trans movement.

I’m glad that I realised before it was too late, as I am now happier in my own body and identity. I think that as a whole, many girls who wouldn’t’ve identified as transgender 10/20 years ago are now thinking they are which is dangerous and harmful to them, and that talking to them maturely and explaining gender as a social construct could really help them.

 

“In the absence of solid evidence”: “Innovators” and “thought leaders” promote under-18 transition

by Overwhelmed

 

The University of San Francisco runs one of the most prestigious and well respected programs for “trans kids” in the United States.  Their publication, “Health considerations for gender non-conforming children and transgender adolescents,” written by Johanna Olson-Kennedy, MD, Stephen M. Rosenthal, MD, Jennifer Hastings, MD and Linda Wesp, MSN, consists of detailed guidelines on treatment for gender dysphoric youth. It appears to be written for providers, not laypeople, with specific recommendations for GnRH analogues and hormones—when to start, options for delivery (e.g. injection, patches, gel), dosages, needle gauge sizes, and lab tests for monitoring. Other areas are addressed too, including the induction of amenorrhea in natal females and the importance of discussing infertility. Towards the end of the protocol, there is a section about genital and chest surgeries.

The authors state that current standards of care recommend waiting until patients are 18 years old for genital surgeries. But regardless of this advice, they advocate for underage surgeries in certain cases:

Both the Endocrine Society Guidelines and the World Professional Association of Transgender Health (WPATH) Standards of Care version 7.0 recommend deferring genital surgery for both transmasculine and transfeminine youth until the age of 18 years. As youth are transitioning at increasingly younger ages, genital surgery is being performed on a case-by-case basis more frequently in minors.

One of the authors of the UCSF document, Dr. Johanna Olson, has frequently argued for relaxing the over-18 guidelines on genital surgery, including earlier this year on the WPATH Facebook page.

Here’s what the UCSF guidelines have to say about “chest” surgeries aka mastectomies:

 While increasing numbers of insurance companies are covering the cost of male chest reconstruction, there are often arbitrary barriers to surgery citing that youth need to be at least 18 years of age prior to undergoing this procedure. Providers should participate in appeal processes so that patients can undergo chest surgery. There are currently no available data that report the positive impact of male chest reconstruction in minors, although a study is underway now.

Gender doctors don’t have the data to back up the double mastectomies and chest contouring they are performing on minor children. But regardless, providers are instructed to recommend health insurance coverage for the procedure—including intervening in appeals processes.

Throughout the guidelines, there are a number of times it is admitted that the science of pediatric medical transition is lacking in data:

 “While sparse data exist regarding the impact of puberty suppression and gender-affirming hormones administered during adolescence, there have been promising results from the Netherlands indicating that this approach in adolescents results in improved quality of life and diminished gender dysphoria.”

 “While there still exists uncertainty as to which GNC children will continue into adolescence and adulthood with transgender identities and/or gender dysphoria and which will not, it is been noted in prior studies that increased intensity of gender dysphoria is a predictor of a future transgender identity.”

 “While data are sparse, preliminary results from the Netherlands indicate that behavioral problems and general psychological functioning improve while youth (age 12 and older) are undergoing puberty suppression.”

 “While clinically becoming increasingly common, the impact of GnRH analogues administered to transgender youth in early puberty and <12 years of age has not been published.”

 No consensus exists on the length of time GnRH analogues should continue after youth begin gender-affirming hormones.”

However, regardless of these caveats, the protocol comes across as very thorough. Eighteen different sources are cited for justification. The authors appear to be knowledgeable and capable.

But at the very end, there is this disclaimer:

ucsf-disclaimer

And there you have it. We are relying on the “expert opinions of innovators and thought leaders” in a field that is in its infancy. “In the absence of solid evidence,” children are being given earlier and earlier irreversible medical interventions based on best guesses about the future.

As the guidelines note, though, studies are indeed underway. Olson and other gender specialists have received a $5.7-million NIH grant to study children and teens who are currently undergoing medical transition. But importantly, these studies aren’t recruiting a control group of untreated trans-identified children, and they are only set to run for 5 years. While any information is better than none when it comes to this modern experiment on youth, the long-term medical and psychological outcomes for the people who were subjected to irreversible medical interventions in their youth will remain a mystery for decades to come.

Could social transition increase persistence rates in “trans” kids?

The trend of “socially transitioning” children as young as 2 or 3 years old to endorse the notion they are “born in the wrong body” is a very new phenomenon. But to read about it in the press, you’d think this was a settled area of clinical practice, with proven results and few doubts about its efficacy.

It is no such thing.

In a 2011 journal article,  Dutch clinician-researchers who first pioneered the use of puberty blockers cautioned that early social transitions can be difficult to reverse:

 As for the clinical management in children before the age of 10, we suggest a cautious attitude towards the moment of transitioning. Given our findings that some girls, who were almost (but not even entirely) living as boys in their childhood years, experienced great trouble when they wanted to return to the female gender role, we believe that parents and caregivers should fully realize the unpredictability of their child’s psychosexual outcome. They may help the child to handle their gender variance in a supportive way, but without taking social steps long before puberty, which are hard to reverse.

Even the Endocrine Society, which actively promotes puberty blockers and cross-sex hormones for pubescent children, counseled against social transition in its practice guideline:

endocrine-society

As recently as last year, a 17-clinic qualitative study reported on doubts some clinicans have about aspects of “affirmative” treatments for children:

As long as debate remains … and only limited long-term data are available, there will be no consensus on treatment. Therefore, more systematic interdisciplinary and (worldwide) multicenter research is required.

But among many clinicians and activists, social transition (which usually leads to puberty blocking and then to cross sex hormones) is now being actively promoted as completely harmless and “fully reversible.” Not only that: it is being shamelessly peddled as the only way to prevent suicide amongst children and teenagers.

What evidence do we have for these assertions? There is no historical record of desperately dysphoric “trans children” who demanded sex change lest they commit suicide.  The constant media and activist drumbeat that very young children must be socially transitioned ASAP; must be called by the correct pronouns; must have their “wrong bodies” fixed prior to the “wrong puberty”– or they will kill themselves–is the most irresponsible thing the mass media and medical profession could possibly do. It is a form of emotional blackmail which has terrorized countless parents into handing their kids over to gender clinics and activist-run “charities” for transition to the opposite sex. And the media, by running breathless stories implying that the only way to support gender-defiant and gender dysphoric children is to  “transition” them, may be contributing to suicide contagion, a phenomenon that has been well known for decades.

As far as evidence that social transition is “reversible,” which of these children is actually “reversing”? Certainly, the ones who have continued on to puberty blockers are not:

spack-100-persist

Imagine the pressures on any of the myriad trans-kid YouTube stars, or the children who are the subjects of the too-many-to-count fawning media portrayals we see in every major newspaper and magazine. Can a Jazz Jennings really change course?

None of the children who have been identified as “truly transgender” by clinicians like Norman Spack and Johanna Olson are going to get the chance to find out if they would have been just as happy not being socially transitioned. We won’t learn in any systematic way whether social transition and media validation could be creating persistence in children who might otherwise have grown up without medical and psychiatric tampering.  We can’t know, because researchers aren’t studying them; they don’t have control groups of children who claim to be the opposite sex but who are not socially transitioned and subsequently puberty blocked.

What is a truly transgender child? According to activists and some clinicians, the key trait (along with being generally “gender nonconforming” and preferring the clothes, activities, and appearance more typical of the opposite sex) is that these children are more “persistent, consistent, and insistent” in saying they are the opposite sex (vs simply wanting to be, or wishing they were).

But what is the meaning of “persistent, consistent, and insistent” with children who have only been on the planet a short time, as are the many toddlers, preschoolers, and grade schoolers now being labeled as “trans kids”?  Especially when a rather large percentage of these children also exhibit traits of autism—a disorder known to be characterized by rigid thinking, gender nonconformity, and obsessive/restricted patterns of behaviors?

Activists don’t seem troubled by any of this, nor by the decades of research showing most dysphoric children desist and grow up to be lesbian or gay adults.

korte

The recent study most often cited by trans activists is one by Kristina Olson at the University of Washington, which essentially proved that children who preferred the activities and appearance of the opposite sex weren’t just pretending; they  really meant what they said! (Why would anyone question that?)

But even Dr. Olson, whose confirmation-bias-riddled study includes no control group of non-socially transitioned children, admits that no one can know the outcome for this new generation of experimental patients. kristina-olson-does-not-know

These kids are, by any measure, guinea pigs being subjected to social engineering and then (in most cases) experimental medical procedures, the results of which won’t be known for decades. Researchers like Kristina Olson are fully aware of this, but they think it’s worth the cost of some regrets, some detransitions. Because hey–it’s science.

kristina-olson-admits-kids-are-guinea-pigs

A commenter on the above article aptly points out the elephant in the room:

comment-on-olson-article-persistence-caused-by-social-transition

Fortunately, there is reliable data from other clinician-researchers which suggest a more cautious approach is still in order. We have a 2012 study by Devita Singh, which demonstrated that a very high proportion of kids—some 88%–happily desisted from a trans identification as adults.  It’s worth noting that several of these children were “persistent, insistent and consistent” in their formerly intense gender dysphoria.

Dr. Singh shared her views about early transition in a recent, unusually balanced article in The Walrus magazine:

Singh is frustrated that, despite the findings of her study and others like it, there’s now more pressure than ever for doctors and families to affirm a young child’s stated gender. She doesn’t recommend immediate affirmation and instead suggests an approach that involves neither affirming nor denying, but starting with an exploration of how very young children are feeling. Affirmation, she argues, should be a last resort.

These days there can be a high price to pay for treating gender affirmation as a last resort. Dr. Ken Zucker, a  renowned gender dysphoria expert, has approved puberty blockers and cross-sex hormones for many adolescents. Nevertheless, he recognizes that children often change their minds, and takes a careful approach in his clinical practice. For this heresy, he was hounded from his position at CAMH in Toronto by trans activists hellbent on preventing any kind of therapy for dysphoric kids besides “affirmation.”

But Dr. Zucker is still actively publishing,  having co-authored several scholarly journal articles in 2016 alone, and he continues to work with families and young people in his private practice.

In an age when too many believe that children, no matter how young, should be affirmed in their gender identities with no further investigation, clinicians like Zucker are very much needed. Desistance, despite trans activist protestations to the contrary, is a real thing. It’s just not as newsworthy as the latest trans kindergartener coming out story.

This places a heavy burden on parents who aren’t sure who their children are, or who don’t accept the notion that a 5-year-old, even an insistent and strong-willed one, has a set identity in the same way adults do. The current politics leave them behind, because their stories don’t fit neatly into the binary in which trans identities are either accepted or rejected, full stop. There’s no natural political grouping for parents of desisters, because desisting isn’t an identity-politics lodestone in the way persisting is. “We’re quieter,” said Amanda of parents of kids whose gender dysphoria desists. “There are a bunch of us scattered around, and we’re not acting collectively.” As Merry put it, “I feel like sometimes there’s no middle ground. You’re either trans or you’re not, and you can’t be this kid who is just kind of exploring.”

 

Too much trust

4thWaveNow contributor Overwhelmed is the mother of a daughter who previously identified as transgender. Her daughter is now comfortable being female even though she chooses to eschew conventionally feminine clothing and sports a short haircut.

Overwhelmed can be found on Twitter: @LavenderVerse


by Overwhelmed

Why does the public seemingly trust that gender doctors know what they are doing? Well, one of the reasons is the frequent media portrayals of trans kids. Children who have recently undergone medical transition are being presented as success stories, even though no one knows the long term consequences of gender-affirming treatments.

I came across this article on the University of California San Francisco website. It covers the transition of three children—two who have puberty blocker implants and one, a natal female named Oliver, whose treatment has included puberty blockers, testosterone, a double mastectomy with chest contouring, a hysterectomy (at 16 years old!) and plans in the near future for the first in a series of phalloplasty surgeries. The article also highlights the involvement of three gender-affirming pioneers—Dr. Ehrensaft, Dr. Rosenthal and Joel Baum—whom I will discuss a little later in this post. But first I will focus on Oliver.

Oliver’s story (which I’ve pulled from three separate articles) starts off as expected—a young child uncomfortable in dresses who likes short hair and playing baseball. When puberty started, it caused a great deal of distress. Suicide was considered. And then:

A few months before his 15th birthday, …stumbled across the word “transgender” online. He read about people who had had medical treatment to align their bodies with their gender identity – their inner sense of who they are.

“Bam, my life changed,” he says. “It lifted a major weight to find out I could do something about all this pressure I had been feeling.”

 At first Oliver’s parents, especially his father, didn’t accept that their daughter was really their son.

“It took me a bit to become a really supportive dad,” ….

For months they didn’t speak. But in the end, reading the suicide statistics for transgender teens brought him around.

“My kid’s not going to kill himself,” …. “I don’t care what he is, as long as he’s a productive person in society, and he needs all the support we can give him.”

Oliver was taken to UCSF’s Child and Adolescent Gender Center.

By age 15, Oliver… was on a dual regimen of testosterone, plus puberty blockers to keep his endogenous estrogen from competing with the male hormones.

While he had to endure a second puberty, and he’ll need to take testosterone for the rest of his life, he’s had no second thoughts about transitioning.

The summer after his sophomore year, he had “top” surgery – a double mastectomy and male chest contouring – in San Francisco. To pay for the procedure, which was not covered by insurance, he used earnings from years of showing and selling pigs at the Tuolumne County fair.

“It’s a lot of money for a 15-year-old,” he says of the $8,000 price tag. “But I appreciate it every day.”

His family’s insurance also wouldn’t cover a puberty blocker implant, so… at first chose cheaper but “gnarly” monthly shots. Later, concerned about unknown long-term effects of the blockers, and hating the painful shots, he opted for a hysterectomy at age 16 – performed by the same family doctor who had delivered him.

In June, he’ll undergo the first in a series of “bottom” surgeries to create male genitalia.

His only regret, he says, is not finding UCSF’s Gender Center sooner. “To not go through the wrong puberty, those kids are lucky,” he says. “That’s a team effort. You have to show [gender dysphoria], and parents have to catch it.”

Oliver’s story has been published in at least three media articles, likely reaching a large audience. The teen has also been influential in Oliver’s small town high school  where at least four other transgender students have since come out.

ucsf-logo

An increasing number of children like Oliver are announcing they’re transgender, and families are looking to the experts in the field for guidance. Diane Ehrensaft, PhD, a clinical and developmental psychologist, is one of a number of pediatric gender-affirming pioneers in the San Francisco Bay area. She is Director of Mental Health and founding member of the UCSF Child and Adolescent Gender Center. She is a well-known proponent of the gender affirmative model and has authored two books on the subject. Ehrensaft has a private practice in Oakland and serves on the Board of Directors of Gender Spectrum.

Her credentials seem impressive, but there are concerns that her stance could unnecessarily pressure parents into eventually medically transitioning their children. She’s often quoted in news reports about trans kids. Here she is in the Duluth New Tribune article from above, rationalizing the dramatic increase in trans-identifying kids seeking treatment:

“We have lifted the lid culturally,” said developmental psychologist Diane Ehrensaft, whose Oakland, Calif. practice has seen a fourfold increase in the number of gender-questioning kids in recent years. “These kids have always existed, but they kept it underground.”

She is also quoted in the UCSF article:

“When a child says, ‘I’m not the gender you think I am,’ that can be a showstopper,” says Diane Ehrensaft, PhD, the Gender Center’s director of mental heath as well as a private-practice psychologist in Oakland. “Some parents say, ‘Not on my watch. No way am I signing off on a medical intervention. When they’re 18 they can do what they want.’ I say, ‘You’re absolutely right, you’re the ones minding the shop, but let me share with you the risk factors of holding back.’”

A parent swayed by Ehrensaft’s logic may believe that, contrary to historical records,  there were always this many trans kids. This could lead parents to disregard the impacts of social contagion. And she tells parents that being cautious and holding back medical interventions until their child is 18 could lead to serious “risk factors.” Suicide seems to be implied.

Stephen Rosenthal, MD, is another pediatric gender-affirming pioneer in the San Francisco Bay area. He is a founder of the UCSF Child and Adolescent Gender Center and currently serves as its Medical Director. He is also the program director for Pediatric Endocrinology, director of the Endocrine Clinics, and co-director of the Disorders of Sexual Development (DSD) Clinic. Additionally, Rosenthal spends time as a professor of clinical pediatrics at UCSF and conducts research. Currently, he is participating in an NIH-funded study of pediatric medical transition.

He has stated that “these kids have a very high risk of depression, substance abuse, suicidal thoughts and suicide attempts. Not treating is not a neutral option. He promotes early treatment—puberty blockers, cross-sex hormones and sometimes surgeries—to alleviate these symptoms without any proof of long term relief.

Under his direction, the UCSF Child and Adolescent Gender Center has grown substantially. It opened in 2010. By 2012 there were 75 patients and currently there are over 300 patients with about 10 new referrals a month. Business is booming. Clinics are being added in San Mateo and Oakland. The UCSF Gender Center network isn’t the only place in the San Francisco Bay area offering pediatric gender affirming treatment. Stanford and Kaiser Permanente provide similar services.

What could be driving all of these children to seek treatment? Well, the San Francisco Bay Area has been well-educated by Gender Spectrum, a “national advocacy group for gender expansive youth whose mission is to create a gender sensitive and inclusive environment for all children and teens.” Many schools in the area have hosted training sessions by Gender Spectrum. The goal of gender sensitivity training is to increase acceptance and decrease bullying, but it’s likely that some children get confused by the information, leading to a rise in referrals to gender clinics.gender-spectrum-logo

Joel Baum, MS, is an advocate for pediatric gender affirmation. He is the Senior Director of Professional Development and Family Services at Gender Spectrum and is the Director of Education and Advocacy for the UCSF Child and Adolescent Gender Center. He co-wrote Schools in Transition, A Guide for Supporting Transgender Students in K-12 Schools, which I discussed in this blog post. He has spoken in schools, at conferences (mentioned in this 4thWaveNow post) and, according to this article, promotes transgender awareness on radio shows.

Per the article, it was Baum who helped Emily and her husband realize that their son was really their daughter (Kelly).

One day Emily got a call from her husband, who was in his car listening on the radio to Joel Baum, MS, the Gender Center’s director of advocacy as well as the director of education and training for the Oakland-based nonprofit Gender Spectrum. “You’ve got to turn on the radio,” he told her. “I think this is our kid.’”

Emily was horrified to learn about the high rates of harassment, school failure, and suicide among transgender youth. “I couldn’t talk about it without weeping. I kept going to all these images in our culture for transgender people, that they’re on the edge, disenfranchised,” she says. “I was thinking, ‘I can’t lose my kid. I don’t care what her gender is. I’ve got to get on the other side of those statistics.’”

Her path forward, she says, was “unconditional acceptance of my child’s truth.”

The family started regular visits to Gender Center clinics and let Kelly be their guide. She grew her hair long. In third grade, she switched her masculine birth name to a gender-neutral nickname. At age nine, she transitioned socially, becoming “she” to relatives, friends, and classmates.

Intensely private, Kelly wanted no emails to parents, no classroom announcement. Just a quiet switch in pronouns. Her elementary school administrators and teachers – faced with their first transitioning student – were “incredibly supportive,” says Emily, who sought out staff training and put Kelly in a classroom with only one student who knew her from “before”: her best friend.

Now 13, Kelly has a matchstick-sized implant under the skin near her left bicep to suppress the male hormones her body produces. She’s blossomed into a “beautiful, smart, artistic, empathetic, fun kid,” Emily says. “I’m like, ‘Whoo! I hit the jackpot.’ But it was definitely a process and a journey for our family, and our daughter, to come to understand who she was.”

Ehrensaft, Rosenthal and Baum are promoting treatment for gender dysphoric children based on unproven theories, not solid evidence. There has been a dramatic rise in trans-identifying youth, but instead of questioning why, Ehrensaft says that the increase is due to hidden trans kids coming out. Rosenthal seems to believe that pre-emptive treatment (leading children to become permanent medical patients with unknown long term side effects) is worth it to potentially avoid future depression, substance abuse and suicide. Baum doesn’t appear to consider that transgender advocacy can lead some impressionable kids to mistakenly self-diagnose as trans. Or, that it can affect how parents interpret their children, potentially leading their gender defiant kids unnecessarily down the path of transition.

And each uses suicide statistics, flawed as they are, to justify early intervention. I’ve seen many parents in news articles state that the motivation to go along with transition was to avoid suicide. Parents are scared and feel pressured. They want to keep their children alive, no matter what. They don’t feel like they have a real choice. “I can either have a live son or a dead daughter” (or the reverse) is a common saying. When parents trust the advice of gender experts, they will accept puberty blockers, cross-sex hormones, mastectomies, and hysterectomies as necessary. Unfortunately, though, this approach does not guarantee a live child.

Tremendous pressure is being placed on parents to provide gender affirmative “support.” Media articles never quote these pioneers recommending what we do at 4thWaveNow—to support our children in defiance of gender. We allow our children to choose their haircuts, clothing and interests. We accept them as is, without pressuring them to conform to societal expectations. We urge caution and encourage reflection on what it means to be male or female. We consider the long term impacts of medical interventions. We don’t rush into gender affirmation via pronouns or treatments. We want to avoid suicide in our children, but realize that the underlying reasons are more complex than the trans kids media articles portray. And some of us have had success with this approach.

There is a great deal of trust being put in the experts in the field, but we need to remember that they are pioneers in the strictest sense. They are still developing new ways of thinking about and treating gender dysphoric patients. The process is not complete. Gender science is rapidly evolving and changes to treatment protocols are likely. Today’s success stories may not be tomorrow’s success stories. The trust in experts should be viewed from this perspective.

The boy who ‘lived in stealth’: Judge challenges ’emerging orthodoxy’

The following guest post, by 4thWaveNow contributor Artemisia, is Part 1 in a series. In this piece, Artemisia investigates a recently reported case of a 7-year-old child in the UK who was removed from the custody of his mother. The court found that the child had been essentially groomed into a transgender identity by his mother. UK charity Mermaids was banned from contact with the mother and child. Part 2 in this series will take a deeper look at Mermaids and the overall state of affairs regarding “transgender children” in the United Kingdom.


 by Artemisia

 On 21 October the Family Division of the High Court published a judgement delivered earlier that month by Mr. Justice Hayden. The case was widely reported in the press under headlines such as ‘Boy “living life entirely as a girl” removed from mother’s care by judge’ (Guardian). guardian-headline

At once the organisation Mermaids began to kick up a fuss on Twitter. Mermaids is a UK charity. Its objects are ‘to relieve the mental and emotional stress of all persons aged 19 years and under who are in any manner affected by gender identity issues, and their families, and to advance public education in the same’. Mermaids asserted that it had been involved with the family for three years, supporting the mother and child. The claim that Mermaids has had a close involvement with the case is corroborated by a passage in the judgement, extracted from a report prepared for the local authority, which states that the child’s mother was receiving ‘support from the charity Mermaids’.

Mermaids strongly disagrees with the decision to remove the child from his mother. In a series of remarkable public statements on Twitter and elsewhere, the charity and its supporters have stigmatized the judge’s decision to transfer the boy to the care of his father as ‘a huge injustice and transphobic practice’, claimed (wrongly) that ‘there is no evidence … to support [his] views’, described the judge as ‘uninformed and cold hearted’, accused him of ‘abuse’ towards the mother and child and demanded that the judgement be ‘overruled by a higher authority’.

mermaids-tweet

 This seems like very indiscreet behaviour for a charity, particularly a charity which has not denied that it was made the subject of a court order, banning it from contact with either mother or child; but discretion, it appears, is not the Mermaids way.

mermaids-tweet-2

The case arrived in the High Court as a child protection case. However, it began as private legal proceedings brought in the county court by the child’s father.

The child at the centre of the case, called in the judgement ‘J’, is seven years old. His parents separated while he was still a baby. The father (‘F’ in the judgement) continued to have contact with the child until he was about three or four, when there was a breakdown in the access arrangements agreed between the parents. In 2013 the father applied to the county court for a child arrangement order. He was not seeking to remove his son from the care of his mother; he just wanted to be back in contact with him.

‘M’, the mother, opposed F’s application. Among other reasons she claimed that her son was ‘gender variant’ and that F was resistant to allowing him ‘to present as a girl’. The case was heard by Her Honour Judge Penna, a specialist in family proceedings.

In April 2014 Judge Penna considered a report from the Children and Family Court Advisory and Support Service (CAFCASS). It recorded that F had stated that he would not have an issue with J’s being ‘gender variant’, though he did request proof that this was actually the case. CAFCASS suggested that ‘this could be provided by the support group’: presumably this was a reference to Mermaids. Regardless, CAFCASS recommended that the court proceedings should be concluded and that there should be no resumption of contact between J and his father. The stated reason for this was that ‘the animosity between the parents was likely to lead to “potential emotional harm not only to [J] but to [M] too” ’.

Mother Must Never Be Upset. This is a precept that more than one of the agencies involved in this case seem to have taken as a guiding rule.

Judge Penna did not accept the conclusions presented by CAFCASS, stating: ‘I am unable to agree that this recommendation addresses J’s welfare needs which include a need to have a rounded sense of his identity as he grows older.’

Early in 2015 Judge Penna directed the local authority to conduct a section 37 investigation. This is an investigation to determine whether the local authority should apply to the court for a care order. Evidently the reports that Judge Penna had been receiving had led her to the view that J might be at risk.

The section 37 report, dated 20 March, records that during the course of the previous two years a number of concerns relating to M’s parenting of J had been raised by a range of agencies, including the local authority housing department, two different schools and the health centre. Some of the concerns raised, but not all, were related to M’s insistence that J was ‘gender variant’ or ‘transgender’.

The child’s first school, for example, reported that M was claiming that J was being bullied because of his ‘gender variance’. She was unable to provide any names of the bullies and the staff had not seen any bullying take place. M wanted to send her son to school ‘dressed as a girl’. The school, however, found ‘that in class, [J] [didn’t] display any differences to the other boys’. M did not wish to hear this, and ‘on occasions she reduced a teacher to tears’ by  ‘her “forceful and confrontational” manner’.

There are other reports of M behaving aggressively when she is challenged.

Transgender activist Fox Fisher, a strong supporter of Mermaids, has posted an ‘open letter’ addressing J as a ‘trans girl’. Fisher says,

‘After having spent time with you and your mum on number of occasions I cannot understand how anyone could not see you as the girl that you really are. … When I met you at the age of 5, you were using female pronouns and were living happily as the girl that you are.’

I am sure Fisher is perfectly sincere and has reported the situation as it appeared. But has Fisher ever met J without his mother? Or witnessed J’s mother in one of her well-documented rages?

The section 37 report did make some acknowledgement that M could be a difficult person to have dealings with and that ‘on occasion’ she had ‘challenged professionals’. However, this was blamed on the schools and other agencies, who, it was said, ‘did not have a full understanding of gender non conforming children’. This made M feel ‘stressed’. (Mother Must Never Be Upset.)

In spite of the large number of referrals, the report concluded that ‘the concerns have not been substantiated and did not meet threshold for further intervention’: in other words, the local authority would not be applying for a care order.

At several points the report mentioned that M was receiving support from a charity. In each case this was given as a reason why there was no need for further action to be taken by the children’s services department. In one place the charity is named as Mermaids. In other places the name of the charity has been redacted.

No doubt the children’s services department is under-resourced. Probably the social workers felt off-balance and out of their depth, faced with a putatively transgender five-year-old and his articulate and sometimes very daunting mother. Still, with the best will in the world, the CEO and volunteers of Mermaids do not have the training that a social worker receives, nor could they have the overview of the case gained from multi-agency referrals. On the other side, handing J and his mother off to Mermaids meant that the department was committed to accepting without proper investigation the claim that J ‘feel[s] like a girl and want[s] to be a girl’, to use his mother’s words. Moreover, the department bestowed its authority on the ideology of transgenderism which Mermaids embraces and propagates, and in particular the highly questionable construct of the ‘transgender child’. And it led to the rather convenient assumption that whenever concerns were raised about J’s welfare, this was merely a sign that the agency involved was deficient in its ‘understanding of gender non conforming children’.

By October 2015 the court and the local authority had lost track of J. His home address was not known, he was not attending school, and M was not co-operating with the court-appointed guardian over her efforts to get in touch. In this situation, concerned for the child’s welfare, Judge Penna took the decision to transfer the case to the Family Division of the High Court, which has statutory powers that the county courts do not possess. At this point the case ceased to be a matter of private legal proceedings and became a child protection case, a matter of public law.

The case came before Mr Justice Hayden, the judge against whom Mermaids has directed so much bile.  Anthony Hayden QC was made a High Court judge in 2013. Before then he was a senior barrister, acknowledged as an expert in family and children’s law. He was one of five specialists  who contributed to a massive, ground-breaking legal handbook on Children and Same Sex Families (2012). Judge Penna was another of the contributors. The book includes a detailed section on ‘Gender Recognition’.

children_and_same_sex_families

The ‘transphobic’ & ‘uninformed’ judges were contributors to this book

Mr Justice Hayden wrote in the foreword: ‘A society that respects diversity, values equality and promotes fairness is a healthier one for children to grow up in and a better one for us all.’

The judges who have dealt with J’s case are among the top authorities in the country on family and children’s law as it relates to transgender people. When Mermaids and its supporters call Mr Justice Hayden ‘transphobic’ and ‘uninformed’, they show up their own ignorance and prejudice.

At the first hearing before Mr Justice Hayden, in November last year, he made what he describes as ‘a variety of highly prescriptive orders, reinforced by a Penal Notice’ (that is, a warning that any breach of the order will be a contempt of court). He discreetly declines to say what was in these orders or to whom they were directed. However, Fox Fisher, a Mermaids volunteer with inside knowledge of the case who does not, it seems, appreciate that there are some things it is better to keep quiet about, has acknowledged being subject to a gagging order. Fisher has also stated that there has been ‘a ban on Mermaids being involved with either [J or M] for many months’. Presumably, after studying the reports, Mr Justice Hayden concluded that the continued involvement of Mermaids would not be helpful.

During that hearing M told the judge that her son was living ‘in stealth’, that is, entirely as a girl. She claimed that in bringing him up as a girl she was following advice that she had received from the Tavistock Centre (which runs a gender identity clinic for children). When the court asked to see the records that the Tavistock held on her child, she tried to bar their production; when, eventually, these were obtained, they did not bear out her claim.

The next hearing was in February this year. Mr Justice Hayden makes some telling observations about M’s behaviour in court:

What struck me forcibly … was that M spoke of J only in the somewhat opaque and convoluted argot of social work and psychology. She offered an impressive, intense and highly articulate evaluation of the problems faced by children with gender dysphoria but she conveyed no sense of J’s personality, temperament or enthusiasms, notwithstanding frequently being encouraged to do so. Repeatedly she struck me as a professional witness giving evidence about somebody else’s child.

This is reminiscent of some of the signs of Munchausen syndrome by proxy (also known as factitious disorder by proxy). An attention-seeking mother gratifies her needs by faking in her child an unusual condition or disease. Typically she is well-informed about medical care and is able to discuss the child’s symptoms in considerable detail.

I am critical of the modern tendency to class every problematic behaviour pattern as a mental disorder. But the fact that this kind of pattern in a mother-child relationship is recognised and documented is a useful notice that it is by no means unheard-of for mothers to treat their children as screens on which they project whatever gratifies their needs. And I think we need to be reminded of this sometimes. The meme of the ever-loving mother is very powerful and there are strong cultural taboos on saying anything that may tend to undermine it.

After the hearing in February, the judge concluded that J ‘was at risk of significant emotional harm’. He agreed with J’s court-appointed guardian that he should be removed from M’s care. A very experienced clinical psychologist had made assessments of M and F. On the basis of her reports and his own assessment of F as a witness, the judge made an order transferring J to the care of his father.

Mr Justice Hayden has set his views out plainly:

My experience in the Family Division leaves me with little doubt that some children, as young as 4, 5, 6 years of age may identify strongly with their opposite gender. Such children can experience rejection and abuse arising from ignorance both on a personal and institutional level. … It is important that such children are listened to and their views afforded respect but, to my mind, they are ill served by premature labelling. What they require … is the opportunity to develop their identity in which ever way it evolves. J was not only deprived of that space and opportunity by his mother, he was pressed into a gender identification that had far more to do with his mother’s needs and little, if anything, to do with his own.

J’s father has undertaken to give him that space; his mother remains convinced that he is ‘a girl whose true gender identity is being repressed by F and the professionals’.

What Mr Justice Hayden says in the passage I have quoted above is simply the epitome of good sense. To the ideologues of the transgender movement, however, it is heresy. The claim that a child’s ‘gender identity’ is immutably fixed, and identified by the child at four, or three, or even two, is often made by trangenderists and their allies and facilitators. It serves an obvious political purpose, bolstering the ‘born this way’ narrative. However, I have never seen any research evidence that supports it.

Is Mr Justice Hayden aware that he is going against a cherished tenet of transgender ideology? I think he probably is – he’s clearly well-informed – and doesn’t care one bit. No good purpose is served by pandering to the promoters of unsupported and unlikely notions. There is little point, even, in undertaking a debate with them, since their arguments typically disintegrate as soon as they are closely examined. There is a great deal to be said for simply stating reason plainly, and leaving it to the other side to find rational grounds to criticise – if they can.

The judgement is highly critical of the local authority for its persistent failure to intervene in a case where, as Mr Justice Hayden says, ‘there were strong grounds for believing that a child was at risk of serious emotional harm’. He continues: ‘I propose to invite the Director of Children’s Services to undertake a thorough review of the social work response to this case.  Professional deficiencies to this extent cannot go unchecked…’ He raises as a special cause for concern the way the local authority ‘moved into wholesale acceptance that J should be regarded as a girl’, disregarding the fact that, as he states, ‘There was no independent or supportive evidence that J identified as a girl at all, indeed there was a body of material that suggested the contrary.’

He is certainly aware, at least to an extent, of the social and political pressures that have been placed on professionals as a result of the directions taken by transgender activism. He suspects (no doubt correctly) that this is part of the reason why the social workers involved with this case failed to conduct a proper assessment.  He makes it plain that he does not find that acceptable. He refers to ‘an emerging orthodoxy’ with, I think, a clear implication that it hasn’t been adequately scrutinised:

Transgender equality has received a great deal of attention in recent times.  I believe that in this case the profile and sensitivity of the matters raised by the mother blinded a number of professionals from applying their training, skills and, it has to be said, common sense.  They failed properly to investigate M’s assertions, in part I suspect, because they did not wish to appear to be challenging an emerging orthodoxy in such a high profile issue.