Is the NHS honest about improving help for gender-confused teens?

9 July 2020

Dr Carys Moseley comments on what help the NHS is giving to gender-confused teens via its website.

During the past few weeks, the NHS web pages on gender dysphoria have been changed significantly. Many people have welcomed the changes as showing a move away from transgender ideology. But how adequate are these changes for the task of helping teenagers confused about their identity? And how honest and serious is the NHS in this regard?

Is the NHS really backtracking on puberty blockers?

The new NHS webs page on treatment of gender dysphoria no longer claims that puberty blockers are reversible. It now contains more skeptical wording. Some critics such as Transgender Trend hold that the new pages are ‘more accurate and fact-based’. How true is this?

Below I show how the NHS is actually sidestepping the issues. It does this by drawing too sharp a distinction between the administration of puberty blockers and cross-sex hormones. In reality most teenagers who are given the former end up being given the latter as well. In addition the NHS is not saying anything about evidence of the harm of hormones. This is not accuracy, it is arrogant deception of citizens and taxpayers.

Damage to the brain?

The NHS page on treatment of gender dysphoria makes the following statement:

“It’s also not known whether hormone blockers affect the development of the teenage brain or children’s bones. Side effects may also include hot flushes, fatigue and mood alterations.”

Can we trust the NHS regarding treatment of the brains of gender-confused teenagers?

Negative effects on the brain are in fact already known as far as testosterone is concerned. Giving testosterone to girls and women who want to be ‘men’ is known to cause decline in verbal fluency skills. When we consider that many of these girls as well as many of the boys referred already have learning difficulties this is clearly unacceptable.

Whilst it is true that the effect of puberty blockers on the brain are unknown, it is not enough for the NHS to say this. For the entire purpose of puberty blockers for girls is to prevent the rise of oestrogen, in order to justify the administration of artificial testosterone instead. The use of puberty blockers paves the way for the damage done by testosterone later. The NHS is sidestepping the problems here.

Puberty blockers may cause early menopause symptoms

As for effect on bones, this together with mention of hot flushes echoes the fact that puberty blockers have been known to cause early menopause symptoms in girls. The same is true regarding giving them testosterone. There are several scientific papers available that admit that puberty blockers can under certain conditions lead to early menopause. You can read some of them here and here. It is very telling that the NHS does not tell us which sex experiences hot flushes. Is it trying to hide the international evidence for puberty blockers causing early menopause?

Detransitioner Keira Bell told the Daily Mail on 1 March this year that she had experienced menopause symptoms due to taking puberty blockers. On the same day, the BBC omitted this part of her statement about her medical history. Other young women who transitioned have similar stories, which you can read here and here. Shockingly an American mother celebrated the fact that her daughter was going through early menopause in her quest to become a ‘man’.

Permanent effects of hormones

The new NHS page on treatment also emphasises clearly that the effect of taking opposite-sex hormones is irreversible. For example, men and boys who take oestrogen in order to look like ‘women’ permanently develop breasts. Women and girls who take testosterone in order to look and sound like ‘men’ experience the breaking or deepening of the voice. The fact that this change cannot be undone has been reported on the BBC.

The old page did say that these effects of hormones were irreversible, but glossed this as ‘some effects’. They did not refer to the scientific research on NHS male-to-female patients which found a sixfold elevated risk of Multiple Sclerosis due to hormonal imbalances partly caused by taking oestrogen. The current page is also silent on this. Why?

Lack of genuine psychological help

The NHS page on gender dysphoria symptoms was updated on 28 May this year. Its next review is due in three years’ time. The good thing about the new page is that it signposts those who have mental health problems to a page with a list of mental health helplines, none of which are transgender groups. However we must recall that the precise reason for this sidestepping is that gender dysphoria is no longer deemed to be a psychiatric illness by the government.

It is therefore unsurprising that the new page on symptoms also downplays the complexity and depth of the psychological problems involved. Indeed it normalises ‘role-playing’ in childhood, by which is meant playing around with opposite-sex roles and cross-dressing. The impression given is that the NHS really just isn’t interested in helping children or adolescents to live more in harmony with their biological sex. It appears to take a back seat and wash its hands of the problems. It can do this precisely because gender dysphoria has been depathologised.

Equally problematic is the fact that the new page ‘How to get help and support’ encourages social transitioning. The obvious reason for this is that gender identity clinics cannot prescribe hormones due to the Coronavirus situation. The NHS page however says nothing about this, pretending that individuals will have to wait longer for referrals “due to more people needing gender dysphoria services.”

GIDS chief ‘shut down’ child safeguarding concerns

This worrying lack of interest in the psychological and social factors involved is significant as it was followed by a leak to the BBC from GIDS. Last month, Newsnight reported that a paper had been leaked to it that was heavily critical of the director Polly Carmichael. The claim was that she prevented clinicians from reporting their concerns that some children had been sexually abused to the GIDS safeguarding lead, Sonia Appleby. Polly Carmichael is alleged by clinicians to have been unable to say that in referring children for puberty blockers, they were not being harmed.

The BBC was told by former clinicians that they felt that Appleby understood how complex the work of the GIDS is. Her solicitors told BBC Newsnight that she had started legal proceedings against the Tavistock NHS Trust in 2019. In light of this, they said it would not be appropriate to say any more.

Is the GIDS involved in covering up child sexual abuse?

In light of these concerns it is important that the NHS web page on child sexual abuse recommends contacting social services, the NSPCC or the police. We would expect co-ordination between different NHS pages so that members of the public can help a vulnerable child. Did the GIDS influence the NHS website content on gender dysphoria to prevent mention of child sexual abuse as a possible causal factor?

A know-nothing attitude

In light of the GIDS leak to Newsnight, these new NHS pages are just not good enough. They make implausible claims to lack of scientific knowledge of the negative effects of puberty blockers. They also remain silent on crucial evidence that the NHS has actually discovered about the harm of hormones. Their barely-concealed lack of curiosity about the psychological causes of gender dysphoria is a disgrace.

It is telling in all this that the Gender Identity pages for NHS Wales have not changed; they are clearly heavily influenced by Mermaids. As there is no gender identity clinic for minors in Wales, children first go to the GIDS satellite clinic in Cardiff and then to London. A genuine and thorough change on the NHS website would be visible on the NHS Wales pages as well.

Not a genuine change by the NHS

This is not a genuine turnaround by the NHS on gender dysphoria in children. It probably signals that the most strident transgender ideologues are going underground to escape scrutiny and accountability. These new pages look as if they have been written to save clinicians from being sued by dissatisfied patients. If this is the case it would partly be because of the pending court case by a detransitioner and the mother of a patient, whilst also anticipating government legislation on gender recognition. Indeed perhaps nothing will really change until the government forces the NHS to change thoroughly.

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