Gender reveal

Labour cautious on blockers; state transition in Switzerland; NYT surprises; Finnish progress; inquiry in Chile; paediatrics in court; Queensland LNP hears Cass; California's school secrecy; JD Vance

Photo by Jon Tyson on Unsplash

GCN in brief

Blocking move

United Kingdom | Britain’s new Labour Party Secretary for Health and Social Care, Wes Streeting, has taken to Twitter to explain his cautious approach to puberty blockers, which were put under a temporary ban by the outgoing Conservative government. Mr Streeting noted that the “Cass review found there is not enough evidence about the long-term impact of puberty blockers for gender incongruence to know whether they are safe or not, nor which children might benefit from them. The evidence should have been established before they were ever prescribed.” He dismissed the argument that blockers for gender distress would be just as safe as blockers for the quite different condition of precocious (premature puberty) and he called out wild predictions of suicide among trans-identifying youth denied hormone suppression. “Some of the public statements being made are highly irresponsible and could put vulnerable young people at risk,” he said. Mr Streeting may impose a permanent ban on blockers for gender, The Telegraph has reported.

Meanwhile, an expert report to the Scottish government on the implications of England’s Cass review has recommended that the use of puberty blockers for gender-distressed minors remain suspended until clinical trials can be undertaken. The expert team set up by Scotland’s chief medical officer accepted the relevance of Dr Cass’s findings on hormonal treatment and the need for further UK-wide research. Also this month, a trans-affirmative attempt to topple the leadership of the UK Council for Psychotherapy (UK-CP) failed. The UK-CP had withdrawn from an activist-driven “anti-conversion therapy” memorandum of understanding. The outcome of an activist revolt within the council of the British Medical Association—there was reportedly a motion seeking a public “disavowal” of the Cass review—was unclear at the time of writing.

State power

Switzerland | The parents of a 16-year-old girl, who has been living in a Swiss government shelter since April 2023, are under legal pressure to approve their daughter’s gender transition, according to the faith-based group ADF International. The girl had reportedly declared a male “gender identity” at age 13, following the Covid pandemic and online immersion. She had pre-existing mental health issues and her parents opposed puberty blockers and social transition at school, preferring a mental health response. The parents await a decision on their appeal against a court order that they hand over documents allowing their daughter to apply to change her legal sex in the civil registry.

Video: “I can’t believe we live in a society where your child can be taken away from you simply for trying to protect her”

News that is news

America | In The New York Times, on July 12, a headline unthinkable just a few years ago—“Why Is the US Still Pretending We Know Gender-Affirming Care Works?” Opinion columnist Pamela Paul’s analysis of England’s Cass report and its curious reception in the US began: “Imagine a comprehensive review of research on a treatment for children found ‘remarkably weak evidence’ that it was effective. Now imagine the medical establishment shrugged off the conclusions and continued providing the same unproven and life-altering treatment to its young patients. This is where we are with gender medicine in the US.”

On June 28, another arresting headline in The Times—“Biden Administration Opposes Surgery for Transgender Minors.” The same administration that is in court fighting Republican-run states over their laws restricting hormonal and surgical interventions for minors? From The Times news report: “The Biden administration said this week that it opposed gender-affirming surgery for minors, the most explicit statement to date on the subject from a president who has been a staunch supporter of transgender rights. The White House announcement was sent to The New York Times on Wednesday in response to an article reporting that staff in the office of Adm. Rachel Levine, an assistant secretary at the Department of Health and Human Services, had urged an influential international transgender health organisation [the World Professional Association for Transgender Health, WPATH] to remove age minimums for surgery from its treatment guidelines for minors.” Since that Times headline, the White House reportedly came under pressure from trans activist lobbies and has muddied what seemed a clear message of “No to surgery.” Whatever the true position is, somebody in charge appears to have realised that trans surgery for minors is not, after all, a popular idea.

Another major outlet, The Economist, has also covered the scientific misconduct of WPATH, and its article, “Research into trans medicine has been manipulated”, is now freely available via the Society for Evidence-based Gender Medicine (SEGM). In its own coverage, SEGM has delved into the WPATH scandal in the context of the World Health Organisation’s plans to developed a trans health treatment guideline.

Beyond gender

Finland | Young people in Finland who present with what looks like gender distress are more likely to get the help they need from professionals in mental health, child protection and schools, according to the prominent Finnish clinician Riittakerttu Kaltiala, professor of adolescent psychiatry at Tampere University. In 2020, new treatment guidelines stressed the lack of evidence favouring medicalised gender change for minors and the need to address the psychiatric and other non-gender problems among young people referred to gender clinics. “Before this, even child-protection services would often not intervene because they assumed that gender distress was the sole cause of the patient’s problems,” Professor Kaltiala said in a recent interview with the Finnish newspaper Aamulehti.

She said: “If an adolescent is having problems associated with growing up, such as trouble at school, trouble with relationships or their mental health, those problems will persist even after sex-trait modification [with hormonal or surgical interventions].” Professor Kaltiala said it was “ethically reprehensible” for anyone to urge these physical interventions as necessary to reduce suicide risk. She said suicidal thoughts, often linked to depression or anxiety, were “very different” from actual suicide. “Death by suicide is generally the result of a very serious psychiatric disturbance and not because the patient is contemplating his/her gender identity.”

Rapid response

Chile | The chamber of deputies, the lower house of Chile’s parliament, passed a motion earlier this month empowering a committee to inquire into the hormonal treatment of gender-distressed minors and trans-affirmative programs of support (acompañamiento) available from the age of three. The motion was approved by 79-25 votes, with most votes coming from opposition deputies, according to media outlet ADN Radio Chile. This follows high-impact coverage of the gender clinic controversy—including England’s Cass report—written by journalist Sabine Drysdale in the media outlet BíoBíoChile in May, which generated swift responses in private and public health, including the creation of an expert committee to draft new treatment guidelines.

In a July 11 interview with Radio Duna, Ms Drysdale said she believed one focus for the lower house inquiry would be the concern that Chile’s gender identity law, approved in 2018 under the government of President Sebastián Piñera, “was being taken a little bit beyond what the law said… in other words, a budget is being granted for all these hormones that were not committed to in that law.” Ms Drysdale said it was also unclear whether the treatment of minors rested on informed consent, “because as much as they say that puberty suppression treatments are reversible, that’s when they’re for a very short period of time.”

Paediatric pushback

America | The American College of Pediatricians (ACPeds) has begun court action against the Biden Administration’s Department of Health and Human Services “over its rule that establishes so-called ‘gender-affirming care’ as the new, although unproven, ‘standard of care’ for those who express discomfort with their biological sex,” ACPeds said in a July 10 media statement. “The rule requires doctors to provide and promote ‘social transitions,’ use of pronouns inconsistent with biological sex, experimental use of puberty-blockers and cross-sex hormones for ‘gender-transition’ purposes, and perform harmful, sterilising procedures on adults and children to appear to be the opposite sex, even if state law restricts these procedures. Doctors are even required to inaccurately code their patient’s charts based on gender identity rather than biological sex.” ACPeds is a smaller, more conservative body than the affirmation-only American Academy of Pediatrics.

Cass Down Under

Queensland | The centre-right Liberal National Party (LNP) in the Australian state of Queensland has passed a motion in favour of restricting puberty blockers to clinical trials, in line with England’s Cass review. An overwhelming majority of LNP members supported the policy resolution at the state party convention earlier this month in Brisbane, according to the Courier Mail newspaper, which opted for a “transphobia” angle. Now in opposition, the LNP is ahead in the polls and favoured to win the state election on October 26. The puberty blocker resolution would go to the parliamentary party for possible adoption as policy for an incoming government. Before the vote, LNP members at the state convention were told of the shift to caution on gender medicine in Finland, Sweden and England. “Here in Queensland, the children’s hospital gender service has put hundreds of children on puberty blockers, despite the known harms and lack of reliable evidence for any benefit,” a speech in favour of the motion stated. Two Queensland critics of gender-affirming medicalisation, psychiatrist Jillian Spencer and paediatrician Dylan Wilson, were also mentioned. “We should listen to these doctors and these inquiries, and ban the use of puberty blockers in minors, limiting any use of these experimental drugs to clinical trials,” the speech concluded.

Gender in the shadows

America | California has become the first US state to ban local policies requiring school authorities to notify parents if a student is socially transitioned with a new name or pronouns at school. The New York Times reported that, “The new law was applauded by LGBTQ organisations who said it would protect the privacy and safety of transgender students, especially those who might fear their parents would not support their identity. But conservatives vowed to challenge the law in court, and Elon Musk, the Tesla chief executive, called it the ‘final straw’ in a post on [X/Twitter], vowing to move the headquarters of X and Space X to Texas as a result of the bill signing.” Mr Musk also tweeted: “I did make it clear to [California’s] Governor Newsom about a year ago that laws of this nature would force families and companies to leave California to protect their children.”

Lawyer Erin Friday, a California Democrat who campaigned for a thwarted plebiscite to end the practice of secret social transition at school, tweeted that Governor Gavin Newsom had “deemed all [Californian] parents abusers and not worthy to know when their suffering children are socially transitioning at school, the first step to becoming a forever medical patient.” A comment article co-authored by Ms Friday and Leor Sapir described the new law as deceptive and likely to arouse strong public opposition. They also cited the warning by England’s Cass review that social transition is not a neutral intervention and may work against the natural resolution of gender dysphoria. “As if anticipating the new California law, the [Cass] review emphasised the need for ‘clinical involvement in the decision-making process’ when considering the social transition of children, adding that ‘this is not a role that can be taken by staff without appropriate clinical training’,” they wrote in UnHerd magazine. On July 16, the Liberty Justice Center filed a constitutional challenge to the new California law on behalf of a school district and several parents.

Video: Detransitioner Carol interviews California teacher Arienne, who was among those to speak against the bill signed into law by Governor Newsom on July 15

VP Vance

America | The recently announced US Republican Party nominee for vice-president, Ohio Senator and author JD Vance, has a track record of concern about medicalised gender change for minors. In July 2023, he introduced the Protect Children’s Innocence Act in the US Senate. The bill, which was referred to the Committee on Finance, seeks to prohibit “gender-affirming care” for minors—puberty blockers, cross-sex hormones and surgery. It also targets federal funding for these interventions as well as higher education “instruction in gender-affirming care”. Senator Vance followed the debate over Ohio’s state law restricting medical transition, the Saving Adolescents From Experimentation (SAFE) Act. On Twitter last November, he shared video of evidence in favour of the Ohio bill given by a young female detransitioner, Morgan Keller; the Senator said, “This is extraordinary testimony about how we’re medicalising mental health problems under the euphemism of ‘gender-affirming’ care… As a society we need to come to our senses.”