Ciara Kelly

A balance must be struck to support gender questioning children before setting them on a path of potentially ruinous puberty blockers

The NHS has banned puberty blockers for children following an independent review. They join the growing list of countries like Norway, Finland, Sweden, France and Denmark who are sharply restricting youth gender transitions. The NHS said there isn’t enough evidence to support the use of puberty blockers following research showing them to be not fully reversible, as was previously claimed. It found instead that they can affect bone and brain development and pose a risk of sterility and lowered IQ. This is in line with the French Academy of Medicine who say the growing cases of transgender identity in young people are often socially mediated and it’s not possible to distinguish a durable trans identity from a passing phase of adolescent development.

The Cass report in the UK which resulted in the closure of The Tavistock gender clinic — where over 200 Irish children were sent up to recently — found that good clinical practice wasn’t followed at the clinic and there were issues such as not taking into account other mental health problems and failing to recognise the significant over representation of children with autism attending, and a fear among clinicians working there that the gender clinic was “transing the gay away”.

In a nutshell, it appears that a huge number of gender questioning children are gay or lesbian and struggling to come to terms with that. Another large cohort are autistic or have mental health issues but none of these things were looked at and instead almost all children attending gender services were funnelled down the ‘trans route’ through social transition and interventions such as puberty blockers — that were originally seen as a pause to give a child space to think — but actually seem instead to set almost all of them on a road to transition whilst also having dangerous risks. The primary principle of medicine is “Do no harm” and evidence-based medicine should always be practised — both these things appear to have been abandoned in the care of gender questioning kids.

To be honest, in my 20 years as a doctor I’ve never seen such radical, experimental treatments ever given to kids in any other area of medicine with such poor evidence to support their use. I can only guess that it’s ideologically driven — a desire to be supportive and progressive — that’s caused healthcare professionals to deviate so far from their normal standards of clinical practice.

Of course gender questioning kids need support but presuming all gender questioning children are actually trans appears to be deeply flawed and putting all these kids on a road to transition means we are also transing kids who are gay, distressed for other reasons or going through a passing phase.

The adults need to re-enter the room. Up until recently we understood kids couldn’t get as much as their ears pierced without parental consent — now we are glibly setting them on a road that can lead to infertility, osteoporosis, lowered IQ and permanent sexual dysfunction as if it’s no big deal, when it is. Ideology cannot be allowed to trump clinical safeguarding. A balance must be struck between supporting those young people who may actually go on to be trans adults and protecting those kids — with myriad other issues — from the real harm of being set on a path that’s not for them and is possibly ruinous. •