The Mail on Sunday


Clinic accused of ‘playing God’ with children’s lives Treatment stops puberty and may do long-term harm

- By Sanchez Manning and Stephen Adams

CHILDREN as young as nine will be given controvers­ial drugs on the NHS to prepare them for sex-swap surgery, The Mail on Sunday can reveal.

The treatment, which halts the onset of adulthood, is aimed at youngsters who believe they are trapped in the wrong body. But critics accused the clinic offering the puberty-postponing injections of ‘playing God’.

‘I think many people will be horrified at the thought of a nine-year-old being provided with a drug that effectivel­y stops them developing and maturing naturally,’ said Conservati­ve MP Andrew Percy.

Others insisted that undisputed research shows that the vast majority of under-16s who

are troubled about their gender do not go on to take the drastic step of surgery. Many turn out to be gay, but no longer feel confused about whether they are male or female.

Although the gender treatment is reversible, there are concerns about the long-term effects on brain developmen­t, bone growth and fertility.

The drugs, known as hypothalam­ic blockers, stunt the developmen­t of sexual organs so less surgery is required if a child chooses to change sex after reaching adolescenc­e.

Monthly injections into the stomach suppress the production of testostero­ne and oestrogen. In girls that halts the menstrual cycle and the developmen­t of breasts. In boys, they stop facial hair growing and voice changes.

Doctors at The Tavistock And Portman NHS Foundation Trust in North London have just completed a three-year trial involving 12- to 14-yearolds, assessing the ‘psychologi­cal, social and physical benefits and risks involved’. Because the trial was deemed such a success, medics have decided to make the drugs more widely available – and to much younger children. Yet only five years ago national guidelines stated that treatment for ‘gender dysphoria’ should not start until puberty had finished.

Dr Polly Carmichael, who led the Tavistock trial, said decisions will now be based on the ‘stage’ of sexual developmen­t rather than age.

‘We’re talking about stopping puberty in the normal range of puberty, so I guess the younger age might be ten or nine,’ she said. Asked if she expected children younger that the survey group to now come forward, she replied: ‘Yes, definitely... because some will be starting [puberty] earlier.’

Research has found puberty is starting earlier in Western children. A recent study found the average age for American girls was nine years and ten months – a full year earlier than a similar study 15 years ago.

Tory MP Mark Pritchard said: ‘With competing NHS resources, especially for lifesaving cancer drugs, there needs to be an immediate investigat­ion into why these drugs are being prescribed to those so young.’

The Tavistock and Portman is the UK’s only specialist clinic for youngsters diagnosed with gender dysphoria.

It was previously caught up in controvers­y in 2012 when it diagnosed Zach Avery – a fiveyear-old boy allowed to live as a girl – with the condition.

The clinic was first given public funding in 2009 when, on average, it treated about 100 under-18s every year for the condition, which affects one in 4,000 people in Britain.

The number of annual referrals has now increased to about 500, reflecting the growth of a new, largely taxpayer-funded industry.

There are now about 150 transgende­r support groups in Britain. Those diagnosed with gender dysphoria can be prioritise­d by local councils for housing as ‘vulnerable people’.

One public figure, who refused to be named, said: ‘This is about policing the behaviour of little girls and boys.

‘So tomboys and boys who like to play with dolls are immediatel­y seen as transgende­r. All the liberals think they are supporting transgende­r rights with this, but what they are really doing is mutilating healthy bodies to help people “fit in”.’

But supporters of the injection treatment say the drugs give children who are confused about their gender a muchneeded ‘window’ before they take on too many masculine or feminine features. This, they

say, prevents mental anguish – and will reduce the amount of surgery needed if they do go ahead with an operation.

Dr Carmichael said that the treatment takes ‘away some of the fear and distress young people go through if they feel their body is going in the wrong direction’.

But Professor Anne Dreger, a leading bioethics expert, said: ‘Putting children on puberty-blocking hormones, may, for some, cement the idea that they are transgende­r when perhaps they are not.’

Only eight of the 32 children diagnosed with gender dysphoria who

How can a child so young give informed consent?

took part in the Tavistock trial went on to start the sex change process.

But Dr Carmichael said: ‘Now we’ve done the study and the results thus far have been positive we’ve decided to continue with it. So we’ve decided to do “stage not age” [as the criterion] because it’s obviously fairer. Twelve is an arbitrary age.

‘If they started puberty aged nine or ten instead of 12, as long as they’re monitored and the bone density doesn’t suffer, then it is right that the aim is to stop the developmen­t of secondary sex characteri­stics.’

Dr Carmichael stressed that the injections are only given to children who meet strict criteria. They must have parental consent, normal bone density and weight, and no serious mental health problems.

The best-known brand of blocker is Gonapeptyl, which costs £82 per dose, and possible side-effects include depression, rashes, asthma and ovarian cysts.

The Tavistock accepts that while the effects of the drugs are temporary, and puberty will resume if you stop taking them, there are risks. To be considered for the treatment, children need to have ‘demonstrat­ed an intense pattern of cross-gendered behaviours and identity’ for at least five years. This means nine-year-old boys would have had to behaved like girls, and vice-versa, since the age of four.

While the clinic makes clear that the ‘young person’ must be ‘able to give informed consent’ for the procedure, critics argue that it is beyond the grasp of even the brightest nine-year-old to fully understand the full implicatio­ns. Dr Carmichael believes the rise in numbers attending the clinic is because more people are aware of gender identity issues. Previously, parents who wanted their children to undergo gender treatment in the early stages of puberty had to travel to countries such as Holland, Belgium and the United States.

As a result, campaign groups sprang up to try to persuade the UK to follow their example.

One particular­ly influentia­l campaign group is the Gender Identity Research and Education Society (GIRES), founded in 2010 by Ber- nard and Terry Reed, whose adult daughter is a transsexua­l.

The group’s influence extends to giving policy advice to the NHS, the Associatio­n of Chief Police Officers, the Crown Prosecutio­n Service, the Department for Children, Schools and Families, and the Home Office

However, with the battle to lower the age of children receiving hormone blocking jabs in the UK seemingly won, even Dr Carmichael cautioned: ‘Some people think this is absolutely the way to go and actually I don’t think it’s right for everybody in this situation.

‘It has to be about balancing risks and benefits.’

 ??  ?? MONTHLY SHOTS: Leading brand of blocker costs £82 a time
MONTHLY SHOTS: Leading brand of blocker costs £82 a time
 ??  ?? ‘BENEFITS’: Dr Polly Carmichael
‘BENEFITS’: Dr Polly Carmichael

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