Children learn about treatments online – but never the risks

AS A practising family doctor, I warmly welcome the Royal College of General Practitioners more cautious approach to the treatment of patients questioning their gender.

None of the other Royal colleges has spelt out the pitfalls of caring for these individuals with such clarity and plain-speaking.

Like most GPs, my ultimate concern is to see patients receive the highest possible quality of NHS care.

That means there must be solid evidence that the treatments offered to them are appropriate – and do more good than harm.

Yet when it comes to the treatment of young patients presenting as transgender, I can’t say this is the case.

First, there is the essential question of whether we should be providing puberty blockers.

We are seeing an unprecedented rise in demand for referrals to gender identity clinics, particularly from teenage girls. Many describe a sudden desire to change gender rather than a long-held conviction. GPs recognise the distress they feel is very real. But is anything else behind their unhappiness?

In these circumstances, a ‘wait and see’ approach should be an option.

Second, there is what the RCGP calls the ‘significant lack of evidence’ for treatments.

Youngsters can pressure us to provide puberty blockers when they have little idea of the long-term implications. But then most of their information appears to come from social media, which perpetuates the notion that these medicines are safe.

Regrettably, specialists advocating slowing the process of transition have often been vilified by activists.

The RCGP has given medics who urge restraint institutional ballast. It should be applauded. The GP has asked to be anonymous to maintain patient confidentiality.