Gradually, the momentum is building against the medical establishment that claims to offer “gender-affirming care” to vulnerable kids. I’ve posted about the abuses committed by the Tavistock clinic in the U.K., its imminent closing and the thousand-plaintiff lawsuit filed against it. That’s an ongoing story to which a recent book, Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children , by BBC journalist Hannah Barnes, adds immeasurable depth. Read about it in this article by Australian journalist Bernard Lane.
Plus, here in the U.S., former case manager Jamie Reed posted this article on The Free Press, risking her career in the process by calling out the doings of her former employer, the Washington University Transgender Center (WUTC).
Surely the most remarkable aspect of Tavistock and the WUTC is their astonishing similarities. The two seem to have been reading from the same script, ignoring the same ethical problems, misleading parents and kids in the same ways, i.e., the same behaviors that brought down Tavistock and should do the same to WUTC.
Most telling is the quasi-religious fervor with which the two clinics approach their minor patients whether gender dysphoric or not. That mindset, seemingly devoid of doubt, leads to an array of decision-making that would never be permitted in any responsible medical field. Just the title of Lane’s article – “Hormones First. Research Later” - gives the game away.
So, for example, for years, an amazingly weak Dutch study was essentially the sole support for medical transitioning. Barnes:
“[T]he early papers from the Dutch team signalled not just a revolutionary approach to treatment, but also a rather curious trend found in this field of research: results are spoken about with great certainty, but they are based on very small sample sizes, very short-term follow-ups and high rates of participants who are ‘lost to follow-up’—that is, people who don’t respond to the researchers’ invitations to participate.”
Likewise, when doctors at WUTC were urged to keep track of their post-transition patients, they simply refused. Reed:
In 2019, a new group of people appeared on my radar: desisters and detransitioners…
We thought the doctors would want to collect and understand this data in order to figure out what they had missed.
We were wrong.
Both Tavistock and WUTC, then, had large ready-made cohorts of children whose information on transitioning could have contributed hugely to the medical literature on trans kids, but ignored it entirely.
It’s hard to avoid the conclusion that they simply didn’t want to know the truth. That’s buttressed by the fact that, when Tavistock eventually did conduct research into its own patients, the results weren’t encouraging. Lane:
[T]he full results of the Early Intervention Study were at last published in December 2020, almost a decade after it had begun. It turned out that this intervention had provided patients with no measurable benefit in psychological functioning, quality of life, or intensity of gender dysphoria.
No wonder they sat on their data for a decade.
Both clinics routinely made claims about the “science” on gender dysphoria that fell somewhere between stretching the truth and outright falsehood. The result was medical experimentation on human subjects. Lane:
Experimental treatment on minors came first, without the ethical guardrails supplied by formal research.
And in both cases, parents, like their children, were left in the dark about the actual science on sexual transitioning, its many possible side-effects, post-treatment disorders, the desire to “de-transition” and the like. Parents were considered obstacles to the goal which, pretty much invariably consisted of giving puberty blockers and then opposite-sex hormones whose impacts on the subject can be lifelong. Reed:
Another disturbing aspect of the center was its lack of regard for the rights of parents—and the extent to which doctors saw themselves as more informed decision-makers over the fate of these children.
Barnes:
“While this study began with admirable aims—to test the claims about what was seen as an experimental treatment in a safe research setting—[the clinic] did not wait for the data to emerge before rolling out early puberty suppression more widely [in 2014].
Reed:
Soon after my arrival at the Transgender Center, I was struck by the lack of formal protocols for treatment. The center’s physician co-directors were essentially the sole authority…
[T]he center downplayed the negative consequences, and emphasized the need for transition… “The studies we have show these kids often wind up functioning psychosocially as well as or better than their peers.”
There are no reliable studies showing this. Indeed, the experiences of many of the center’s patients prove how false these assertions are.
Neither the minor patients nor their parents were made aware that, by signing up for those hormones, they were committing to a lifetime of medications to counteract their side-effects. Lane:
It also meant that children as young as age 10 were signing up to a pathway likely to sterilise them, potentially rob them of future sexual pleasure, and leave them as permanent medical patients on lifelong drug regimens.
Reed:
I doubt that any parent who's ever consented to give their kid testosterone (a lifelong treatment) knows that they’re also possibly signing their kid up for blood pressure medication, cholesterol medication, and perhaps sleep apnea and diabetes.
Perhaps worst of all, at both the Tavistock and WUTC, kids with long histories of non-gender-related mental problems were treated as if sexual transitioning were the only appropriate treatment. The saying that, if you’re a hammer, every problem looks like a nail, has never been truer than at the two clinics. Neither made any serious effort to disentangle the often quite complex mental/emotional deficits these kids exhibited. Lane:
An analysis of 218 young people referred in 2012 catalogued “non-suicidal self-harm, suicidal ideation, suicide attempts, autism spectrum conditions, ADHD, symptoms of anxiety, psychosis, eating difficulties, bullying and abuse (i.e., physical, psychological/emotional, sexual abuse and neglect).”
But any passing reference to a gender issue in a child’s file was often enough to have him or her referred to the overwhelmed Tavistock clinic.
Reed:
The mental health of these kids was deeply concerning—there were diagnoses like schizophrenia, PTSD, bipolar disorder, and more…
Yet no matter how much suffering or pain a child had endured, or how little treatment and love they had received, our doctors viewed gender transition—even with all the expense and hardship it entailed—as the solution.
And, in both places, evaluation of a child’s problems was not only cursory, but often engineered for the desired result. Lane:
By 2014, the Tavistock was becoming known as a clinic that would turn no child away—where a referral for blockers seemed likely for any distressed patient who wanted them and who’d fulfilled the (easily met) diagnostic criteria for gender dysphoria…
At the Tavistock…, there was typically only one treatment path—leading to endocrinology, blockers, and hormones.
Reed:
[The minor patients] had no idea who they were going to be as adults. Yet all it took for them to permanently transform themselves was one or two short conversations with a therapist…
To begin transitioning, the girls needed a letter of support from a therapist—usually one we recommended—who they had to see only once or twice for the green light. To make it more efficient for the therapists, we offered them a template for how to write a letter in support of transition. The next stop was a single visit to the endocrinologist for a testosterone prescription.
That’s all it took.
In the process, not only was transitioning often neither appropriate nor even desired, but the very urgent need for treatment of the child’s actual condition was left by the wayside. Here’s Lane on one boy with an extreme case of obsessive-compulsive disorder:
[Child and Adolescent Mental Health Services] dealt with him as a woman, and his OCD went untreated.
One of the salient features of the recent trans trend is its astonishing growth, particularly among girls. So new referrals to Tavistock “skyrocketed from 97 in 2009–10 to 2,748 in 2019–20, an increase of more than 2,700 percent.” Reed reports that, in her four years at WUTC,
Teenage girls, many with no previous history of gender distress, suddenly declared they were transgender and demanded immediate treatment with testosterone…
When I started there were probably 10 such calls a month. When I left there were 50, and about 70 percent of the new patients were girls. Sometimes clusters of girls arrived from the same high school.
The Royal Children’s Hospital in Australia reported much the same:
In 2012, when Dr. Telfer became director, there were just 18 new referrals. In 2019, there were 336.
The findings of a study conducted by Tavistock and RCH strongly suggest a reason – “a correlation between the appearance of transgender-related media stories and spikes in new referrals at their clinics one to three weeks afterwards.”
In short, it’s entirely possible that the dramatic increase in the number of kids claiming to be the “wrong” sex is a matter of social contagion, i.e., a case of adolescent “monkey see/monkey do.” But, despite their own findings, the trans establishment so far refuses to admit the possibility.
Finally, it is abundantly clear that sex transition practice in the U.S. and at Tavistock is out of step with “best practices.” In Finland, the medical establishment has made ethically and therapeutically sound reforms that simply must become a part of protocols in the U.S. and elsewhere. Lane:
Having done their own research, as well as a systematic review of the evidence base common to youth gender clinics internationally, the Finns radically changed their clinical practice. In 2020, a Finnish public health agency declared that “gender reassignment of minors is an experimental practice”; that first-line treatment for gender dysphoria should be mainstream mental health care and support at school; and that if these young people showed psychiatric symptoms, one could not assume their declared opposite-sex identity to be stable.
But until the U.S., the U.K. and Australia (at least) make similar commonsense reforms, Reed’s conclusions remain most to the point:
[W]e are permanently harming the vulnerable patients in our care.
[W]hat is happening to them is morally and medically appalling.