NHS England is commissioning specialised services for people with gender dysphoria, and it is holding this consultation to seek views on a proposed interim service specification for services for children and young people with gender dysphoria.
The consultation is open until midnight 4th December. You can read the supporting documents and respond to the consultation here. It’s important that the NHS gets as many responses as possible from people who are concerned about children being irreversibly harmed by being taught that they have been “born in the wrong body”. The new NHS services MUST be made on the overriding principle of “First Do No Harm”.
The FET response is below:
To what extent do you agree with the four substantive changes to the service specification listed in the supporting documents?
Composition of the clinical team Partially Agree
We agree that a multi-disciplinary approach is the best way forward since gender dysphoria is a mental health issue which especially impacts on children with co-existing conditions such as autism as well as other mental health conditions. A multi-disciplinary team would also be able to investigate any childhood trauma such as sexual abuse, bullying or family breakdown, all of which are known to contribute to children presenting with gender dysphoria.
Many of these co-existing conditions can be overlooked when the focus is on gender dysphoria.
However due to the significant concerns that have been highlighted around clinicians and processes in existing gender services we would be concerned about simply expanding the team and moving clinicians to a new service.
Clinical leadership Partially Agree
We agree that a suitably experienced and qualified medical doctor should lead on gender services to ensure that children are treated in a holistic manner. However, we do not agree with the reason cited for this that some children require medical intervention. Since gender dysphoria is a mental health condition, no children should require medical intervention that involves prescribing puberty blockers or hormones. Evidence shows that most children progress onto cross sex hormones once prescribed puberty blockers. Children cannot give informed consent, and parents should themselves be investigated if they are pushing for their child to be given medical interventions rather than talking therapies or other psychological counselling to resolve
their gender dysphoria. Services should be led by medical professionals with the ability to holistically assess children and appropriately manage all areas of concern.
Collaboration with referrers and local services Partially Agree
We agree that a tiered approach is needed so that vulnerable children are not automatically fast tracked to NHS gender services by GPs. Since gender dysphoria in children has a whole myriad of causes, it’s important that each child is assessed by the relevant professionals, which may not always include a referral to gender services. In some cases, it is the parents who have convinced a child that they are “trans” because of their own issues which they transfer onto the child. In cases like this, social services should be involved to ensure the welfare of the child and parents should be referred to mental health services. We are concerned however that given the significant rise in numbers of children referred with gender dysphoria there are simply not the resources available to provide an adequate service to support these vulnerable young people.
Referral sources Agree
We agree that referrals should only be made by doctors and NHS health professionals. We have had many parents contact us for advice due to teachers at school or college referring their child to gender services without their consent. We have also heard many cases of organisations such as Mermaids or Gendered Intelligence which provide youth groups and online helplines referring children to gender services without the knowledge or consent of parents. This should not be allowed as these people are not doctors or health professionals and have their own agenda for indoctrinating children with gender ideology. This cannot be allowed to continue, and it’s important that children are properly assessed by doctors and/or trained therapists before
referral to gender services in order to find out more about the causes of their gender dysphoria. In many cases there are comorbidities such as anxiety disorders, autism, social isolation or family breakdown.
To what extent do you agree that the interim service specification provides sufficient clarity about approaches towards social transition? Partially Agree
We agree with Dr Cass that social transition is an active intervention. However, we disagree that social transition of children should ever be considered as this accepts the idea of a “trans child”. All evidence suggests that the increase in gender dysphoria in children is caused by a multitude of co-existing mental, emotional, social and family issues – gender dysphoria is a symptom rather than an innate condition. The document states social transition will be approved when considered “necessary for the alleviation of, or prevention of, clinically significant distress or significant impairment in social functioning and the young person is able to fully comprehend the implications of affirming a social transition.”
Children cannot fully comprehend the implications of social transition because their brains are not fully developed until the age of around 25. They cannot make decisions which could impact on the rest of their life. Neither doctors, parents or schools should be affirming social transition as it can have serious lifelong consequences for the child. No-one can change sex, therefore adults should not be allowing children to believe that this is possible.
To what extent do you agree with the approach to the management of patients accessing prescriptions from un-regulated sources? Agree
We agree that patients should not be accessing hormones online as this is dangerous. There have been many cases of the online provider Gender GP prescribing drugs to children after just one online consultation. In one case this led to the suicide of one of the young people involved. We agree that if children are accessing drugs from providers such as Gender GP then local safeguarding protocols should be initiated. We urge the government to shut down providers such as Gender GP and strike off doctors who are involved in prescribing drugs in this way as they are causing irreversible harm to children and families. We also agree that NHS professionals should not assume responsibility for prescribing recommendations made by private providers regarding puberty blockers and cross-sex hormones.
Are there any other changes or additions to the interim service specification that should be considered in order to support Phase 1 services to effectively deliver this service?
We are concerned about the service being labelled as a specialist service for children and young people with gender dysphoria as this is likely to make a child/young person even more convinced that the problem lies with gender rather than exploring other possibilities for why they feel as they do. It would be better for children and young people to be managed in a more generic mental health service which could holistically explore their difficulties and look at appropriate psychological interventions. Many LGBT organisations define being transgender as a natural, innate condition which is a huge part of the problem when children are told this in
school. Doctors need to accept that it is not possible “to be born in the wrong body” and stop using the term “gender assigned at birth”. Sex is determined at conception and observed at birth.
To what extent do you agree that the Equality and Health Inequalities Impact Assessment reflects the potential impact on health inequalities which might arise as a result of the proposed changes?
Agree