The Observer’s view on gender dysphoria: criminalizing therapy poses risk to children’s well-being | Observer Editorial


There has been a welcome change to the way NHS England says it will provide care for children with gender dysphoria. In recent months, it has moved away from the ideologically driven “affirmative” model that views gender dysphoria in children purely as a sign of a fixed trans identity.

Instead, it is taking a more evidence-based approach – as set out in distinguished pediatrician Dr. Hilary Cass’s review – that begins with the understanding that children’s feelings of gender incongruence are often transitory and fluids, and may be associated with autism, childhood trauma, children struggling with their own developing same-sex attractions, and intense discomfort about puberty.

Consequently, the NHS now says Social transition (treating a child as if he or she were the opposite sex) should only be considered in cases where there is significant clinical distress or impairment in social functioning. Puberty-blocking drugs, the entry point of a medical pathway that can lead to cross-sex hormones and sex reassignment surgery, will only be prescribed as part of a clinical trial, given fears about possible long-term impacts on the bone and brain development. fertility and sexual functioning; and concerns that create permanent gender dysphoria that would otherwise resolve itself naturally. He “watchful waitingThis approach advises that children should be allowed to experiment with identity without adult support or criticism and access talk therapies that include exploration of the reasons for their gender discomfort.

There are a number of serious challenges for the NHS in implementing a new approach; the lack of funding for children’s mental health services and some The continuing ideological affinity of doctors. to the affirmative model. Another is that activists are trying to make the provision of exploratory therapy effectively impossible by entangling it in an ill-defined criminal ban on trans “conversion therapy.” The ban has been linked to parallel proposals to ban gay conversion therapy; However, the fluidity of gender dysphoria makes it a completely different phenomenon than sexual orientation in young people.

No one has been able to precisely define what “trans conversion therapy” is; When the government consulted on a ban, the They criticize the Equality and Human Rights Commission for failing in this regard. But advocates of a ban clearly envision including therapy to explore the causes of a child’s gender distress and help them become more comfortable with her body as an alternative to medicalization. A proposal It even suggests that a doctor who does not prescribe puberty blockers could be criminally sanctioned by a ban.

One wonders what problem an undefinable ban is trying to solve: a government-commissioned study found no evidence that trans conversion therapy is taking place in the UK beyond methodologically flawed methodology. self-report survey. An independent NHS review highlighted that many mental health professionals are already reluctant to treat children with gender distress due to pressure to adopt the affirmative approach.

The chilling effects of criminalizing exploratory conversations between a therapist and a young person that could be perceived as a denial of their identity will only make it even more difficult to access the holistic therapy recognized as critical by the Cass review. Activists will have no qualms about twisting unclear laws to tell doctors, therapists and parents that they may be committing a criminal offense and be subject to “conversion therapy protective orders” unless they immediately affirm that a child is trans. Redefining exploratory therapy as something as terrible-sounding as “conversion therapy” to make it a criminal offense is a forceful campaign tactic, one that any government concerned about the welfare of children with gender dysphoria must resist.

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