Source: Women are Human
UK — England. Expert testimony from the Keira Bell court case that persuaded judges effectively to ban the prescription of puberty blockers to gender-questioning children has been made public this week.
British newspapers The Sunday Times and Daily Mail successfully overturned a court order banning publication of clinicians’ testimony, arguing it was in the public interest to hear evidence that:
- puberty blockers are associated with impairment in brain development, bone strength and significantly higher risks of heart attacks and blood clots
- vulnerable teenagers such as those with autism or anorexia are being steered towards gender transition as a solution for other problems
- there is growing evidence of transition regret amongst those have undergone medical interventions
- there has existed failure to inform families that ‘almost all’ children grow out of gender dysphoria and that suicide rates are higher amongst those who receive medical intervention than those who ‘wait and see’
Professor Stephen Levine, a clinical psychiatrist and expert in the field of gender treatment, said puberty suppression medicine – also used for infertility, prostate cancer and to ‘chemically castrate’ violent sex offenders – was “experimental” and the injections had not been scientifically established as a “safe and effective intervention in the short or long term”.
He said: “There was no other field of medicine where such radical interventions are offered to children with such a poor evidence base.”
The NHS Tavistock Centre’s Gender Identity Development Service (GIDS) with clinics in London and Leeds, began prescribing puberty blockers to under-16s in 2011. There has been growing concern ever since about the irreversible, life-changing dangers, and the steep rise in the number of children, especially girls, being referred for treatment.
Referrals of girls to the Tavistock rose from just 32 in 2009/10 to 1,740 in 2018/19, a staggering increase of 5,337% in less than a decade.
In December, the clinic suspended referrals for puberty blockers after judges ruled it was “highly unlikely” and “very doubtful” under-16s could give informed consent to a treatment whose long-term effects were unknown even to the medical profession, and that 16 and 17-year-olds should need the approval of a court to commence medical intervention.
Now the publication of expert testimony shines a light on some of the evidence that led to this ruling, which effectively left GIDS at risk of medical negligence charges if it continued to prescribe puberty blockers to children. The clinic has lodged an appeal against the ruling.
Long-term harm to physical health
The court heard from Professor Sophie Scott, director of University College London’s Institute for Cognitive Neuroscience, that “puberty blockers have profound effects on the developing body, and as part of the changes seen in adolescence involve hormonal effects on brain function, the impact of these drugs on the brain maturation are likely to be deleterious”.
Prof Levine, from Cleveland, Ohio, also warned of “life-long consequences”. He said the vast majority of females on puberty blockers for two years had lower bone density than their peers’ and early research indicated “negative effects on IQ for gender-dysphoric children”.
He said nearly 100 per cent of children treated with puberty blockers went on to take cross-sex hormones, which trigger “irreversible changes” such as hair growth and a deepening voice in females and the growth of breasts in males. Recent studies showed a four-fold increased risk of heart attacks in biological females and three times the risk of deep-vein blood clots in biological males after treatment.
Fashion instead of science
Prof Levine said modern approaches to dealing with gender confusion were based on a “cultural fashion” rather than science. And there had been no controlled clinical trials – the gold standard of scientific testing – for puberty blockers.
Scientific requirements for establishing an intervention’s utility are well known in medicine. Advances are undertaken through carefully controlled clinical trials. Why should gender problems be considered an exception?Prof Stephen Levine, evidence to High Court Dec 2020
Prof Christopher Gillberg, an expert in child and adolescent psychiatry with posts at universities in Glasgow and Sweden, said: “In my years as a physician, I cannot remember an issue of greater significance for the practice of medicine. We have left established evidence-based clinical practice and are using powerful life-altering medication for a vulnerable group of adolescents and children based upon a belief.”
Increased risk of suicide
Prof Gillberg said that, if left alone, the gender dysphoria usually resolved itself, and that as girls grew up they accepted that they wanted to live as women.
John Whitehall, professor of paediatrics at Western Sydney University in Australia, said that information given to families attending the Tavistock clinic “does not appear to share with confused children and their parents and carers the statistical assurance that almost all confused children will revert to an identity congruent with chromosomes through puberty, that ‘puberty blockers’ and cross-sex hormones have structural effects on the brain, and the warning that the rate of suicide in adults is significantly higher after transgendering.”
Autistic children especially vulnerable
The court heard evidence that teenagers with autism or anorexia and those with difficult childhoods were more likely to say they wanted to change sex. A paper published in 2020 suggested autism spectrum disorders had “a prevalence of 6%-26% in transgender populations”, much higher than the 0.9% prevalence in the general population.
Prof Gillberg said that in 45 years of treating autistic children, he saw few cases of gender confusion until 2013. Since then there had been a worldwide explosion in the number of children, mainly girls, saying they wanted to change sex.
Gillberg said: “Adolescence can be a particularly turbulent time when young people often make reckless decisions they later regret. Young people with autism and young people with anorexia nervosa are particularly vulnerable.”
There was “growing anecdotal evidence that many would regret their decision to undergo the biological sex change”. Doctors should tell families that they were “dealing with a live experiment on adolescents and children”.
