Change at last: How has it taken the NHS so long to see sense on puberty blocking drugs that can damage children, asks SUE REID
Change is at last taking place in the controversial arena of caring for Britain’s transgender children.
The turn of events is so dramatic it is being hailed by family campaigners as a huge step towards ending what they call a ‘massive medical and social experiment’ on youngsters who believe they have been born in the wrong body.
Momentously, NHS England — which has a history of listening to the pro-transgender lobby — has just announced plans to stop treating patients with powerful puberty blockers unless they are part of a strictly controlled clinical trial.
The plans, if implemented, mean the use of these blockers — which ‘pause’ puberty and are feared to cause irreparable harm — will be radically reduced.
The draft guidelines on future treatments — published recently and currently out for six weeks’ consultation — say that children who believe they are transgender could be going through a ‘phase’ which they may grow out of as they get older.
Change is at last taking place in the controversial arena of caring for Britain’s transgender children
Doctors are advised in the guidelines not to encourage young patients to change their names and pronouns.
Meanwhile, the NHS says its medics will not take ‘clinical responsibility’ for children or their parents who buy puberty-blocking drugs illegally without prescriptions off the internet or through unregulated foreign clinics, and warns they could face knocks on the door from social workers, or even the police.
Make no mistake about the importance of NHS England’s new stance. Thousands of children in this country have been given blockers and other sex-change drugs by our health service over the years in what could become the biggest medical scandal of this century.
The use of puberty blockers has been curtailed in Sweden, France and several U.S. states (even though President Joe Biden this week said, bafflingly, that children who wished to take them had a right to do so).
Now it appears Britain is finally beginning to see sense as well.
Of course, genuine cases of gender dysphoria exist and require clinical treatment. But I have investigated the effects of puberty blockers over many years and am convinced they do immense and irreversible harm in a worrying number of instances.
There are fears that the drugs could endanger fertility, damage the still-developing adolescent brain and can blight intimate pleasure in adulthood.
In many cases, those who take them opt later to undergo brutal surgery to irretrievably reassign their sex organs.
In Paris, a top medical academy blames social media for fuelling demand for blockers, particularly among pubescent girls who want to stop their breasts developing, their periods starting and their hips widening as they pursue their aspiration to live as boys.
In Stockholm, a leading paediatrician has said the blockers chemically ‘castrate’ children and can cause mental health problems.
A ground-breaking investigation by Sweden’s state-run TV channel revealed that 13 of 440 transgender children treated with blockers at the country’s Karolinska University Hospital Gender Identity Development Service had suffered catastrophic injuries.
Their ailments include liver damage, weight gains of up to two stone, mental health problems, skeletal damage and a failure to grow to their natural height.
One 17-year-old suffered from spinal fractures and a bone-weakening condition called osteopenia. It is a disease generally seen in people in their 60s and 70s and is almost impossible to reverse.
After the film aired, the Karolinska reported itself to the national health board which has said, unwaveringly, that using blockers on children ‘carries risks that outweigh benefits’.
Here in the UK, the tide has turned more slowly. Earlier this year the NHS decommissioned London’s flagship clinic for treating children with gender dysphoria.
The Tavistock Gender Identity Development Service (GIDS), will shut next spring after offering consultations to 20,000 young people since 2009, including 5,000 in the past two years alone.
Astonishingly, it emerged last week, more than 30 of these 5,000 children were only aged four or five. It is not known how many, if any, received drug treatment.
The Tavistock Gender Identity Development Service (GIDS), will shut next spring after offering consultations to 20,000 young people since 2009, including 5,000 in the past two years alone
But what we do know is that many patients were referred to endocrinologists for blockers.
One of them was Keira Bell, who at 16 thought she no longer wanted to be a girl and was prescribed puberty blockers after three one-hour GIDS consultations.
She then had her breasts removed in an NHS operation three years later.
Keira told her heartbreaking story to the Daily Mail in January 2020, explaining that she regretted her decision to become a man, had de-transitioned and feared for her fertility because blockers may have irreparably harmed her female reproductive organs.
The decision to shut the Tavistock followed a review of child and youth gender identity services by Dr Hilary Cass, a leading paediatrician, who concluded little was known about the long-term effects on children of blockers and cross-sex hormones which make someone either more masculine or more feminine.
In an accompanying letter to young people, she said: ‘Whenever doctors prescribe, they want to be as certain as possible that the benefits will outweigh any adverse effects so that when you are older you don’t say: ‘Why did no one tell me that might happen?’
Tavistock pioneered the use of blockers on children in 2011 when their impact on future development was largely unknown.
They were prescribed prior to detailed research into their effects and had only previously been used to treat precocious puberty, when a child’s body accelerates into adulthood too soon.
The clinic said it increased the use of blockers in response to high demand from girls wanting to be boys. In 2014, it lowered the minimum prescription age for the drugs from 16 to 11.
‘The good thing is,’ one of the GIDS staff told an apparently dysphoric female child in CBBC programme I Am Leo: ‘If you stop the injections, it’s like pressing a start button and the body just carries on developing as it would if you hadn’t taken the injection.’
It sounds so simple, but this is now known to be dubious advice. The NHS consultation report says that it is still gathering evidence on the ‘safety, potential benefits, and harms of blockers’.
Four years ago worried medics — both current and former Tavistock employees — were already sounding the alarm.
One was erstwhile nurse Susan Evans, who at the time warned the Mail: ‘Children with gender identity problems expect hormone blockers to be handed out quickly. They think these drugs will solve all their concerns: such as how they look, lack of friends, physical changes and typical teenage angst.’
She added: ‘I think the risks of blockers are long-term, including fertility loss. There are worries they interfere with the full development of adolescent brains.’
Four years ago worried medics — both current and former Tavistock employees — were already sounding the alarm
A little publicised report from the Tavistock soon afterwards admitted that some of the clinic’s child patients had shown signs of the same stunted height and thin bone density conditions shown in Karolinska University Hospital. It got scant attention.
Yet, however belatedly, it is eminently sensible for the NHS now to deter the consumption of blockers as if they were lemon sherbets.
The plan will lead to protests from pro-transgender groups, not least because they consider blockers the Holy Grail for treating youngsters.
This week the website of Mermaids, a leading pro-trans organisation advising children, was still unequivocally preaching the virtues of blockers as an ‘internationally recognised safe, healthcare option’.
Adding that they’ve been prescribed to trans people since 1988, the charity said blockers ‘allow a young person to consider their options when exploring their gender identity, as well as alleviating the distress of gender dysphoria’.
A clinic called GenderGP, which offers British transgender children medical care over the internet from an outpost in Spain, also proclaimed: ‘The medical support of trans youth is constantly under attack.
‘GenderGP stands firmly with the world’s more progressive organisations who completely understand that supporting youth with puberty blockers and hormones, where appropriate, is a necessary and life-saving intervention.’
It is fair to say that whatever the new-found intentions of the NHS, there will be a battle ahead.
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