The growth in requests to transition is due to information being more readily available, empowering many young people to recognise what is behind their feelingsby Stephen Whittle / March 3, 2020 / Leave a comment
I am a trans man. In 1975, I failed the clinical assessment for cross-sex hormone therapy, and was told I would never be treated. In the 1960s, 54 per cent of family doctors claimed they would prefer a patient commit suicide rather than provide them with gender reassignment treatments. Thankfully, my GP was different and I got the treatment I needed. Aged 19, as I started life as Stephen, I knew how lucky I was, having managed to avoid being sectioned and given aversion therapy. Being trans was bloody hard work.
Today, clinicians increasingly challenge Emma Hartley’s assumption that there is an absolutely clear distinction between the biology of sex and the social constructs of gender. Some sex dimorphic nuclei and other physical brain features, along with genetic indicators, have been found to differ in trans people, meaning biological elements may well feature in the trans or non-binary person’s experience of gender.
The UK has nine regional Adult Gender Identity Clinics, but still only the Tavistock serves trans and non-binary identified children and adolescents (T/NB children). With limited resources the clinic is having to respond to a worldwide exponential growth in the numbers of T/NB children seeking gender affirmation treatments. The growth is a consequence of multi-channel television and the internet, which have made quality information on gender reassignment accessible to all, empowering many to recognise what is behind their feelings.
Accusations of an institutional rush to prescribe pubertal postponement treatment (PPT) are wrong. In 1995, the head of the Tavistock, Domenic Di Cegli, refused to accept any child under 18 as old enough to consent to pubertal postponement. In 2000, a colleague and I published a paper explaining that this was an incorrect interpretation of clinical and legal rules. Rather than exploring whether the child was competent, doctors were rushing to judge a child as being too young. In law, though, even if a child is not competent, their parents can consent.
Things have changed since then but the Tavistock staff are still careful, considered and cautious. Most complaints from those using the services are about the length of time to get an initial appointment, and then the length of the assessment process before PPT will be considered.
PPT has been shown to be a beneficial pathway. The…