On Wednesday night [21 November 2018], Channel 4 broadcast a much-debated documentary examining the staggering rise in children being referred for consultation on gender re-assignment. In the last nine years, referrals for children to the NHS’s Gender Identity Development Service have risen some 2500 per cent.
The presenter of the film, psychotherapist Stella O’Malley, recalled her childhood struggle with gender dysphoria. She had been a girl who wanted to be a boy, and remembers feeling distressed at this. Eventually, these feelings subsided and Stella felt comfortable with her sex and went on to be a mother.
Stories like this raise concern that hundreds of children are being pushed into inappropriate and unnecessary treatments that they will later abandon – albeit it not without some psychological distress and, potentially, lifelong infertility. There’s also the worry that many of these children will be suffering from underlying mental health issues, which will not be addressed by gender re-assignment.
So what’s behind this rise in referrals? Part of the reason is that today’s gender non-confirming children are receiving very different messages from those in Stella’s day. Blue Peter and Grange Hill have been replaced by YouTube and Tumblr. From across the internet, they are told that along with freedom of expression comes a freedom to choose their own sex. As science falls victim to wishful thinking, anyone who challenges them can be dismissed as a bigot.
But are we making promises to these children that can never be delivered? Are social media influencers telling the truth about what it’s like to grow up transgender? Indeed many self-appointed experts who transitioned in mid-life – often after fathering their own children – have no idea what it would have been like to transition as youngsters. And how do they know their followers are not just going through a phase – or perhaps struggling with their sexuality or something deeper – like Stella herself experienced thirty years ago?
As a transwoman, I agree with Stella about the profound difficulties in determining a child’s gender identity. Like Stella, I also take issue with those transgender activists who insist there’s some kind of inherent sense of what it means to be transgender. There is no secret code: I have no idea what it feels like to be a woman, any more than I know what it feels like to be a man – all I know is how it feels to be me.
In my case, this meant a childhood punctuated by gender dysphoria. It waxed and waned but the desire to be a girl never went away. I struggled, but got through life nonetheless: my children grew up, I developed my career as a teacher and got on with life.
Unlike Stella, I eventually did transition. But this was a decision I made an as adult – these children are not old enough to decide on their own bedtimes.
Whereas in the past gender identity services adopted a policy of watchful waiting with psychological support, increasingly strident calls are being made to affirm a transgender identity without question. Treatments are being presented in a way which minimises what is involved: powerful cancer drugs used to block puberty are described innocuously as a “pause button”.
Those who argue these extreme measures often cite the threat that gender non-conforming children will commit suicide – but this didn’t happen with previous generations. However, unlike today’s unfortunate young people, their expectations had not been raised to stratospheric levels by a society that had no idea how to deliver, and instead leaves many trans people in a state of perpetual victimhood.
These are difficult questions but, in my view, the solution is not to tell gender non-conforming children that they are somehow the opposite sex. Instead we should abolish the restrictions which make children in Stella’s position feel lost and isolated, and let boys and girls express themselves freely regardless of sex.
Either way, the rush to diagnose and medicalise young people is serving no-one – not least the vulnerable children pushed towards treatment that may only add to their distress.