More than 800 children in England – some as young as ten – are being given
controversial drugs to help them change gender.
The NHS treatment, which halts the onset of adulthood, is aimed at young
people who believe they are trapped in the wrong body.
Powerful monthly hormone injections stop the development of sex organs,
breasts and body hair, making it easier for doctors to carry out sex-swap
surgery later.
Until now it was thought that just a handful of children and teenagers were
receiving the injections, known as ‘puberty-blockers’.
But The Mail on Sunday can reveal that more than 600 young people are
undergoing treatment at the Gender Identity Development Service clinic at
University College Hospital in London, and a further 200 at a clinic in Leeds.
The MoS has been told that 230 of those 800 are under the age of 14.
The huge growth in the number of youngsters being prescribed the drugs came
after the NHS scrapped the age limit in 2014, which was previously 16.
Now doctors can give the injections to children from the very early stages
of puberty – meaning that in some cases, ten-year-olds are receiving them.
The MoS revelation comes a week after the Government announced plans to
allow adults to legally change their sex without a medical diagnosis. In
future, individuals who want to change gender are expected to simply make a
statutory declaration that they intend to live in the sex they have
transitioned to until death.
Last night Mary Douglas, a spokeswoman for Grassroots Conservatives
campaign group, said: ‘Adolescence is the age when you’re in a turmoil because
you’re trying to work out who you are and gender is a big part of that.
‘So to introduce such powerful
medication into that is unwise.
‘This drastic notion that we should change our gender should be a last
resort. Caution needs to be the watchword for everyone engaged in this,
including doctors.’
Stephanie Davies-Arai, of Transgender Trend, a parent group concerned about
the rise of children identifying as the opposite sex, added: ‘These kids are
not old enough to make life-changing decisions that will affect them for the
rest of their lives. It’s unethical to pursue this line of treatment with
children who cannot possibly understand what they’re doing.’
Professor Gary Butler, the lead clinician for the gender identity service
in London and Leeds, revealed how many youngsters are now taking
puberty-blockers. He defended the use of the drugs and said critics did not
appreciate the distress puberty can cause transgender young people or how much
‘relief’ the blockers can give to these patients and their families.
However, other medical experts have questioned the safety of the treatment,
warning that little is known about its long-term mental, psychological and
physical effects.
Last month three top US doctors, Professors Paul Hruz, Paul McHugh and
Lawrence Mayer, published a highly critical report on the use of puberty-blockers
to treat gender dysphoria.
Writing in American academic journal The New Atlantis, they warned that the
safety of this ‘experimental’ treatment was ‘unsupported by rigorous scientific
evidence’.
They further argued that the use of such drugs may be driving children to
‘persist in identifying as transgender’. Research shows that the vast majority
of under-16s who are troubled about their gender do not go on to take the
drastic step of surgery. Meanwhile, the three professors point to another study
from a Dutch clinic – where all the adolescents prescribed puberty blockers had
gone ahead with gender-reassignment surgery – as evidence that the drugs can
‘solidify’ patients’ feelings they were born the wrong biological sex.+8
Concern has also been raised about the blockers’ long-term impact on bone
health. But Prof Butler said the drugs have no ‘permanent effects’ on the
reproductive system or the body as a whole.
‘When you stop the blocker, the puberty hormone process just starts up
again within a couple of months. If you’ve gone through puberty already, you
start where you left off,’ he said. ‘You don’t go back to the beginning again.
If you haven’t gone through puberty, you would just complete the full puberty
development process.
‘You would go through it at the same rate as you would if you hadn’t taken
the blockers, but the timing will just have been delayed.’
He also insisted that the drugs were safe because they had already been
used for decades to treat other conditions such as fertility problems in women
and prostate cancer.
Addressing fears about the effects the drugs can have on bone development,
Prof Butler said there was no need to ‘worry unduly’. ‘Our preliminary analysis
suggests that the blocker just halts bone-calcium increases – it doesn’t weaken
the bones directly,’ he added.
Prof Butler said his gender identity clinic now ‘routinely’ prescribes
puberty-blockers to children diagnosed with ‘life-long’ gender dysphoria – the
belief that a person is inhabiting the wrong sex.
‘When the team feels the young person is genuinely transgender they welcome
[the use of] puberty-blocking drugs right from the early stages,’ he said.
His clinic has treated more than 600 under-18s with the blockers and Leeds
Gender Identity Service has prescribed them to a further 200, he said. Of
these, he said ‘about 230’ were 14 or under – with the youngest being ten. His
disclosure comes three years after The Mail on Sunday revealed how NHS doctors
were set to give the puberty blockers to nine-year-olds – causing outcry from
critics who accused them of ‘playing God’ with children’s lives.
Explaining the process, Prof Butler said his patients were first
‘carefully’ psychologically assessed by experts at the NHS’s nearby Tavistock
Clinic. ‘We then do medical assessments to see if the young person has started
puberty and how far they are into puberty,’ Prof Butler said.
If suitable, both physically and psychologically, they then advise GPs to
prescribe the blockers.
He added: ‘We’re lucky in the UK that people don’t miss out – they will get
this treatment.’
Advocates of puberty-blockers argue that it represents a prudent and ‘fully
reversible’ way to give young people with gender dysphoria and their families
time to sort out the difficult issues surrounding gender identity.
Puberty-suppression as an intervention for gender dysphoria has been
accepted so rapidly by much of the medical community, apparently without
scientific scrutiny, that there is reason to be concerned about the welfare of
children who are receiving it.
There remains little evidence that puberty-suppression is reversible, safe,
or effective for treating gender dysphoria.
Psychologists do not understand what causes gender dysphoria in children
and adolescents.
They also cannot distinguish reliably between children who will only
temporarily express feelings of being the opposite sex from children whose
gender dysphoria will be more persistent.
We frequently hear from neuroscientists that the adolescent brain is too
immature to make reliably rational decisions.
But we are supposed to expect emotionally troubled adolescents to make
decisions about their gender identities and about serious medical treatments at
the age of 12 or younger.
For patients and doctors who are committed to the view that the young
person’s gender dysphoria represents a persistent and real problem that can
best be solved by transitioning the patient to living as the opposite sex,
puberty-suppression can seem like a desirable approach.
But most children who identify as the opposite sex will eventually come to
identify as their biological sex.
Until much more is known about gender dysphoria, and until controlled
clinical trials of puberty-suppression are carried out, this intervention should
be considered experimental.
Regardless of the good intentions of the physicians and parents, to expose
young people to such treatments is to endanger them. (dailymail.co.uk, 24/8/2017)
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