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Child gender report is admirable – but why did it take so long?


DR HILARY Cass has submitted her final report into the review of gender identity services for children and young people and her recommendations for NHS England. It has been four years in the writing, and despite resistance and non co-operation by some involved in the service, it provides a comprehensive overview of what went wrong, and why. She has emphasised the lack of robust clinical evidence to support the treatments prescribed by the Tavistock Gender Identity Service in the management of children presenting with gender incongruence, and the lack of evidence as to the outcomes of the social transitioning of young children. She has highlighted the toxic culture surrounding the whole issue of gender re-assignment resulting in many clinicians being fearful of working with such children, or of questioning the use of puberty-blocking drugs, or the issues of social transitioning.

All well and good! It is an excellent report which I hope and pray will be taken seriously and acted upon by the Government, the NHS, schools and anyone who has an interest in and care for children and young people. My only issue is, why has it taken so long?

In April 2016, Brighton and Hove City Council (where else?) wrote to the parents of four-year-olds due to start primary school, asking that children be allowed to choose the gender they most identified with.

The letter said: ‘We recognise that not all children and young people identify with the gender they were assigned at birth or may identify as a gender other than male or female, however the current systems (set nationally) only record gender as male or female.

‘Please support your child to choose the gender they most identify with or if they have another gender identity please leave this blank and discuss this with your child’s school.’

This should have set alarm bells ringing, but somehow it passed by the media. This was the first time that I became aware of the developing issue.

At that time, like almost everyone else, I was fairly ignorant of gender dysphoria and transgenderism. I had a friend identifying as male whom I subsequently discovered was a transsexual, having developed dysphoria as a child and undergone surgical treatment as a late teenager. He had a gender recognition certificate and was a quiet, pleasant, unassuming individual. His gender status was never discussed and was not an issue. However the Brighton letter got me thinking and researching the whole issue of transgenderism. This was before it morphed into such a toxic issue.

A paper published in 2011 in Sweden, a country famed for its positive approach to LGBT issues, studied a large cohort of individuals who had undergone surgery for sexual reassignment. The study showed that, despite treatment, they continued to show very high psychiatric morbidities, including depression, self-harm, attempted and actual suicide, compared with the ‘normal’ population. The study concluded that the reason for this was that the individuals’ underlying psychiatric conditions had never been treated.

In August 2016 the American College of Pediatricians published a position statement titled ‘Gender ideology harms children’. It stated: ‘The American College urges educators and legislators to reject all policies that condition children to accept as normal a life of chemical and surgical impersonation of the opposite sex. Facts – not ideology – determine reality.’ It concluded by stating that this ideology was, in fact, child abuse. A further paper in 2018 confirmed the lack of evidence used to support clinical management of such children.

In view of all this, and much more, I started my campaign to raise concerns by writing in September 2017 to the then Secretary of State for Education, Justine Greening, outlining my deep concerns about the way that trans activists, such as Mermaids and Stonewall, were influencing schools with their ideology. I quoted the Brighton example, stating: ‘In my view the actions of the Brighton and Hove Council amount to nothing more than irresponsible social experimentation, based on no evidence of benefit, and inflicted without consent on the most vulnerable members of society – children. There is no reliable long-term research on the long-term effects of teaching young children that they may “choose” their gender, and it seems that no consideration whatsoever has been given to the physical, psychological and sociological consequences.’ I also referenced the known negative effects of gender transition. I copied the letter to my own MP and, of course, received no response from either.    

I also copied the letter to the BBC Today programme (which I listened to in those days) and a week later was interviewed by the venerable John Humphrys, my comments being broadcast as part of a larger collage. My comments formed the last words of the piece, ‘We seem to be changing the definition of what it means to be human’.   

I continued campaigning, writing letters, articles and attending meetings including one in Parliament hosted by a concerned MP. In the end groups such as the excellent Transgender Trend came to the fore so I took more of a back seat. But here is the issue: I was just a minor character in the great scheme of things with no real influence or authority, yet I was able to pick up on a dangerous trend and a serious threat to the wellbeing of children from 2016! How come ‘they’ did not notice? Where was the Royal College of Paediatricians and Child Health in all this? Until Professor Cass began her review in 2020 I am not aware of a single pronouncement by the College. What about the higher echelons of the NHS? Did they really not have a clue what was happening in the Tavistock GIDS clinic despite the many whistleblowers?

I am relieved that the Cass report is as strong as it should be, but I am furious that so many children and young people have been damaged beyond repair because too many adults ‘passed by on the other side’ when there was plenty of evidence if you bothered to look for it.

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Dr Tom Goodfellow
Dr Tom Goodfellow
Tom Goodfellow is a retired NHS consultant radiologist who had a specialist interest in paediatrics and cancer diagnosis.

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