Writing to my MP about trans young people

After some shitty news appearing across social media today, I’ve written to my MP again. The only changes I’ve made to this version are turning footnotes into links and fixing a couple of typos.

We read with alarm reports on social media today that the Northern Ireland executive has extended their temporary ban on provision of puberty blockers to gender-questioning and gender-dysphoric young people and that the Health Secretary is expected to announce the same for England and Wales.

As you may already be aware, there is nothing in the Cass Report that suggested restricting access to puberty-blockers — even ignoring the questions around the legitimacy of the report and the widespread international criticism of its methodology and conclusions, from, for example, the Royal Australian and New Zealand College of Psychiatrists, the Canadian Pediatric Society and Children’s Healthcare Canada, and both the Endocrine Society and the American Academy of Pediatrics, as well as from Dr Cal Horton.

A paper published in the Archives de Pédiatrie last month (Brezin et al, 2024), where the French Society of Pediatric Endocrinology and Diabetology commissioned a group of experts to draft the first national consensus on the topic, recommended that adolescents who are starting to experience puberty should be offered puberty blockers (or, more properly: “gonadotropin-releasing hormone analogues”, GnRH analogues), stating that “we recommend that puberty suppression be offered by a multidisciplinary team or network trained in supporting transgender adolescents”.

France is in no way unique here; standards in Australia (Telfer et al, 2018) and clinical practice guidelines from the Endocrine Society (Hebree et al, 2017) and the World Professional Association for Transgender Health (WPATH, Coleman et al, 2022), for example, all recommend suppression of puberty for adolescents who are experiencing distress as a result of gender incongruence.

Equally, concerns over the risks of providing puberty blockers to adolescents are overblown — with suggestions that this has been politically motivated by the loud minority who appear to be opposed to the very existence of trans people. As Brezin et al make clear, “since the mid-1990s, treatment with GnRH analogues … has become common clinical practice as a first step in medical treatment of transgender adolescents” and, by contrast, “a wait-and-see attitude in adolescence does not reduce psychological distress, increases the risk of committing suicide and can affect psycho-affective and cognitive development”. Brezin et al explicitly rebut several of Cass’s findings, while Giordano and Holm found in 2020 that it is implausible to describe puberty blockers for young people as “experimental” treatment. Lee et al (2024) found that anti-trans laws, including limiting access to gender-affirming healthcare, can cause up to a 72% increase in suicide attempts by trans and non-binary young people.

The UK is already an outlier in how we treat trans people, and especially trans children (see Horton, 2024; Pearce et al, 2020; Faye, 2021), with concerns being raised by the United Nations Independent Expert on protection against violence and discrimination based on sexual orientation and gender identity and by the Council of Europe and with UN Women describing the “gender-critical” movement as an “anti-rights movement”. Whereas most countries in Western Europe recognise gender self-determination, allowing a statutory declaration to change one’s legal gender, we have moved in the opposite direction, with The Gender Recognition (Approved Countries and Territories and Saving Provision) Order 2024 removing the ability for foreign gender certification to be recognised in the UK if it comes from a territory with self-ID.

We hope, as a fellow member of the LGBTQ+ community, that you share our concerns in this regard. In any case, we would ask you please to speak with the Health Secretary, the Prime Minister and both Women and Equalities Ministers to relay our concerns. We would also ask that you entreaty the Health Secretary to reconsider his reported intention to extend the puberty blockers ban further and instead for he and the Prime Minister to move the United Kingdom back into alignment with international best practice and trans inclusion.

Yours sincerely, in pride and solidarity,

Owen Blacker