There is a common misperception, perpetuated by lobbyists and activists, that there is an unusually high level of suicide attempts among children and adolescents who identify away from their sex. No-one, least of all parents, want to be responsible for harming children and the spectre of suicide evoked by the phrase ‘Would you rather have a live son or a dead daughter’ has ensured that the medicalised pathways of puberty blockers and cross sex hormones have been embedded in paediatric medical pathways across the globe. After all, we are assured that without this essential ‘gender affirming healthcare’, our children may die.
This has been the narrative for more than ten years, however a data review of suicides by young patients of the Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust, was published in July of this year. The independent review was undertaken Professor Louis Appleby, Department of Health and Social Care adviser on suicide prevention. The review drew the following conclusions:
1. The data do not support the claim that there has been a large rise in suicide in young gender dysphoria patients at the Tavistock.
2. The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide.
3. The claims that have been placed in the public domain do not meet basic standards for statistical evidence.
4. There is a need to move away from the perception that puberty-blocking drugs are the main marker of non-judgemental acceptance in this area of health care.
5. We need to ensure high quality data in which everyone has confidence, as the basis of improved safety for this at-risk group of young people.
The report was commissioned by the Department of Health & Social Care following the backlash to the announcement by Minister for Health Wes Streeting, that he intends to permanently ban puberty blockers for children on this pathway, outside clinical trial settings.
Furious posts on Twitter/X following Streeting’s announcement emphasised the imminent danger to children’s lives. Jolyam Maugham, Director of The Good Law Project, posted a series of controversial tweets claiming that not only have sixteen children died by suicide since the 2021 Bell vs Tavistock High Court judgement - which led to a reduction in the prescription of puberty blockers - but that ‘(Streeting’s) colleagues will slowly be coming to terms with him locking them into a future of bereaved parents tipping ashes outside number 10’.
Not to be outdone, journalist India Willoughby said in an interview with Attitude Magazine, and with no small amount of hyperbole, that ‘Labour have decided to side with evil’.
Streeting took to Twitter/X to say ‘Cass Review found there is not enough evidence about the long-term impact of puberty blockers for gender incongruence to know whether they are safe or not, nor which children might benefit from them. The evidence should have been established before they were ever prescribed.
The Cass Report was undertaken by a team of researchers from the University of York led by Dr Hilary Cass OBE, the former President of the Royal College of Paediatrics & Child Health, and former Chair of the British Academy of Childhood Disability. During a distinguished career in paediatrics, she practiced as a Consultant in Neurodisability; relevant because within the quantitative research arm examining the epidemiology and outcomes for children referred to GIDS, one of the questions that the team looked to answer was ‘What is the incidence of co-occurring autism in children with gender dysphoria’. Given that autistic children form 35% of all referrals to GIDS and a further 13% show autistic traits, and 76% of all referees are adolescent girls, this question is highly relevant.
One of the ways that Lobbyists have promoted the suicide myth, is by seeding the idea (online and more recently in books and through the education system), that the LGBT+ community - and by default the children and adolescents who are referred to GIDS or identify away from their sex - are hated. Thus they neatly divide society into two camps: Allies and Haters. We are then invited to decide to which camp we belong.
A great deal of this narrative has travelled via the messenger of fear. We constantly hear how dangerous it is to be trans (it is in some countries, much less so in the UK); how people who identify as trans experience violence daily (some may, most don’t); that misgendering counts as literal violence (it isn’t, it’s simply linguistic manipulation). The net result is that there are many children who are genuinely scared.
They are growing up in a very uncertain world with increasingly unstable global politics, fewer prospects than their parents, less earning power and no guarantee of ever owning their own home. It’s also a world in which porn consumption is high, and the hypersexualising and judging of women and girls is commonplace.
Autistic girls who adopt a trans identity are highly likely to have experienced discrimination and abuse specific to their autism, while also living with the heightened levels of anxiety common in autism. Some may have adopted a trans identity specifically to escape this trauma or bullying, only to find that despite finding a new community, they are still living in fear.
Crucially for autistic girls, they are living with a statistically much higher risk of suicide before gender identity is even entered into the equation. Research from The Karolinska Institute in Sweden, confirms that not only do autistic people have a higher than average risk of suicide attempts and suicides, but that risk increases greatly for autistic women, particularly if they have comorbid ADHD.
The study of 55,000 autistic people (with a matched control group of 270,000) showed that autistic women with no intellectual disabilities were at a higher risk, but among autistic women with ADHD , one in 5 had actively attempted suicide. That the suicidal ideation among girls and young women with a trans identity may be better accounted for by autism, is rarely considered by activists.
Interviews with children who identify as trans often mention the same thing - how scared they are going out, that they live with the threat of violence, and how they believe people want them dead or want to erase them from existence; the result of constant overreach and hyperbole on the part of the lobby groups who purport to speak for them. They have wielded inaccurate suicide statistics and threats of violence for so long that it has become lore amongst children and young people. Vulnerable children, a considerable proportion Autistic, almost all either Lesbian, Gay, believe that not only are they genuinely oppressed, but that people genuinely hate them and that around every corner, as they leave the safety of their home, lie violence and harm.
It can be hard to imagine how that feels; to believe (wrongly) that you are in constant danger. Children are told by adults that the author they idolise wants to erase them. At a 2018 event held at Goldsmiths University, Queering Children’s Literature, a young teen spoke up about how author J K Rowling hates trans people, to rapturous applause from the overwhelmingly adult audience. This message is reinforced by lobbyists but they are sacrificing the mental health of children in the process. And the message spreads like wildfire across TikTok & social media until it is regarded as the truth.
The negative social media response to both the recent Cass Report and to Dr Cass herself, is indicative of the considerable number of adults who have unquestioningly swallowed the narrative about the ‘trans child’ and ‘gender affirming healthcare’. Wes Streeting spoke eloquently in Parliament about his support of the Cass report findings, despite until recently, being a prominent cheerleader for an ideology that has led to irreparable harm. We are immensely glad that he has the courage to investigate, change his mind and speak out (and would be delighted to talk to him in more depth about how this has affected autistic girls) and hope fervently that it encourages more MPs across all parties to do the same. However if, as rational and educated adults, they can so easily be misled by online rhetoric, what hope do our children have with minds still yet to fully form?
Over the months since Cass was published, activists have vowed to fight back against the increasing move towards evidence-based medicine. Former CEO of Mermaids, Susie Green, announced a new project providing a helpline service to trans identified children and their families, as well as exploiting a legal loophole to import puberty blockers from Northern Ireland. She added in an article in the Daily Mail, that she had been told by an unnamed ‘source’ at the Tavistock GIDS, that ‘since the Bell vs Tavistock judgment was handed down in December 2020, which then prompted NHS England to stop all access to care within 2 hours, there have been an unprecedented number of deaths. Deaths of young people referred to the service and on the waiting list, being seen but then having all chance of treatment removed’.
Private company Gender GP, founded by disgraced GPs Helen and Michael Webberley (both currently struck off the General Medical Council Register), posted on X that ‘we know that children and young people will suffer and die if these recommendations are implemented’.
To tell a child or young person that they are hated or that they are at a high risk of death, is an act of extraordinary wickedness. Deliberately inciting fear among children is one of the darkest and most unforgivable aspects of the current landscape. The message, aimed at autistic children who adopt a ‘gender identity’, that they are vulnerable and in danger, is unconscionable and speaks more clearly about activist priorities than anything else.
It's very simple.
If a treatment pathway is reliant on the promotion of fear in order to avoid acknowledging the low evidence base for its effectiveness, then it isn’t fit for purpose. If a social justice movement is reduced to wielding fear as a weapon, then it isn’t social justice. And anybody who lets children believe they are hated cannot ever be in the service of good.
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