The Observer editorialises:
There has been a welcome shift in the way NHS England says it will provide care for children with gender dysphoria. In recent months, it has moved away from the ideologically driven “affirmative” model that views gender dysphoria in children purely as a sign of a fixed trans identity.
It is instead adopting a more evidence-based approach – as laid out in the review by the distinguished paediatrician Dr Hilary Cass – that starts from the understanding that children’s feelings of gender incongruence are often transient and fluid, and can be associated with autism, childhood trauma, children grappling with their own developing same-sex attraction, and intense discomfort about puberty.
Accordingly, the NHS now says social transition – treating a child as though they are of the opposite sex – should only be considered in cases where there is significant clinical distress or impairment in social functioning. Puberty-blocking drugs – the entry point of a medical pathway that can lead to cross-sex hormones and sex change surgery – will only be prescribed as part of a clinical trial, given fears about potential long-term impacts for bone and brain development, fertility and sexual functioning; and concerns they make permanent gender dysphoria that would otherwise naturally resolve itself. The “watchful waiting” approach counsels that children should be allowed to experiment with identity with neither endorsement nor criticism from adults and access talking therapy that includes exploration of the reasons for their gender distress.
There are a number of serious challenges for the NHS in rolling out a new approach; the underfunding of child mental health services and some clinicians’ continuing ideological affinity to the affirmative model. Another is that campaigners are seeking to make the provision of exploratory therapy effectively impossible by ensnaring it in an ill-defined criminal ban on trans “conversion therapy”. The ban has been linked to parallel proposals to ban gay conversion therapy; yet the fluidity of gender dysphoria makes it a completely different phenomenon to sexual orientation in young people.
No one has been able to precisely define what “trans conversion therapy” is; when the government consulted on a ban, the Equality and Human Rights Commission criticised it for failing on this count. But advocates for a ban clearly envisage it including therapy to explore the causes of a child’s gender distress and help them feel more comfortable in their body as an alternative to medicalisation. One proposal even suggests that a clinician not prescribing puberty blockers could be criminally proscribed by a ban.
There is a question of what problem an impossible-to-define ban is trying to fix: a government-commissioned study found no evidence that trans conversion therapy happens in the UK beyond a methodologically flawed self-report survey. An independent review for the NHS highlighted many mental health professionals are already reluctant to treat children with gender distress because of pressure to adopt the affirmative approach.
The chilling effects of criminalising exploratory conversations between a therapist and a young person that could be perceived as denying their identity will only make the holistic therapy recognised as critical by the Cass review even harder to access. Campaigners will have no qualms about misrepresenting unclear law to tell clinicians, therapists and parents they may be committing a criminal offence and subject to “conversion therapy protection orders” unless they immediately affirm a child as trans. Redefining exploratory therapy as something that sounds as terrible as “conversion therapy” to turn it into a criminal offence is a blunt campaigning tactic, one that any government concerned for the welfare of children with gender dysphoria must resist.
Only a section of the left seriously opposes this, "Ooh it's a bit weird" won't cut it philosophically.
ReplyDeleteNor is it intended to. The section of the economic and foreign policy Hard Right that pretends to be socially conservative, exists to change the definition of the term in the service of those economic and foreign policies, and by means of them. In Britain, it does not even have the ties to intellectually serious religion that it cultivates strategically in the United States. Even there, though, it does not mean a word of it, or even understand very much of it.
DeleteAs you've often mentioned, the right-wing philosophy is the root of gender ideology.
ReplyDeleteQuite so. With its concept of the self-made man or the self-made woman, Thatcherism has inevitably ended up as gender self-identification, which was unknown in 2010, and which has therefore arisen entirely under a Conservative Government. Margaret Thatcher was last depicted on British television, for the first time in quite a while, in December’s Prince Andrew: The Musical, the title of which spoke for itself, and in which she was played by one Baga Chipz, a drag queen. Well, of course. A figure comparable to Thatcher, emerging in the Britain of the 2020s, would be assumed to be a transwoman, just as Thatcher herself emerged in the Britain of everything from Danny La Rue and Dick Emery to David Bowie and The Rocky Horror Show.
DeleteHence Thatcher’s destruction of the stockades of male employment, which were the economic basis of paternal authority in the family and in the wider community, an authority that cannot be restored before the restoration of that basis. Thatcher created the modern Labour Party, the party of middle-class women who used the power of the State to control everyone else, but especially working-class men. Truly, as she herself said, her greatest achievement was New Labour. Leo Abse, who had had the measure of the milk-snatcher, also had the measure of Tony Blair’s androgyny.
And if this is a culture war, then where is the culture on our side? At 46, I had always assumed that we would win this one in my lifetime. But I am less and less certain. The other side enjoys the full force of the State and of a cultural sector that the State very largely funds. That double force was what turned the England of 1530, an extravagantly Catholic country of many centuries’ standing, into the England of 1560, a country that would define itself as fundamentally anti-Catholic for the next 400 years. Again I say that that State is the Tory State, there having been no other for as long as the notion of gender self-identification has existed. There is no suggestion of a Government Bill or amendment to give statutory effect to the rhetoric of Kemi Badenoch or Suella Braverman, which is pointedly never quite echoed by Rishi Sunak, whose choice of words to the Conservative Party Conference was very careful indeed.
Feelings are real, but they are not facts. As poverty of aspiration is a real feeling, but it is economic inequality that is a fact, so gender identity is a real feeling, but it is biological sex that is a fact. Those who failed to hold the first line, but who instead followed Marxism Today in whoring after Neil Kinnock and then after Blair, are now unable to hold the second line, either. And those who are failing to hold the second line will be unable to hold the first, no matter how devoted they might have been to Jeremy Corbyn. There are already signs of that, since without a robust material realism, there can be no pursuit of economic equality and international peace through the democratic political control of the means to those ends, led by the people who suffered most as a result of economic inequality, namely the working class, and led by the people who suffered most as a result of international conflict, namely the working class and the youth. It is no wonder, then, that Keir Starmer is so keen on the denial of material reality.