Pressure to change sex

Scare story in the Daily Mail: NHS pressured our kids to change sex: Transgender backlash as desperate parents accuse overzealous therapists of ‘blindly accepting’ children’s claims to have been born in wrong body… Doctors fear being sued after the NHS signed a ‘memorandum of understanding’ banning staff from challenging patients who believe they are born the wrong sex. YouTube, Instagram and Tumblr make trans cool, encourage teens to threaten suicide or self-harm if their parents oppose them, show where to find binders and hormones “and other sex change aids”, whatever those might be, and spark a social contagion. Adolescents are “heavily influenced” by messages they send to one another. NHS Scotland and NHS England have signed a Memorandum of Understanding banning staff from challenging patients who believe they are born the wrong sex. Doctors fear being sued, and a psychotherapist called Bob Withers cautioned that the memorandum could prevent therapists from exploring patients who say they are transgender but are suffering from other mental health conditions. He says it means the psychotherapist cannot look at the psychological reasons for the gender dysphoria.

So much for the Daily Mail. What is the truth? Here is the Memorandum. It commits the NHS and other bodies to ending conversion therapy, defined as the assumption that any gender identity is preferable to any other, leading to attempts to change or suppress gender identity or sexual orientation. Gender identity includes all binary, non-binary and gender fluid identities.

Personally I find non-binary and gender fluid identities preferable, as they give people more freedom. My identity as a TS liberated me to be myself, at the cost of undertaking the transition I understood an M-F TS would undertake. Non-binary or gender fluid permits maximum variation in gender expression without preventing any surgery or hormone treatment. It’s not “I am trans therefore I want hormones” but, given that I have this identity and these desires, might I want to transition, or to have medical treatment? What desirable or negative effects might that have? We move beyond one size fits all- I am TS, therefore I have hormones then surgery- because that is restrictive.

The memorandum goes on, gender identity is not a mental disorder; but people uncertain of their gender identity might seek psychological help. Some people may benefit from the challenge of psychotherapy and counselling to help them manage dysphoria and to clarify their sense of themselves. Clients make healthy choices when they understand themselves better. Withers and the Daily Mail are wrong: counselling for self-understanding is still possible.

There may be grounds for exploring therapeutic options to help people unhappy about their transgender status live more comfortably with it, reduce their distress and reach a greater degree of self-acceptance. So professionals may explore hormone or surgical treatment, within the guidelines for that. The real problem is that there is little funding for specialist assessment or mental health treatment. Adolescents get referred to the Tavistock clinic, whose waiting lists grow.