In news which rapidly began trending on social media yesterday, it was announced that children in England will no longer be prescribed puberty blockers at gender identity clinics. The decision from NHS England, according to one government minister, was a landmark one, and will ensure that care is based on “evidence, expert clinical opinion, and is in the best interests of the child”.
A 12-week public consultation was undertaken, along with the development of an interim policy and an independent review, commissioned by NHS England in 2020 and carried out by paediatrician Dr Hilary Cass. The outcome? The NHS now states on its website that puberty blockers (gonadotropin-releasing hormone analogues blocking the effects of puberty) will no longer be available to children and young people for gender incongruence or gender dysphoria because there is not enough evidence of either safety or clinical effectiveness.
Contrast the approach of the UK – whose government and national health service has listened to the evidence gathered by healthcare professionals to inform its policy, and to the views of its people – with Ireland, where our own approach to these life-altering drugs has been to adopt an activist-informed model of care.
This shambolic approach seems, to this point, to have paid little attention to the evidence which urged the need to exercise caution and proritise safety, with one of our most senior doctors admitting last year that he believed there was an “ideology” at senior HSE levels, led by transgender activists who only want affirmative care offered.
(Affirmative care means that medical professionals act to affirm a desire to change gender in patients, rather than maintaining a broad clinical perspective and embedding the care of children and young people with gender uncertainty within a broader child and adolescent health context.)
Professor Donal O’Shea’s comments, which were nothing short of extraordinary, are worth revisiting in light of Britain’s puberty blocker ban, something many have said is long overdue.
It was absolutely an indication of the sorry state of our own health service, when Prof O’Shea told The Irish Independent’s Mark Tighe last September that he expected he may be “silenced and sanctioned” for speaking out against alleged attempts by the HSE to establish an “activist-led” transgender service that he said would be “dangerous for patients.”
Just before Christmas, Prof O’Shea, along with Dr Paul Moran – two of Ireland’s most experienced experts in the area – said their concerns around gender care had been “consistently ignored” by the HSE. They told RTE’s Prime Time that the HSE was being spearheaded by “trans activists” while pursuing an “ideological model of care.”
The leading clinicians lodged a formal complaint against the HSE to health standards watchdog, HIQA, alleging that the HSE has not adhered to evidence-based care in the treatment of children expressing gender identity confusion, and that Irish children have been referred for “unsafe and harmful” treatments. The HSE denies the allegations.
We have been warned before, but the alarm should be sounding loudly for Ireland in light of the unprecedented step taken by NHS England on Tuesday. A 2022 review of gender identity services for children and young people carried out by Dr Hilary Cass found that there was a lack of clarity over whether the powerful drugs given to children simply “pause” puberty or if they act as “an initial part of a transition pathway” – with fears that the majority of young patients become “locked in” to changing their gender once the process has started.
It is worth mentioning that trans activists and pressure groups, in Ireland and in Britain, are of course aware that the vast majority of children who are prescribed puberty blockers later go on to cross-sex hormones. Data from both the Netherlands, and a study conducted by GIDS, showed this was as high as 96.5% and 98% of children respectively.
While the UK appears to be slowly waking up, Ireland remains unquestioning in its approach to setting children on a permanent pathway involving hormones which, the evidence resoundingly shows, can cause a catalogue of problems, from infertility to bone damage.
The comprehensive Cass review also found that the administration of puberty blockers is “arguably more controversial” than the administration of feminising or masculinising hormones, due to the fact there are “more uncertainties’ ‘ associated with them.On the short-term effects of the drugs, Cass noted that the immediate side effects, including low mood and anxiety, may make the day-to-day functioning of a child “more difficult,” particularly when that child may already be experiencing distress. Short-term reduction in bone density is of course another well-recognised side effect listed in the damning review.
The review pointed to the “unknown impacts on development, maturation and cognition if the child is not exposed to the physical, psychological, physiological, neurochemical and sexual changes that accompany adolescent hormone surges.” As the interim report identifies, we must also worry about whether pubertal sex hormones are essential to brain maturation processes – as they are in animals – prompting the question of whether there is a ‘critical time window’ for the processes to take place, or whether ‘catch up’ is at all possible when oestrogen or testosterone are introduced at a later stage. The neurological outcomes of pubertal suppression are also unclear, as the report outlines.
All of the evidence, now thankfully part of the basis of NHS policy and British law, lays bare the fact that puberty blockers are an experimental treatment – and shame on us for experimenting on our children.
While the news out of Britain should be welcomed, we still have to grapple with the fact that hundreds of children have been prescribed puberty blockers on the NHS since 2011, and that for many, it is tragically too late. Hundreds of under-16s have been referred to the now disgraced gender identity clinic run by Tavistock and Portman NHS Foundation Trust in north London — including hundreds of Irish children, referred there by our HSE.
As we speak, 72 children from Ireland remain on the waiting list at Tavistock, with a total 5,000 patients on the waiting list overall. A report from the HSE last Spring found that in the 10 years since 2012, 233 Irish children and young people were referred to the English clinic for psychological and psychiatric assessments.
As recently as February 2023, the HSE confirmed that the notorious and ‘unsafe’ British gender clinic was still involved in treating Irish children and young people experiencing gender confusion.
This is huge. Where is the Irish investigation? Where are the government ministers – aside from the scattering of brave opposition Independents – willing to raise this scandal in the Dail?
The vast majority of our politicians seem blind and dumb to the realities of what is at stake, blind-sided by an NGO industrial complex which is waging war with our children. As recently as last week, in a question to the Minister for Health, People Before Profit’s Gino Kenny demanded to know when and how puberty blockers “and other essential services for trans teenagers” would be provided by the HSE; and if the health service had a plan in place to recruit more surgeons to perform gender-affirming surgeries. Is this not plainly indicative of just how behind the curve we, even compared to those across the water?
A report from 2020 outlined how 40 per cent of children referred to Tavistock received medical treatment such as puberty blockers in the three years prior. At that clinic, some children were given life-altering medication after a single face-to-face assessment, despite many of them suffering from mental health or family issues.
Horrifying revelations about the Tavistock gender service also revealed that more than a third of young people referred there had moderate to severe autistic traits – compared with under 2 per cent of children in the general population.
Indeed, a 2022 audit carried out by the HSE-operated National Gender Service mirrored this trend, finding that up to 90 per cent of those referred there may have been autistic.
We now know, and the NHS is quietly acknowledging, that children have been damaged for life due to being placed on medication that should never have been given to them. It is nothing short of an abomination – and is a scandal that has been driven by ideology. As Irish taxpayers, we absolutely should expect our healthcare system to be evidence-based, but as Britain has shown, this is not always the case.
As Dr Hilary Cass said, it is not a neutral act to transition someone. The evidence is clear that if allowed to go through puberty, the majority of children will settle happily with their biological sex. We must support children to come through the difficult teenage years and come out the other side, and allow common sense to return to the room. For the past five years or more, groups like TENI have infiltrated our care pathways, while the concerns of top doctors have been ignored, with those very doctors demonised by the powerful lobbies that seem to control our health service.
The fact that our children have, and continue to be medicalised through irreversible hormonal and surgical interventions, is a scandal that has created devastation.
Ireland must quickly follow suit in learning the lesson that has been a long time coming for Britain, and unshackle itself from an activist-driven model of care which has already created untold devastation.