Appeal against the rejection of the motion “Time to Rethink the Medicalisation of Gender Questioning Children”
Reason for the appeal: Treating this motion under Equalities may have been prejudicial. It is a Health motion for the reasons set out below.
Recent medical publications have only further increased its timeliness. This motion does not seek to curtail the human rights of transgender children or prevent appropriate medical interventions for transgender adults. It asks the party to reflect on a growing medical consensus. History has been unkind to politicians who dictated medical practice to medical practitioners. The Liberal Democrats, of all parties, should be mindful of the dangers of this.
To address specific objections to the motion:
That the Conference Notes sections contain ‘deeply contentious’ opinions. Further to the Cass 2020 systematic reviews (https://cass.independent-review.uk/nice-evidence-reviews/) there have been other systematic reviews summarised by Levine and Abbruzzese in April 2023 (https://doi.org/10.1007/s11930-023-00358-x). Simultaneously, in April 2023, Ludvigsson et al, published yet another high-quality systematic review in Acta Paediatrica (https://onlinelibrary.wiley.com/doi/full/10.1111/apa.16791). There is a growing concern in the international medical literature that the use of puberty blockers carries excess risk and offers limited benefit in children. Whilst other views exist, it cannot be held that mainstream opinions are deeply contentious, given their scientific rigor, unless such rigor is of little concern, and an opinion is only held to be deeply contentious when it is disagreed with.
Three recent studies, published since 2021, as summarised by Levine and Abbruzzese, have shown there to be detransitioning rates of 10-30%. The reasons why are complex, and uncertainty about sexuality and how this is seen by family and society, are noted driving factors leading to gender confusion. To ignore the lived experiences of detransitioners is highly contentious, not the wish to debate the impact treatment may have had on them.
That the stance on Conversion Therapy is ‘a significant departure’ from existing policy. the treatment of minors (children and adolescents) presenting to transgender services is clearly set out in the WPATH Standards of Care Version 8. This internationally recognised guidance is influential in UK service provision and must have been known to clinician members of the Conference Committee. The motion is not at odds with the WPATH guidance and emerging medical opinion, and so again cannot be called deeply contentious. What is defined as "Gender-affirmative care" by WPATH relates only to the medical care provided once transition has been agreed upon. WPATH also set out the essential role of psychological assessment and therapy in children and adolescents prior to any such intervention. The motion articulates a concern that the LD ban on conversion therapy conflates such therapy with forms of aversion therapy. Limited space may have prevented this being as clear as it could have been, and again it is unfortunate that clinician members of the Conference Committee did not bring this distinction to the attention of lay members of the committee.
The risk of ‘a fraught, toxic and potentially very damaging debate’. NHS England, in June 2023, announced a major change in how puberty blockers would be given to transitioning children (https://www.bmj.com/content/381/bmj.p1344). For Conference to refuse to discuss this issue will at least leave a public impression that the Liberal Democrats have their collective heads in the sand. At worst it will bring the party into significant disrepute.
That the motion is thin on policy proposals. Our three points are sensible, general guidelines. Some supporters of the motion are medical and other health care practitioners, but it is not for the Liberal Democrats, or other political parties, to dictate clinical best practice. Rather our policies should follow recent and high-quality medical research and be facilitative of its transition into good practice. To reject this motion is to promote the antithesis of this principle. We ask that the Conference Committee reconsider.