Time to Rethink the Medicalisation of Gender-questioning Children

Current Lib Dem policy, which calls for children and young people who are gender-questioning to be prescribed powerful drugs to block the onset of their normal puberty, is in urgent need of review. Evidence is rapidly emerging that, far from being a harmless “pause button”, puberty blockers may serve to compound distress, instead of ameliorating it, and also carry serious health risks such as impaired cognitive function, reduced bone density and infertility. It is becoming clear that the effects of puberty blockers are not, as is often claimed “fully reversible”.

The NHS, as well as a number of progressive European countries, has taken the decision to dramatically restrict access to this experimental treatment.

Our motion to Autumn Conference proposes an update to Lib Dem policy which would bring our party into line with these important developments. To sign our petition in support of the motion, which will be delivered to the Chair of Federal Conference Committee in advance of its meeting on July 8th, click here. To learn more about why the policy change is needed, read on…. 

In her groundbreaking investigative book, Time to Think, BBC journalist Hannah Barnes charts the “explosion” of referrals to the GIDS and describes the shift in patient profile from largely pre-pubescent boys to adolescent girls, as well as the change in clinical practice from a “watchful waiting” to a “gender affirming” approach - the latter typically being associated with hormone drugs and, eventually, genital surgery. 

The book paints a picture of how the service routinely prescribed puberty blockers to children after only three or four sessions, and (despite the best attempts of some clinicians wishing to take a more cautious approach) offered little or nothing in the way of alternative, non-invasive treatment options. It also exposes a shocking failure to track patient outcomes, a lack of clinical enquiry (with a failure to consider the patient’s wider mental health issues, autism, past trauma, family situation), safeguarding failures and the excessive influence of external lobby groups, especially the controversial charity, Mermaids.

Clinicians and whistle-blowers are cited as describing the situation at the Tavistock as “mad” and “the site of a serious medical scandal, in which ideological concerns took priority over clinical practice”. 

Ultimately the service was ordered to be closed down completely. Meanwhile, detransitioners are increasingly beginning to speak out about their experiences of regretting the irreversible changes made to their bodies as a result of hormone drugs prescribed to them.

The Cass Independent Review of Gender Identity Services for Children and Young People was commissioned as a result of serious concerns about the quality of care being provided by the GIDS. The Interim Cass Report has informed the new NHS Interim Service Specification, which restricts the use of puberty blockers to the context of formal research. Several European countries, including Finland, Sweden, Norway, France have adopted new treatment protocols which move away from the “gender affirmative” (drug and surgery-based) model of care in favour of a psychosocial and psychotherapeutic approach. 

Yet current Lib Dem policy, as passed by Conference in 2015, which calls for the NHS to safeguard “The right of transgender and gender-variant children to receive puberty-blocking medications until they are eligible for hormone replacement therapy” still remains in place.  

The Lib Dems’ commitment to the medicalisation of gender-distressed children is further bolstered by a Ban Conversion Therapy motion passed in 2021, which calls for “a criminal ban on all forms of conversion therapy; including those claiming to be psychiatric, psychological, therapeutic, or consultative”. Such a policy, if enacted, would be likely to deny these children and young people the very support that they most need as it would impede clinicians’ ability to do their jobs and also potentially criminalise parents and teachers acting in the best interests of children in their care.

The lack of transparency and suppression of intellectual enquiry that appears to have characterised practice at the GIDS can be seen to have been replicated in our party. No amendments to the Conversion Therapy motion were accepted for that debate, and during the debate only members supporting the motion in full were called to speak. The silencing of any genuine debate is covered here and here. 

Until now our party has unwisely allowed trans identification in children to be framed as a “rights” issue, rather than an issue of safeguarding, child development or mental health. This has meant that an ideological imperative has taken precedence over evidence or, in the words of Dr Hilary Cass, one that would have allowed gender-distressed children and young people to “receive the same standards of clinical care, assessment and treatment as every other child or young person accessing health services.” 

It is often claimed by commentators that Lib Dems are bound to these policies by financial incentives, namely £1.5 million in donations from Ferring Pharmaceuticals, a leading manufacturer of puberty blocking drugs, between 2013 and 2019. We believe these claims are unsubstantiated: there are many reasons why international trading companies might have wanted to donate to the Lib Dems, considering our party’s support for international trade. However, our persistent and seemingly irrational commitment to policies promoting unevidenced drug treatments for children and adolescents makes it increasingly difficult to counter such accusations.

Accepting this motion for debate at Autumn Conference would make the Lib Dems the first progressive party to take a proactive approach to revising its policies regarding the treatment of gender-distressed children. As the full extent of this medical scandal unfolds, we have an opportunity to show leadership, rising above political tribalism and mischaracterisation of concerns as “anti-trans”, and respond to emerging evidence with courage and maturity.

We invite you to endorse our motion for inclusion in the agenda for Autumn Conference, in the hope that we can overturn this policy, which is not only unethical but politically harmful, and move on from it in the knowledge that our party is doing the right thing by children. 

Please use this form to add your name to the list of signatories in support of it. The list of existing signatories can be viewed at the foot of the motion.