Time to Rethink the Medicalisation of Gender-questioning Children
Conference notes that:
i. The Independent Review of Gender Identity Services for Children and Young People (The Cass Review) was commissioned by NHS England in Autumn 2020 to consider the significant increase in referrals to the Gender Identity Development Service (GIDS) in England in the context of increased medical interventions by way of hormone drugs. Its Interim Report confirms failings in the current system. Key findings include:
“A lack of consensus and open discussion about the nature of gender dysphoria and therefore about the appropriate clinical response.”
“Significant gaps in the research and evidence base.”
A need to address “cultural issues within the service”.
The Review also identifies:
Clinicians’ concerns about the pressure to adopt an unquestioning “gender affirmative” approach that is at odds with their professional training;
Peer and social media influence on vulnerable children and young people;
Social transitioning, which it considers to be “not a neutral act” but an “active intervention” that may significantly affect the developing psychological functioning of the child or young person.
ii. The Review’s findings have led to the pending closure of the GIDS and planned replacement with new regional services and a new model of care to be delivered by NHS England.
iii. The resulting NHS Interim Service Specification for the treatment of gender dysphoria in children, which sets out the standards and quality measures that clinical service providers must satisfy, states that, because of “uncertainties surrounding the use of hormone treatments [...], NHS England will only commission GnRHa [puberty blockers] in the context of a formal research protocol.”
iv. Several European countries have distanced themselves from the “gender affirmative” (typically medicalising) model of care. France’s National Academy of Medicine has cautioned against it, “given the vulnerability, particularly psychological, of this population and the many undesirable effects, and even serious complications, that some of the available therapies can cause.” Sweden and Finland have ceased or discouraged the use of puberty blocking drugs in favour of a psychosocial and psychotherapeutic approach. Norway and Ireland are also reviewing their practices.
Conference further notes that legislation is proposed to ban “conversion practices” but that clinicians and others have expressed concerns that, while the proposals are laudable in their intentions, they pose a number of risks, notably that:
The threat or perceived risk of prosecution may inhibit clinicians from offering any psychosocial or therapeutic treatment other than the “gender affirmative” model as a response to gender distress in children, regardless of background history, other psychological symptoms and conditions and the child or young person’s best interests;
Standard therapeutic practice such as exploratory therapy could be inadvertently criminalised, preventing vulnerable children and young people from accessing the care they need;
Lesbian, gay and bisexual people (especially young people) may be misdiagnosed as transgender, leading to the prescription of cross-sex hormone drugs and resulting in exactly the opposite outcome to that which the legislation seeks to achieve.
Conference believes that the treatment of vulnerable children and young people should be based on rigorous scientific and clinical study, and that the best interests of each individual should always be the paramount concern.
Conference calls for:
Protocols to ensure the continuing rapid development of a solid evidence base for the risks and benefits of puberty block drugs, starting with the interim NHS service specification;
Appropriate treatment, chosen from a range of options to address the needs of the individual patient based on holistic, multidisciplinary investigation of their mental health, neuro-developmental and personal, family and social background;
Any legislation on banning “conversion practices” in relation to gender identity to include robust protections for clinicians engaging in conventional, ethical psychotherapy, and protections for parents and teachers to be free to assist the children in their care to engage in healthy exploration of their identity as needed.
This motion is supported by the following Lib Dem members:
Dorothy Thornhill, Member of the House of Lords, Watford Lib Dems
Dr Zoe Hollowood, Chair, Liberal Voice for Women, St Albans Liberal Democrats, Elected Member Federal Council, English Council Representative
Alison Jenner, Vice Chair, Liberal Voice for Women; OxWAb Liberal Democrats, Member, Federal Council; Member, South Central Exec; Member, Federal Conference Committee
Toby Keynes, Chair, LGB Liberal Forum, Brighton & Hove Liberal Democrats
Katherine Howells, Bath and NES Liberal Democrats, Ward Rep on Local Party Exec
Dr Richard Hopkins, Wrexham & Clwyd South Liberal Democrats
Anne Williams, Gwynedd a Môn Liberal Democrats
Cllr Iris Walker, Aberdeenshire West Liberal Democrats
Judith Bailey, Southend Liberal Democrats, local branch committee chair.
Mark Johnston, Reigate Liberal Democrats (various party roles)
Mohammed Amin, Manchester Liberal Democrats, Liberty Network Board Member
David John Barnsdale, Kingston Borough Liberal Democrats, English Council
Richard Kirker, Tower Hamlets Liberal Democrats, English Council Member
Edmund Jankowski, St Albans Liberal Democrats, English Council Member
Claire Loneragan, Member Yeovil Liberal Democrats
Emma Louise Talbot, Treasurer, Tendring Liberal Democrats,
Juliet Line, Member, St Ives Liberal Democrats
Jenny Turner, Member, Liverpool Liberal Democrats
Nigel Scott, Haringey Liberal Democrats, English Council Member
Catherine Russell, Bexhill and Battle Liberal Democrats, Data officer
Kieran Seale, Westminster Liberal Democrats
Gary Wilson, Liverpool Liberal Democrats
Trish Kilgour, West Berkshire & Newbury Liberal Democrats
Rachel Barker, Sheffield Liberal Democrats, English Council Member, committee member, branch party
Mariana Yarnold, Member, Angus and Mearns Liberal Democrats
Jeremy Wright, West Dorset Liberal Democrats
Barbara Lindsay, Cheadle Liberal Democrats
Dan Boresjö, Windsor Liberal Democrats
Tony Hutson, Edinburgh North and Leith Liberal Democrats
Gary Bridge, Darlington Liberal Democrats
Jon Irwin, Wandsworth Liberal Democrats
Maurice Leslie, Warrington Liberal Democrats
Isobel Platings, Ealing Liberal Democrats, local committee member
Ben Eaton, Telford & Wrekin Liberal Democrats
Jacci Stoyle, Inverclyde Liberal Democrats
Kevin White, Liverpool Liberal Democrats
Jane Vaus, Lambeth Liberal Democrats
Susan Evans, Liverpool Liberal Democrats
Charlotte Revely, Yeovil Liberal Democrats
David Stevens, Edinburgh North and Leith Liberal Democrats
Mary Leslie, Warrington Liberal Democrats
Denise Robertson, Wokingham Liberal Democrats
Cllr Alex Brenton, Mid Dorset and N. Poole Liberal Democrats, County and Borough Councillor - cabinet member
Dr Allison F Wren, St Albans Liberal Democrats, Vice chair, Harpenden Liberal Democrats
Cllr Thalia Marrington, St Ives Liberal Democrats, PPC for Camborne, Redruth, Hayle
Cllr Dan Smith, Canterbury & Coastal Liberal Democrats, District Councillor
Meher Oliaji, Secretary, Hammersmith and Fulham Liberal Democrats
Quintin Peppiatt, Tower Hamlets Liberal Democrats
Sarah Martin, SE Cornwall Liberal Democrats, Executive committee member
Kirsti Wenn, Harpenden Liberal Democrats, Town Councillor
Jo Clements, Poole Liberal Democrats, Local Councillor
Cllr Luke Rogers, St Ives Liberal Democrats
Susan Sutcliffe, Morley and Outwood Liberal Democrats
Suzanne Gill, Richmond Park Liberal Democrats
Philip Lister, Oxford East Liberal Democrats
David Beacham, Haringey Liberal Democrats, Vice-Chair, Haringey
David John Bolwell, Bridport Liberal Democrats, Membership Development Secretary
Anne Woods, Brecon & Radnorshire Liberal Democrat, Local Party Chair
Sue Caul, Vale of White Horse Liberal Democrats, Cabinet Member
Martin Eggleston, Oxford West & Abingdon Liberal Democrats, English Council - South Central representative
Gillian Wilder, Woking Liberal Democrats
Imogen Beattie, Rutherglen & Hamilton West Liberal Democrats, Treasurer
Peter Blackaller, St Albans Liberal Democrats, East of England & England committee member
Christopher Barclay, Richmond upon Thames Liberal Democrats
Jenny Voyce, Wandsworth Liberal Democrats
Laura Cowen, Winchester Liberal Democrats
John Payne, Epsom & Ewell Liberal Democrats
Marion Moffatt, Tandridge Liberal Democrats
Helen Baxter, Hackney Liberal Democrats
Penelope Young, Membership Engagement Officer, St Ives Liberal Democrats