First Do No Harm
First Do No Harm
Some things to remember in the wake of Friday's Court of Appeal ruling
In December last year Keira Bell and Mrs A won a landmark High Court judgement regarding the prescribing of puberty blockers to children.
Three judges ruled that a 13-year-old is ‘highly unlikely’ to have the competence to understand the effect of these drugs on future fertility and sexual function, that it is ‘doubtful’ a 14 or 15-year-old could knowingly consent to them, and that they are so experimental and life-changing, it is appropriate for doctors to seek a court order before prescribing them to 16 and 17-year-olds.
The Court of Appeal has just overturned that judgment.
It deemed that the Divisional Court had departed from Gillick Competence ie the established belief that children under 16 can make their own decisions if assessed as competent to do so by the clinician treating them.
In making its judgement, the Court of Appeal stated, “Clinicians will inevitably take great care before recommending treatment to a child and be astute to ensure that the consent obtained from both child and parents is properly informed by the advantages and disadvantages of the proposed course of treatment and in the light of evolving research and understanding of the implications and long-term consequences of such treatment.”
I wish I could believe that was true. But all the evidence suggests otherwise.
In June 2020 BBC’s Newsnight reported on The Tavistock and Portman NHS Trust’s Gender Identity Development Service (GIDS). It revealing that staff voicing concerns about the treatment of patients there were being silenced. The programme had leaked transcripts of staff interviews from a review into the service. These ‘damning’ interviews demonstrated that staff had very serious concerns about patient welfare but were being ignored and even shut down by their superiors.
In January Channel 4 News interviewed former Tavistock governor, Dr David Bell.
In 2018 Dr Bell wrote an internal report detailing the concerns of his colleagues about patient care at GIDS after around 10 of the clinic’s staff came to see him, unsolicited and independently, with grave worries. Trust authorities subsequently tried to suppress the report and silence Dr Bell.
He discussed the report’s main areas of contention on Channel 4 News:
Patients did not have the capacity to consent to the treatment they received.
Children were rushed into medical treatment so transition became a ‘self-fulfilling prophecy’.
There was no follow-up data kept after patients had been discharged.
Comorbidities, such as childhood trauma and autism, were not examined prior to a trans diagnosis being given.
Medical treatment was a form of ‘conversion therapy’ for gay and lesbian gender non-conforming children.
Dr Bell also referenced the influence of the trans lobby on GIDS: “Leaders of movements of a very powerful ideological commitment have managed to capture policy, both medically, professionally, in the media and in government, with no evidence base.”
He described children as having been “Very seriously damaged”.
Dr Bell is one of many clinicians who have expressed serious concerns over the treatment of patients and the prescription of puberty blockers at the Tavistock.
In 2019 consultant psychotherapist, Dr Marcus Evans, resigned from the trust over its ‘blinkered’ and ‘one-sided’ response to the clinicians who voiced concerns about the ‘woefully inadequate’ care. He said that the trust had created a ‘climate of fear’ and was trying to ‘dismiss or undermine’ issues raised by its own staff.
A further five clinicians resigned from the trust shortly after Dr Evans’ departure, voicing concerns over the use of puberty blockers and the treatment of patients.
Dr Matt Bristow, a former psychologist at GIDS, voiced his concern about the gay and lesbian children seeking help there. He was one of several gay staff members who expressed fears that gay children are being put on a pathway to transition without their sexuality or potential issues around it being explored. They were ignored. Bristow said that GIDS was offering ‘conversion therapy for gay kids’.
Dr Bristow was echoing concerns already expressed by other Tavistock clinicians who spoke about homophobic parents bringing gay, lesbian and gender non-conforming children to GIDS to be ‘fixed’. One clinician told The Times, “There was a dark joke among staff that there would be no gay people left”.
It’s not only clinicians who have expressed concerns over patient care at GIDS.
Sonia Appleby is a social worker and psychotherapist and the Named Professional for Safeguarding Children and the Safeguarding Children Lead at the Tavistock and Portman NHS Foundation Trust.
She made ‘protected disclosures’ to her line manager after GIDS staff raised concerns with her about the health and wellbeing of children seeking treatment there. She was subsequently ostracised, subjected to quasi-disciplinary action and actively prevented from doing her job.
There was a covert directive from Tavistock management that staff should not make Appleby aware of any safeguarding concerns and clinicians were discouraged from speaking to her. She is the clinic’s safeguarding lead.
Sonia Appleby took the trust to an employment tribunal which ruled in her favour.
A Care Quality Commission inspection of the Gender Identity Development Service highlighted various areas of failure and designated it ‘inadequate’, the lowest safety rating. The clinic’s record-keeping was heavily criticised, as was its lack of research into the high number of patients with autism.
BBC journalist, Hannah Barnes, detailed the report’s findings in this Twitter thread.
There is obviously cause for alarm over the quality of care and safeguarding being provided by GIDS’ to its vulnerable young patients. What we know about the hormone blockers being prescribed to them is even more disturbing.
According to the NHS, “Little is known about the long-term side effects of hormone or puberty blockers in children.” A number of psychiatry papers have been published recently which discredit affirmation treatments for gender dysphoric children. (For example, Griffin et al, published in the BJPsych Bulletin.)
Earlier this year, Sweden’s Karolinska Hospital stopped prescribing puberty blockers to children under sixteen. “These treatments are potentially fraught with extensive and irreversible adverse consequences such as cardiovascular disease, osteoporosis, infertility, increased cancer risk, and thrombosis.”
The dangers and side effects, many of which are only now just coming to light, have been expertly and meticulously documented by Professor Michael Biggs.
Earlier this year NICE, The National Institute of Health and Care Excellence, carried out an independent assessment into the use of puberty blockers. It concluded that the standard of evidence to support prescribing puberty blockers to children is ‘very low’.
It described previous studies as “Subject to bias and confounding” and highlighted a number of issues with them, particularly the potential bias of results due to insufficient data on additional interventions such as counselling.
In February the British Medical Journal reported on the findings of the Tavistock’s own puberty blockers trial. It found the drugs did not alleviate the negative thoughts of children with dysphoria and issued warnings over their potential side effects.
“Puberty blockers used to treat children aged 12 to 15 who have severe and persistent gender dysphoria had no significant effect on their psychological function, thoughts of self-harm, or body image... However, as expected, the children experienced reduced growth in height and bone strength by the time they finished their treatment at age 16.”
These drugs are, at best, experimental. Their long-term effects and harms are not yet properly understood and their benefit to the patient is negligible. How can a child as young as thirteen understand and consent to the effects and long-term consequences of life-altering drugs if the so-called experts are still in the dark?
Moreover, how can we entrust vulnerable children to an ideologically captured organisation that’s heavily influenced and intimidated by the trans lobby and where the standard of care has so frequently been found wanting?
Of course, following the Court of Appeal ruling, the usual suspects couldn’t wait to gloat over their so-called victory.
Gay conversation therapy and eugenics, robbing thousands of kids of their fertility and future sexual function, medicalising healthy children and putting them at risk of serious and permanent health problems.
That’s what these ghouls are celebrating.
Very informative and interesting piece, thank you. One to bookmark I feel.
"Life saving puberty blockers" is a disgraceful lie.