Ultimately, I hope that all trans children have at least the opportunity that my son has had.
December 5, 2022 11:16 a.m.
In the summer of 2015, and what seems like a lifetime ago, my son announced via text that he was trans. He was, like almost every other parent of a trans child I’ve spoken to since, shocked as hell. My life changed instantly and I embarked on a journey to learn as much as I could about what it meant to be trans and how to best support my son.
Then things were easier. We only had to wait five months before her first appointment with the NHS Gender Identity Development Service, something that now seems like a pipe dream, where waiting lists have reached nearly three years.
It wasn’t perfect. We experience variations between doctors and their approaches, overwhelmed and overburdened staff, as well as incessant and unnecessary personal questions. It was clear that the entire service needed a radical overhaul. Although my son was finally able to access the puberty blockers he needed, he felt like a holding pattern until he reached adulthood.
Part of the problem was the unbearably repetitive and unnecessarily personal questions. I remember my son counting on his fingers (and running out of hands) how many people he had to talk to about deeply personal and invasive things, to jump through hoops and get treatment.
There were also more fundamental issues: The same doctors who were evaluating whether my son would be allowed to be referred for puberty blockers or hormones were also tasked with providing therapeutic support. It was clear to me and other parents I met in the service that young people would never fully open up to those they saw as the “gatekeepers” for the medical support they needed. This meant that monthly or quarterly appointments were so often filled with conversations that they were never going to be useful, as young people self-censored for fear that their medical support would be denied, delayed or suspended.
I also heard stories of other parents with children experiencing significant gender-related distress, who were told there was no help for them. Conversations in private support groups were filled with questions from parents trying to help dysphoric, depressed, and mentally spiraling teens who had nowhere to turn while on the multi-year long waiting list. For those with teenage children, it became a race against time to try to find some solution before their bodies were irrevocably changed. Desperate, some parents of trans teens sought private medical care as their children entered puberty.
I therefore welcomed the news earlier this year that youth gender services should be decentralized in regional centers, allowing trans and gender diverse youth to receive the care they desperately need in a timely manner. However, when I read the NHS specsmy heart sank.
The core of my concern is the apparent absence of any plan to educate or train healthcare professionals within the NHS who will treat trans youth. As parents of trans children have already observed, many GPs and other medical professionals are wary, ignorant or downright hostile towards supporting trans youth. Unless there is a widespread education program to educate professionals, I fear the level of quality support will be unpredictable and could even be detrimental.
The new specification also raises the question of co-occurring mental health issues and potential challenges presented by neurodiversity. It has been observed by a number of studies that there appears to be a high number of young people with autism who are coming out as trans. Furthermore, anxiety, depression, self-harm, and suicidal ideation are significantly higher in children with gender dysphoria than in the general population.
I am afraid that the new NHS protocols will direct doctors to diagnose and ‘treat’ these problems, before tackling their gender issues. I am concerned that, in trying to shield itself from criticism from anti-trans lobbyists, the NHS is designing a specification that deliberately delays support for the transition. While it is positive that gender-challenging youth are supported in a holistic way, the service needs to be developed so that it does not just rebuild the old model of healthcare gatekeepers.
Most alarmingly, I am deeply concerned about the threat of doctors and health professionals potentially suing trans youth, and their supportive parents, simply for seeking care while on the years-old waiting list for NHS services.
The proposed specification advises that GPs will be advised to initiate “local protection protocols” if children, young people and their families obtain puberty blockers or hormonal drugs from unregulated sources or from unregulated online providers. by UK agencies. This threat feels dangerously close to laws currently being implemented in some regressive conservative states in the US, where families have been reported to local services for providing take care of their trans children.
In an ideal world, I want to see the NHS endorse affirmative healthcare, a position of believing young trans people when they tell you who they are, and supporting them in their wishes. Most importantly, I pray for a service that truly recognizes that a child who is trans is not a bad outcome.
Ultimately, I hope that all trans children get at least the opportunity my son has had: access to puberty blockers in a timely manner, a supportive GP, and the transition to adult services that allow him to continue your gender-affirming health care. in adulthood. Even better would be a service that learns from the mistakes it has made, including pathologizing gender-questioning children and forcing them to adhere to preconceived ideas of gender conformity in order to access vital healthcare.
If the NHS really cares about young trans people, they need to start by listening to them and their parents.
The writer is a father living in the North East of England.