NHS to give sex change drugs to nine-year-olds: Clinic accused of 'playing God' with treatment that stops puberty

Treatment with controversial drugs is for youngsters trapped in wrong body

Monthly drug injections into the stomach stop puberty and may do harm

Trial in North London was completed - and is set to be rolled out further



Children as young as nine will be given controversial drugs on the NHS to prepare them for sex-swap surgery, The Mail on Sunday can reveal.



The treatment, which halts the onset of adulthood, is aimed at youngsters who believe they are trapped in the wrong body. But critics accused the clinic offering the puberty- postponing injections of ‘playing God’.



‘I think many people will be horrified at the thought of a nine-year-old being provided with a drug that effectively stops them developing and maturing naturally,’ said Conservative MP Andrew Percy.

Others insisted that undisputed research shows that the vast majority of under-16s who

are troubled about their gender do not go on to take the drastic step of surgery. Many turn out to be gay, but no longer feel confused about whether they are male or female.

'Benefits': Dr Polly Carmichael led trials of the hormone blocking treatment in North London

Although the gender treatment is reversible, there are concerns about the long-term effects on brain development, bone growth and fertility.

The drugs, known as hypothalamic blockers, stunt the development of sexual organs so less surgery is required if a child chooses to change sex after reaching adolescence.



Monthly injections into the stomach suppress the production of testosterone and oestrogen. In girls that halts the menstrual cycle and the development of breasts. In boys, they stop facial hair growing and voice changes.



Doctors at The Tavistock And Portman NHS Foundation Trust in North London have just completed a three-year trial involving 12- to 14-year-olds, assessing the ‘psychological, social and physical benefits and risks involved’.

Because the trial was deemed such a success, medics have decided to make the drugs more widely available – and to much younger children. Yet only five years ago national guidelines stated that treatment for ‘gender dysphoria’ should not start until puberty had finished.

Dr Polly Carmichael, who led the Tavistock trial, said decisions will now be based on the ‘stage’ of sexual development rather than age.



‘We’re talking about stopping puberty in the normal range of puberty, so I guess the younger age might be ten or nine,’ she said.

Asked if she expected children younger that the survey group to now come forward, she replied: ‘Yes, definitely... because some will be starting [puberty] earlier.’

Monthly shots: The children are injected with Gonapeptyl, which costs £82 a time

Research has found puberty is starting earlier in Western children. A recent study found the average age for American girls was nine years and ten months – a full year earlier than a similar study 15 years ago.



Tory MP Mark Pritchard said: ‘With competing NHS resources, especially for life-saving cancer drugs, there needs to be an immediate investigation into why these drugs are being prescribed to those so young.’



The Tavistock and Portman is the UK’s only specialist clinic for youngsters diagnosed with gender dysphoria.



It was previously caught up in controversy in 2012 when it diagnosed Zach Avery – a five-year-old boy allowed to live as a girl – with the condition.



The clinic was first given public funding in 2009 when, on average, it treated about 100 under-18s every year for the condition, which affects one in 4,000 people in Britain.



The number of annual referrals has now increased to about 500, reflecting the growth of a new, largely taxpayer-funded industry.



There are now about 150 transgender support groups in Britain. Those diagnosed with gender dysphoria can be prioritised by local councils for housing as ‘vulnerable people’.



One public figure, who refused to be named, said: ‘This is about policing the behaviour of little girls and boys.



‘So tomboys and boys who like to play with dolls are immediately seen as transgender. All the liberals think they are supporting transgender rights with this, but what they are really doing is mutilating healthy bodies to help people “fit in”.’



But supporters of the injection treatment say the drugs give children who are confused about their gender a much-needed ‘window’ before they take on too many masculine or feminine features. This, they say, prevents mental anguish – and will reduce the amount of surgery needed if they do go ahead with an operation.



Dr Carmichael said that the treatment takes ‘away some of the fear and distress young people go through if they feel their body is going in the wrong direction’.



But Professor Anne Dreger, a leading bioethics expert, said: ‘Putting children on puberty-blocking hormones, may, for some, cement the idea that they are transgender when perhaps they are not.’



Only eight of the 32 children diagnosed with gender dysphoria who took part in the Tavistock trial went on to start the sex change process.



But Dr Carmichael said: ‘Now we’ve done the study and the results thus far have been positive we’ve decided to continue with it. So we’ve decided to do “stage not age” [as the criterion] because it’s obviously fairer. Twelve is an arbitrary age.



‘If they started puberty aged nine or ten instead of 12, as long as they’re monitored and the bone density doesn’t suffer, then it is right that the aim is to stop the development of secondary sex characteristics.’



Dr Carmichael stressed that the injections are only given to children who meet strict criteria. They must have parental consent, normal bone density and weight, and no serious mental health problems.



The best-known brand of blocker is Gonapeptyl, which costs £82 per dose, and possible side-effects include depression, rashes, asthma and ovarian cysts.



The Tavistock accepts that while the effects of the drugs are temporary, and puberty will resume if you stop taking them, there are risks.

To be considered for the treatment, children need to have ‘demonstrated an intense pattern of cross-gendered behaviours and identity’ for at least five years. This means nine-year-old boys would have had to behaved like girls, and vice-versa, since the age of four.



While the clinic makes clear that the ‘young person’ must be ‘able to give informed consent’ for the procedure, critics argue that it is beyond the grasp of even the brightest nine-year-old to fully understand the full implications.



Dr Carmichael believes the rise in numbers attending the clinic is because more people are aware of gender identity issues.



Previously, parents who wanted their children to undergo gender treatment in the early stages of puberty had to travel to countries such as Holland, Belgium and the United States.



As a result, campaign groups sprang up to try to persuade the UK to follow their example.

One particularly influential campaign group is the Gender Identity Research and Education Society (GIRES), founded in 2010 by Bernard and Terry Reed, whose adult daughter is a transsexual.



The group’s influence extends to giving policy advice to the NHS, the Association of Chief Police Officers, the Crown Prosecution Service, the Department for Children, Schools and Families, and the Home Office



However, with the battle to lower the age of children receiving hormone blocking jabs in the UK seemingly won, even Dr Carmichael cautioned: ‘Some people think this is absolutely the way to go and actually I don’t think it’s right for everybody in this situation.



‘It has to be about balancing risks and benefits.’

How Lily became Leo on clinic's trial at the age of 12 with hormone blockers

Leo Waddell was one of the young people who started taking hormone blockers on the Tavistock and Portman clinic’s trial at the age of just 12.



The schoolboy, who began life as Lily, has favoured boy’s clothes over dresses and frills since he was a toddler and at the age of nine told his mother: ‘I don’t want to be a girl any more.’



He admitted that if he had been forced to continue living as a girl, ‘I would probably kill myself’.



Transformation: Leo Waddell, who was born Lily, poses with his mother Hayley

Leo described being referred to the gender identity development service in 2001 as ‘amazing’ because he was finally able to start living his life.



Initially ‘Lily’s’ mother Hayley, pictured, left, with her son, thought her desire to act like a boy would be something she would grow out of, but as she got older and continued to reject all things feminine she realised this wasn’t the case.



At the age of 11 she allowed Lily to change her name by deed poll to Leo.



But Leo, from Lowestoft, Suffolk, recalled how even with his family’s understanding, he still struggled.



He said: ‘School was tough. It was normal until year six, but then when I got my name changed they wouldn’t call me Leo for about three months, and then when they started calling me Leo they still wouldn’t call me “he”, they carried on calling me “she”.’



His mother added: ‘Especially where we come from there was a lot of ignorance surrounding gender dysphoria because no one had heard of it – not the doctor, not the schools, not even social services.’

So, is NHS right to offer this treatment to 9-year-olds?

In favour: Susie Green says that hormone blockers offer a chance to stop terrible trauma of conflicted children

YES, says SUSIE GREEN chair of Mermaids, the support group for young people with gender identity issues



Making hormone blockers available on the NHS in the early stages of puberty is a hugely positive step.



For many years, desperate British parents have had to almost bankrupt themselves travelling to get treatment in Holland or the US.



The blockers offer the only chance for them to stop the terrible trauma their children have started to go through as they begin to develop into a sex they feel is absolutely alien to them.



If you offer hormone blockers at the end of puberty, that is too late.



Their body shape will have already changed and they will have had to live through physical developments that have caused massive distress.



The self-harm and suicide rate among transgender teens is extremely high so offering blockers saves lives. It’s quite simple.



And they are completely reversible, so puberty will resume normally if they cease to be taken.



Studies have shown that young people given this treatment in the early stages of puberty have better psychological well-being, self-confidence and self-esteem.



Society has to accept that some people may not fit with their birth gender. In which case it’s surely our responsibility to help them.



Blockers are a way of pressing the pause button and giving people the choice to be the person they feel they are. What is wrong with that?



Objections: Victoria Gillick says the treatment plays fast and loose with children's futures

NO, says VICTORIA GILLICK, a pro-life campaigner who brought landmark court case against health authorities giving under-16s the pill



I think it’s an appalling idea. How can they possibly know at such an early stage of their psychological development if they should go one way or another?



This is destroying a child’s future before he or she is old enough even to give a valid consent to treatment.



They shouldn’t be giving unnecessary drugs to children anyway.



We know now that too much Ritalin has been prescribed to children who are supposedly hyperactive and this strikes me as another example of the medical profession jumping in with drugs when what the children need is probably a different form of caring.

This is playing fast and loose with a child’s future.



Let the child develop naturally until they are of an age, at least 16, to give valid consent to treatment.



That was the argument I always put against giving contraceptives to a child, which will affect every cell in their body.



There will, in the future, be an awful lot of doctors who will be sued by older men and women for having done something to them before they were of an age to understand what the significance of it was.



The children are not of an age to decide and it’s probably the parents who need more and better counselling rather than starting to medicate their children so drastically.

