Let me be absolutely clear: I am in no doubt there are people who feel they are one gender while having the body of the other.

Living with such constant, internal conflict is horrifying for many of those affected, and it should never be ignored.

No one should seek to suppress another person’s genuinely held sexual orientation or gender identity.

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But the question we must ask ourselves today is this – how do we decide whose needs are genuine? And how, then, should we treat them?

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Since 2011, specialists at The Tavistock Centre’s Gender Identity Development Service in London have seen more than 1,000 under-18s

I have been a psychotherapist for more than 30 years and, in that time, I have worked with a small but significant number of patients who wished to change gender.

For everyone’s sake, I believe that surgery – which is irreversible – should only ever be a last resort. We should always begin by working to help the mind fit better with the body before we start altering the body to fit the mind.

Yet in today’s NHS, professionals are enabling hundreds – possibly thousands – of teenagers to have major surgery to change their gender.

It is being done, almost unchallenged, in the name of transgender rights. But in 20 years’ time, I believe we will look back on this folly as one of the darkest periods in the history of modern medicine.

We will question why we failed to challenge their belief that they were born in the ‘wrong’ bodies.

We will ask why we so readily ignored the clanging alarm bells that many were autistic, or had mental health problems.

What we are faced with today is extremely worrying. While 17 children are transitioning in one secondary school, be in no doubt – it is almost certainly being repeated in other schools. What is happening is this: we are bringing up a generation of children who have quite complex mental health issues.

Identifying as trans can feel like a way to explain that suffering. Rather than understanding where it might be coming from – feeling lonely or isolated, being bullied, having an autistic spectrum disorder or struggling with any number of issues from sexuality to abuse to self-harm – we are allowing them to change sex.

It’s a lazy and damaging solution and one which NHS professionals, teachers, politicians and the law are all too eager to embrace to signal their progressive views.

In 2015, I published a prize- winning but controversial paper examining whether therapy could replace some patients’ perceived need for surgery.

Personally, I believe that as a society we should celebrate gender variance. Some of my patients have been able to live creatively with the mismatch between their mind and body. Where that isn’t possible – and where a patient is obviously suffering – we should always do something about it.

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Yet the debate on this issue has been silenced by transgender activists who label as ‘transphobic’ anyone who dares to challenge their dogma.

This blind adherence to ideology has real, dangerous consequences.

In my field, for example, many psychotherapists are now afraid to properly question a patient who identifies as trans: afraid to explore their past, ask questions of their sexuality, or look into their mental health. They won’t go there, for fear of being struck off.

One major problem in today’s blinkered reality is that, if you don’t ‘affirm’ a patient’s claim to be transgender, you can run the risk of being accused of practising ‘conversion therapy’.

Conversion therapy is the practice of trying to convince a homosexual person that they are really straight. It’s abhorrent, and is rightly banned. Now, powerful bodies including the NHS and major counselling organisations have signed a Memorandum of Understanding – an agreement on how to practise – which extends the definition of conversion therapy to cover patients who might be transgender.

Online: Young children watch transgender YouTube star Miles McKenna

And this well-meaning memorandum is being used by trans activists to stop therapists, psychologists and others from asking rigorous questions about whether or not a patient does, in fact, have genuine ‘gender dysphoria’.

A therapist might have good cause to believe that the trans-identifying teenage boy in front of them hates his body because he was abused as a child and feels vulnerable. But they can’t explore that possibility.

They might spot a pattern of several schoolgirls saying they are trans, after witnessing a peer transformed from social non-entity to social butterfly after identifying as a trans-boy.

The attraction of popularity should not be overlooked.

Yet none of these possibilities can now be safely raised by psychotherapists, psychiatrists or teachers. Recently, 650 trans activists signed a letter published in Therapy Today, the house magazine of the British Association of Counselling and Psychotherapy, calling on anyone not practising ‘affirmation therapy’ to be booted out. If the Government presses ahead with plans to allow people to ‘self- identify’ as whatever gender they like, without external validation, I fear that would strengthen the hand of those arguing for trans-affirmative therapy.

But in my view, to avoid asking such probing questions of patients who claim to be trans – especially teenagers – is a cowardly dereliction of our duty.

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We abdicate our responsibility if we simply become their Yes men, just passing them on to the next stage of the sex-change process.

The danger is that, once on the medical pathway which leads to a sex change, it’s very hard to get off.

Youngsters referred to the Gender Identity Development Service run by The Tavistock and Portman NHS Foundation Trust in London undergo just six sessions to assess whether or not they are trans. Several members of staff have told me they are quietly appalled that, too often, no psychotherapy is offered before they start medical treatment.

They are then given ‘puberty blocker’ drugs which halt physical developments – powerful medicines not even licensed for transgender treatment which we know can weaken the bones, perhaps for life. There is little long-term data on their safety yet the NHS routinely hands them out.

Then most will receive cross-sex hormones, which carry their own risks. Giving testosterone to females, for instance, can raise the risk of ovarian cancer.

Exactly how many make the full surgical transition to the ‘opposite’ sex is unclear. Whether it brings lasting happiness is even less so. Short-term studies, usually conducted soon after surgery, suggest patients are immediately happier. But the few long-term studies that exist paint a different picture.

One, which followed men who had transitioned to be women for 15 to 20 years after surgery, showed they had a 20-times higher risk of suicide than others matched for age, social class and mental health problems.

On YouTube, some transsexuals are now posting videos warning young people not to go ahead with reassignment.

The backlash has begun.

It surely can’t be long before more difficult questions will be asked by a new generation. They will ask why nobody stopped them, told them treatment could destroy their sex life – or warned them that it would make them infertile and might not make them happy after all. They might also have lawyers asking the same questions, eyeing millions of pounds in compensation.

We need some honesty now, free from political correctness.

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Otherwise, we are heading towards catastrophe.