AT TCW, we have repeatedly called for a change in the Government’s approach to the surge in young people seeking help with gender dysphoria. While the Government ‘banked a credit’ for announcing an inquiry into the matter, there was no public follow-up for over a year.

Now, at last, the Times reports that the NHS has ordered an independent review into the use of puberty suppressants and cross-sex hormones for gender-dysphoric adolescents. The National Institute for Health and Clinical Excellence (NICE), which is responsible for clinical practice guidelines in England and Wales, has also been asked to produce guidance for the first time about referring children to gender identity services.

Not before time. The Times article sets out just how bad things are. ‘NHS rules . . . enable children to start gender transition treatment before puberty without their parent’s support’ and ‘children unhappy with their birth gender can begin treatment after as few as three therapeutic assessments’. ‘They can discuss treatments separately from their parents’ and ‘are encouraged to self-define their status and to develop “autonomy” in decision-making’. It is beyond me how anyone could not have seen this for the safe-guarding crisis it surely is. More and more evidence stacks up that the majority of young people presenting with gender dysphoria have other problems: they may be on the autistic spectrum and often have a history of trauma and mental health problems.

Even as the NHS ploughed ahead with the ‘affirmation approach’, and the supposed Government inquiry remained on the back burner, last June the Royal College of General Practitioners wrote: ‘Children who have been on [puberty delaying] GnRH for a certain period of time and are roughly 16 years of age can be offered cross-sex hormones by the NHS, the effects of which can be irreversible . . . There is a significant lack of robust, comprehensive evidence around the outcomes, side effects and unintended consequences of such treatments for people with gender dysphoria, particularly children and young people, which prevents GPs from helping patients and their families in making an informed decision’. [My italics]

Many of the young people presenting at gender clinics are likely to be gay, leading commentators to point out that gender-confirmation may be the new conversion therapy. A clinician told the Times last year: ‘Young lesbians considered at the bottom of the heap suddenly found they were really popular when they said they were trans‘. Tavistock ‘whistleblowers’ have expressed concern at how little confusion over sexuality is explored when a young person requests treatment to change their body. ‘I would ask who they wanted to have relationships with, but I was told by senior management that gender is completely separate to sex,’ a female clinician said. ‘I couldn’t get on board with that, because it isn’t. Some people were transitioning their gender to match their sexuality.’

Critics of the ‘affirmation’ approach to gender dysphoria have also repeatedly referred to a staggering finding: of those adolescents initially seeking support, when a more cautious support approach was adopted, 85 per cent had the dysphoria dissipate with puberty.

@harvardmed are you aware of the existence of the following literature, and if so, how does it fit with "gender affirming medical protocols?" pic.twitter.com/BoZfC5vxZx — Will Malone, MD (@will_malone) February 9, 2020

Thinking through the logic of this is quite appalling. The ‘affirmation’ approach could mean that 85 per cent of those seeking support are being sent down the wrong path. They are being pushed into a lifetime of medication with an irreversibly changed body when on most other measures they are still immature. They face a lifetime of complex human interaction and discourse where they need to ‘correct’ people’s pronouns and navigate their confusion, to say nothing of a lifetime of regret. If they are gay, the process may have changed their bodies so much that it will be immeasurably harder for them to find the love and companionship which for most people gives life meaning.

Doctors in Ireland have called for an immediate stop to the current approach to treating gender dysphoria, claiming it is unsafe.

Health chiefs in Australia have described the rise in the number of transgender teens as an epidemic.

So it is good news that at last NHS seems to be taking the concerns of whistleblowers seriously and is beginning the process of an independent review. However, what the Conservative government must do is consider its own role in fuelling the epidemic. One of the latest such initiatives is its plan to promote the notion that you can chose your own ‘gender identity’ to every household in the land, via the census no less. Another has come from the Crown Prosecution Service which has recently produced a ‘resource pack’ for schools aimed at teaching children about ‘gender identity’, leaving any who want to challenge the concept open to accusations of ‘transphobia’ and ‘hate’.

It seems not to have occurred to ministers that the actions of the public sector might be helping to fuel the very gender dysphoria epidemic, the treatment and tragic outcomes of which it has finally realised it must review.