Spinning the Tavistock Story – Bernard Lane

Activists are twisting the closure of Tavistock as a win for gender ideology.

Can the fall of the Tavistock truly be transitioned into a victory for youth gender medicine?

[I]t’s not surprising that expert reviews in jurisdictions as different as Finland, Sweden, the UK, and the US state of Florida have all failed to find sufficient evidence to justify medicalised gender change as a routine treatment for today’s troubled minors. In June 2020, Finland’s public sector Council for Choices in Health Care was quite blunt: “gender reassignment of minors is an experimental practice.”

In April, the British Medical Journal published an opinion piece by Australian champions of the gender-affirming approach who put the case for business as usual. They argued that Dr Cass was wrong to say in her February interim report that the evidence was so patchy and poor that she was unable to give a confident verdict on the safety of puberty blockers and opposite-sex hormones for minors. Notwithstanding multiple systematic reviews to the contrary, the Australians claimed that existing evidence and agreement among (fellow affirmative) clinicians are enough to keep prescribing these drugs as routine treatment.In 2018, the journal Pediatrics published what was said to be the first systematic review of the evidence for hormonal treatment of adolescents with gender dysphoria. The outcome? Medium to high risk of bias in all the studies reviewed.

Four months later, those systematic reviews and the Cass interim report culminated in the announcement that the Tavistock would be shut down. This was rightly reported as big international news, but much of its significance and relevance is being obscured by spin.

Amid polarisation and polemic, Dr Cass has been tactful and pragmatic, so you won’t find an outright rejection of the affirmative model in her commentary. But there is plenty on the record to show she is conscious of the risks associated with dogmatic affirmation.

The need for shorter waiting times at clinics is common ground. Dr Cass is understandably troubled by the two-and-a-half-years-plus waiting time to be seen at the UK’s only specialist gender clinic—but not because it delays affirmative medicalisation for “trans kids” who know they need puberty blockers.

Dr Cass has said it is “not helpful to exceptionalise gender identity issues.” The argument against the affirmative model is precisely that its gender lens detects nothing but gender. Hence the Cass report’s warning against “diagnostic overshadowing”: “many of the children and young people presenting [at clinics] have complex needs, but once they are identified as having gender-related distress, other important healthcare issues that would normally be managed by local services can sometimes be subsumed by the label of gender dysphoria.”

It’s incoherent when the affirmative position is to reject pathologisation, while insisting that young people should be medicalised—potentially resulting in their sterilisation and sexual dysfunction—if, according to some unclear personal criterion, they happen to request drugs and surgery to become who they always were. For example, the “informed consent” approach (a misnomer for the fast-tracking of “affirmative” hormonal interventions) seems to promote a form of identity medicine available on demand as a human right.

In any event, it’s clear that the Cass review is no charter for a regional rollout of affirmation-only gender clinics. Instead, the idea is to more safely anchor clinics in mainstream health with a timely and tailored offering of interventions, so that the whole person, not just a disembodied gender identity, is given proper clinical attention.

Source: Spinning the Tavistock Story

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