NHS England’s shift to a ‘watchful waiting’ brief on trans identity faces being undermined by campaigners seeking criminal ban on ‘conversion’ treatment
There has been a welcome shift in the way NHS England says it will provide care for children with gender dysphoria. In recent months, it has moved away from the ideologically driven “affirmative” model that views gender dysphoria in children purely as a sign of a fixed trans identity.
It is instead adopting a more evidence-based approach – as laid out in the review by the distinguished paediatrician Dr Hilary Cass – that starts from the understanding that children’s feelings of gender incongruence are often transient and fluid, and can be associated with autism, childhood trauma, children grappling with their own developing same-sex attraction, and intense discomfort about puberty.
There are a number of serious challenges for the NHS in rolling out a new approach; the underfunding of child mental health services and someto the affirmative model. Another is that campaigners are seeking to make the provision of exploratory therapy effectively impossible by ensnaring it in an ill-defined criminal ban on trans “conversion therapy”.
No one has been able to precisely define what “trans conversion therapy” is; when the government consulted on a ban, theit for failing on this count. But advocates for a ban clearly envisage it including therapy to explore the causes of a child’s gender distress and help them feel more comfortable in their body as an alternative to medicalisation.
The chilling effects of criminalising exploratory conversations between a therapist and a young person that could be perceived as denying their identity will only make the holistic therapy recognised as critical by the Cass review even harder to access. Campaigners will have no qualms about misrepresenting unclear law to tell clinicians, therapists and parents they may be committing a criminal offence and subject to “protection orders” unless they immediately affirm a child as trans.
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