Psychologist Dr. Aiden Kelly warns of a worsening situation for transgender youth in England following the Cass report, emphasising the urgent need for improved gender-affirming healthcare services. Here’s the full story.
TERF Island
The UK has not been a particularly welcoming or compassionate country for transgender individuals, even earning the moniker “TERF-Island” online in reference to the Trans Exclusionary Radical Feminism movement, which advocates for a strictly sex-based understanding of gender.
JK Rowling
JK Rowling is a fierce proponent of the ideology and has frequently courted controversy by deadnaming transgender individuals and pushing back against any perceived advance in transgender rights, as she is cheered on by the right-wing press whose attitudes to transgender individuals are frequently hostile at best.
Consistent Support
YouGov polling has shown consistent support for transgender rights among the British public, but the numbers are steadily falling. When YouGov first asked the question, “Is a trans man a man and a trans woman a woman”? In 2018, the response was 43% agreed, and 38% disagreed.
Constant Erosion
Probably in part due to the constant avalanche of negative news stories surrounding the trans rights debate, those numbers have now fallen significantly to 38% agreeing and around 40% disagreeing.
Cass Report
The latest development for trans rights in the UK has been the publication of the Cass report, which highlighted significant shortcomings in the provisions of gender services, particularly at the Tavistock and Portman NHS Mental Health Trust’s Gender Identity Development Services (GIDS).
Decentralizing Services
The report recommended decentralizing services into regional hubs to improve accessibility and reduce waiting times.
Dire Circumstances
Due to the closure of the service, transgender children in England are facing increasingly dire circumstances in their quest for gender-affirming care.
“Very, Very Worried”
Dr. Aiden Kelly, a clinical psychologist specializing in gender, has expressed grave concerns about the deteriorating situation, saying he was “very, very worried” about the NHS’s ability to cope with the closure of GIDS.
“Far Worse Position”
Kelly said to the Guardian, “We’re in a far worse position than we were four years ago. The Cass review and NHS England’s policy updates, and the kind of measures and decisions they’ve made in terms of what to do with services, how to set up services – or not, as the case may be – means we’re in a far worse position.”
Long Delays
The closure of GIDS and the subsequent delay in establishing new clinics have led to lengthening waiting lists and exacerbated the challenges faced by transgender youth.
Private Clinics
While private clinics have emerged as an alternative for some families facing lengthy NHS waiting times, the Cass report expressed severe reservations about their quality of care.
“I Do Have Concerns”
Speaking to the BBC Radio 4 Today programme, Dr Hilary Cass, the report’s author, stated, “Everybody should be getting the same standard of care. And I do have concerns about private provision, which is not providing the level of assessment that I’m recommending in the NHS.”
5,000 on the Waiting List
Despite plans to open regional clinics, logistical complexities have delayed their launch, leading to over 5,000 children on the waiting list.
“Best Way to Serve Their Children”
Dr Cass acknowledged, “I fully understand why parents have felt that going down that path is the best way to serve their children … We have asked NHS England to provide advice to families about what it means if they go down a private route in terms of coming back into the NHS later.”
Drastic Measures
The report further warns parents against taking drastic measures to ensure their children get the care they need, such as buying unregulated hormones online.
“Doesn’t Fit With The Narrative”
Dr Kelly, whose clinic does not prescribe puberty blockers, highlighted that in 2019, merely 16% of those referred to Gids commenced hormone treatment, asserting, “so it doesn’t fit with the narrative that people were rushed onto treatments, that everyone just got it handed out like candy, how you hear some people talk about it. It was the exact opposite to that.”
“Caution and Fear”
Dr Kelly, who worked in mental health and has been a gender specialist for almost ten years, was particularly critical of the Cass report, stating, “It’s important to remember that people carrying out this expert review have never worked in gender. The people who actually know the work, and have been doing the work for a long period of time, don’t hold that level of caution and fear.”
“More Research is Needed”
He continued, “Yes, more research is needed. But not at the cost of actually offering meaningful care.”
Bearing the Brunt
As transgender youth bear the brunt of service disruptions and delays, Dr Kelly calls for urgent action to address the shortcomings in England’s gender healthcare system.
“No History, No Expertise”
Dr Kelly stated, “The decision to get rid of [Gids] and start afresh with two services with no history, no expertise in the field, with hiring clinical teams who have never worked in gender before, [who would be seeing] a much greater and much longer list of referrals, doesn’t sound to me like a successful approach and it really seems like we’re going backwards instead of forwards.”
“Incredibly Worrying”
He continued, “You’re going to have people who’ve been waiting over four years to see a gender specialist; they’ll arrive at one of these new gender clinics and they may well know more about the field of gender than the clinician will and that’s not an exaggeration. That, to me, is incredibly worrying.”
Lacking Compassion
The plight of transgender children in England underscores the critical need for comprehensive and accessible gender-affirming care and the need to treat transgender individuals with respect and compassion, which has seemed thin on the ground recently.
Systemic Deficiencies
While the Cass report sheds light on systemic deficiencies, it also highlights the urgent need to prioritize the needs of transgender youth and ensure their access to quality healthcare services.
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