Thread by @JolyonMaugham

Good Law Project holds a copy of new NHS Guidance published yesterday and it is clear that Wes Streeting is continuing his war on trans people.

Remarkably the national health service is now directing GPs to cause harm to the community. 🧵

Background: the UK is a serious international outlier in how it approaches healthcare for young trans people. All over the world Governments are declining to follow the policy based evidence making of the Cass report. I believe we now have the most hostile regime anywhere.

Families in the UK who want to follow best medical practice - rather than pleasing Wes Streeting's true electorate (right wing media barons) - obtain puberty blockers (criminalised in the UK) from regulated prescribers in eg France or Netherlands or Switzerland.

(These are the ‘lucky’ families.

Streeting’s ban means that less wealthy families - or trans kids who are not supported by their parents - “DIY”. They buy drugs from unregulated suppliers over the dark web and learn how to administer those drugs from videos on YouTube.)

To ensure that puberty blockers can be taken safely, their effects are monitored with blood tests.

This is what the international Endocrine Society says (note the references to "monitoring".)

Those blood tests were once routinely done by GPs under “shared care arrangements”.

GPs might not feel expert enough to make a decision whether to prescribe puberty blockers. But they recognised they had a responsibility to protect their patient's health by monitoring bloods.

To take an analogy, if a GP has a patient who is a heroin addict they still monitor their health. The fact they disapprove of taking heroin would not be a reason to withdraw care.

Of course blood tests supported arrangements made by *regulated* prescribers abroad.

What NHS England did, in new guidance issued yesterday, was direct GPs no longer to offer shared care arrangements.

This means the NHS is directing GPs to expose their patients to additional risks by refusing to monitor their hormone levels; to actively cause harm.

The foundation for the Guidance is a simple and demonstrable lie. This is the basis for the instruction - that the prescriber is “unregulated”.

But these prescribers are not unregulated. They are regulated elsewhere in the world: in France or Switzerland or the Netherlands or Germany. Just not in the UK - which is an international outlier.

You can see this from how NHS England dishonestly defines “unregulated”.

You can see this even more explicitly in this section which amounts to a statement that it is every other country’s regulators which create additional risk and only England's which do not.

(Despite NHS England clearly and actively forcing GPs to create risk for its patients.)

NHS England also continues to encourage GPs to make safeguarding referrals in respect of a practice which is entirely orthodox in most of the rest of the world.

Again, this is intellectually dishonest. There is NO BASIS AT ALL, not even in the policy based evidence making Cass Review, for suggesting puberty blockers pose an “immediate safety risk”.

The intended effect of these referrals - and many are being made by social workers or Councils who basically want to eradicate the idea of transness - is that families who wish to adhere to international treatment protocols are frightened into ignoring them.

The consequence is to transfer scare social services resources away from children who are actually at risk like these children - who Wes Streeting’s government pretends to cares about.

I regret to say that Wes Streeting’s war against trans people is not confined to young trans people.

Here NHS England (presently only gently) discourages GPs from supporting shared care arrangements with adult trans patients as well.

Standing back, families are left with unenviable choices. Trans people are taking their own lives in numbers and Wes Streeting is suppressing the evidence.

There remain private providers based outside the UK who can offer both PBs and blood tests - to those who can afford them.