" The sole legal issue in the case is the circumstances in which a child or young person may be competent to give valid consent to treatment in law and the process by which consent to the treatment is obtained."
"We note here that we find it surprising that such data was not collated in previous years given the young age of the patient group, the experimental nature of the treatment and
the profound impact that it has. "
In other words, why did Tavistock not collate data for evidence?
With reference to high levels of autism.
"Again, we have found this lack of data analysis – and the apparent lack of investigation of this issue - surprising. "
A pattern emerging of lack of scientific rigour perhaps?
And again the sloppiness ,"The court asked for statistical material on the number, if any, of young people who had been assessed to be suitable for PBs but who were not prescribed them .... Ms Morris could not produce any statistics on whether this situation had ever arisen."
And again.
"No precise numbers are available from GIDS (as to the percentage of patients who proceed from PBs to CSH"
And this is unreal,
"We were told that the defendant did not have any data recording the proportion of those on puberty blockers who progress to cross-sex hormones"
IN other words Tavistock did not collate data on one of their key medical interventions!
And finally part of the conclusion.
"A child under 16 may only consent to the use of medication intended to suppress puberty where he or she is competent to understand the nature of the treatment. That includes an understanding...
... of the immediate and long-term consequences of the treatment, the limited evidence available as to its efficacy or purpose, the fact that the vast majority of patients proceed to the use of cross-sex hormones, and its potential life changing consequences for a child.
A question. How can a child consent to experimental treatment when the clinic administering that treatment does not itself understand the implications of giving that treatment?
The reason being it does not collate data on that treatment.
Another question.
In what other branch of medicine would an NHS be allowed to get away with such sloppy practice around data and evidence?
Why are children with gender dysphoria exempted from the usual safeguards?
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Here is a question to ask those promoting gender affirmative care.
Please provide high grade evidence that a child has an immutable gender identity?
There is none. But there are decades of empirical evidence that a child's sense of their own gender is in constant flux.
Every child goes through massive developmental changes as they mature -see Piaget, Kohlberg, Erikson etc. The evidence is clear but has been set aside.
Why would a child's sense of their own gender remain static, while all other aspects of their body, mind, brain develop?
For work with gender dysphoric children to be evidence based, child development theory must be at the center of any approach. It must be paired with trauma informed practice and psychotherapeutic interventions, so the child can come to better understand gender constructs.
1/ Sonia Appleby is an experienced social worker who qualified in 1981. She has a long career in safeguarding children and is currently the named Designated Safeguarding Children Lead for the Tavistock and Portman NHS Trust.
2/ She is responsible for ensuring that children and young people treated at the Tavistock are protected from avoidable harm, and to recognise when children are in need of safeguarding. This is a statutory role which public organisations must have.
3/ Sonia tried to raise concerns for children that she and clinicians from the Gender Identity Development Service. That was her role.
For this has been bismirched and clinicians were discouraged from raising their safeguarding concerns with her further.
1/ An important new research study examining the clinical characteristics of children presenting at an Australian gender clinic and the challenges faced by the treating clinicians. journals.sagepub.com/doi/full/10.11…
2. The children presented with high levels of distress including suicidal ideation (41.8%), self-harm (16.3%) and suicide attempts (10.1%).
There were high rates of comorbid mental health disorders including anxiety , depression behavioural disorders and autism.
3/ These children were found to have experienced high rates of family conflict (65.5%), parental mental illness (63.3%), Loss of important figures via separation (59.5%) and bullying (54.4%). A history of maltreatment* was also common (39.2%).
[*social workers take note]