Thread by @AlisonTunley

The updated 2022 @educationgovuk policy "Keeping children safe in education" conflates a child's attested trans identity with sexual orientation & thus fails to recognise potential safeguarding concerns that may apply for these children. #edutwitter🧵1/14

This new KCSIE guide does not come into force until September, so now is the time to urge DfE to update the guidance in line with the available evidence (including the interim Cass Review) & help teachers offer appropriate support for trans-identified students. 2/14

The new guide correctly says that LGBT is not an inherent risk, however, the simplistic conflation of "T" with "LGB" means there is a failure to flag specific risks that apply for trans-identified children & adolescents. 3/14

The interim Cass Review notes "many of the children & young people presenting have complex needs, but once they are identified as having gender-related distress, other important healthcare issues [...] can [...] be overlooked." A similar risk of oversight applies in schools. 4/14

Cass emphasises the complexity of gender dysphoria and mentions "sexual abuse/other trauma" among several possible presentations. Schools must be alert to such concerns and not blinded by whatever "explanation" a child might have settled on for their distress. 5/14

35% of referrals to GIDS had "moderate to severe autistic traits": a child declaring a trans identity may require additional pastoral support in school & possibly a referral for further assessment. Schools must be attuned to these needs. 6/14
adc.bmj.com/content/103/7/…

Adolescents presenting as trans are more likely than their contemporaries to have other mental health issues, with disproportionately high rates of depression, anxiety & eating disorders. Schools need to understand these risks. 7/14
statsforgender.org/mental-health/

Importantly, Finnish researchers found "severe psychopathology preceding onset of gender dysphoria was common", i.e. these problems could be *cause* not *effect* for children declaring an opposite-sex or non-binary identity. 8/14
ncbi.nlm.nih.gov/pmc/articles/P…

By equating "LGB" & "T", KCSIE ignores the stark contrast in consequences. Sexual orientation poses no risk, but a trans announcement is often accompanied by severe distress about the body (i.e. dysphoria) & a desire to make physical changes to "match" the child's identity. 9/14

Girls may use "painful, and potentially harmful, binding processes to conceal their breasts." (Cass). A 2021 study says: "negative physical side effects, ranging from chronic pain to rib fractures, are common." Does DfE not consider this a "risk factor for harm"? 10/14

Internalised homophobia can cause a mistaken trans identity. Cass: "we have heard from young lesbians who felt pressured to identify as transgender male". Confusing an LGB orientation for trans (with its associated medical interventions) is far riskier than vice versa. 11/14

When it comes to the medical interventions linked with trans identities, NICE describes puberty blockers & cross-sex hormones as being based on "very low certainty" evidence; parents might reasonably fear that a child who announces a trans identity is at risk of harm. 12/14

Standard safeguarding is already in danger of being forsaken here amid fears that concerns about a trans-identified child could be perceived as "transphobic". Schools need information from DfE that spells out the risks for these children rather than glossing over them. 13/14

In summary, the KCSIE guide overlooks 2 key issues:
i) a trans identity can mask other risk factors that should not be left unaddressed
ii) the consequences of medical transition mean it is imperative that mistakes are avoided & proper safeguarding policies followed
END