Thread by @JolyonMaugham

I see my tweets about the effects of Wes Streeting's ban on puberty blockers on younger trans people have been criticised by the DHSC’s adviser on suicides. 🧵

1. What is undoubtedly true is that Victoria Atkins was warned by her own civil servants about the ban on puberty blockers posing “a high risk of self-harm and suicide” and Wes Streeting followed his predecessor in ignoring that advice.

2. Before publishing my thread (below) we went to the Tavistock and Portman with these numbers for a response. Other journalists went to NHS England for a response. Neither denied the numbers and both declined to comment.

https://x.com/JolyonMaugham/status/1803729360731406489

3. Here are the emails we sent. Of course, had the Tavistock (or NHS) responded denying our figures we would have engaged with their response. But they did not.

They have sought to avoid transparency.

4. Under Wes Streeting, DHSC seems to hold itself to a far lower standard. It did not give us or me any advance warning that it was putting out this statement. Given the very direct attack on us made by a Government Department this is, to put it mildly, surprising.

5. It is absolutely true that they have better data. Many have made FOIA requests of NHSE and Tavistock which have been rebuffed. This is not transparency. And it is of course why we put our numbers to them - to see what they had to say. And they chose to say nothing.

6. I can't help but wonder how these attempts to block FOIA data and ignore requests for comment sit with this statement from the DHSC’s adviser on suicides? Many of us have been after data for years - but we have been consistently blocked and employees threatened.

7. Still, I have profound difficulties with his figures and analysis. Let me set out some of the reasons why.

First, the analysis is surprising given that less than a month ago NHS England denied (in response to a FOIA request) it held the data that DHSC says it analysed.

8. Second, we seem to be comparing apples and pears.

The DHSC adviser is talking about the small group of “current and former GIDS patients” whereas my figures are primarily directed to the larger group of “those on the waiting list”.

9. Of course, a consequences of NHSE largely closing off healthcare to young trans people in 12/20 is more on waiting lists and less patients.

It’s hard to improve upon the Tavistock’s own description of the effects (about GICs but the point is the same).

https://x.com/JolyonMaugham/status/1803738408642027872

10. Third, although I took my numbers from two whistleblowers (I now have a third) I triangulated it with contemporaneous public evidence of the Tavistock’s own minutes.

That evidence was published before the Tories (and now Wes Streeting) sought to weaponise trans healthcare.

11. What does that contemporaneous evidence show? First, it discloses only one “apparent suicide” in GIDs in the three years before the shutters came down in 12/20.

If there were the higher numbers asserted by DHSC they do not appear in the minutes.

https://x.com/JolyonMaugham/status/1803733250797363602

12. What about in the three years after the appalling Bell decision from 12/20 which started all of this? Well, here is what the Minutes show.

13. More snips here. Taken together these numbers are broadly consistent with what I was told by the two whistleblowers I refer to in my thread (I am now waiting to speak to a third who I understand to confirm the story of the first two).

14. I also hold a contemporaneous email from 1 February 2023 (I have deleted the names) which refers to 11 deaths in two years since the NHS pulled down the shutters on trans healthcare. This is also consistent with 16 deaths over three years.

15. DHSC explicitly only analyses suicides at the Tavistock and so it ignores that care for young trans people passed over to NHS Arden & GEM CSU in (I believe) early 2023. Any suicides at the CSU DHSC does not even claim to have counted.

16. DHSC also does not take into account that, as para 5.65 of the Cass report acknowledges, a trigger for suicides is young people moving from GIDS to the adult service (GICS). Those suicides are of young trans people but will not be counted in the GIDS data.

17. I also understand from one source (I can responsibly put it no higher than that) that the DHSC data only counts those where the suicide has been confirmed by the coroner. Whereas the Tavistock Minutes reports “probable” and “suspected” and “likely” suicides.

18. This is an incredibly important point when it comes to counting recent deaths by suicide given the very lengthy delays in holding inquests. Eg we are supporting the family of someone who hung themselves in 2022 where the inquest has been delayed. leighday.co.uk/news/blog/2022…

19. There is also no denying the emails I have from terrified parents who are, eg, sleeping on the floor of their child's bedroom to watch over them. Or the reports from NGOs working in the sector of multiple attempts in the immediate aftermath of the ban.

20. Wes Streeting will not know about this material because he closed his mind to it. The papers in our court case show that, before banning puberty blockers, his predecessor chose not to consult with organisations representing trans people or their families. Nor did Wes.

21. What about the other points that the DHSC adviser makes, about speaking about suicide? He says: “Guidance has been developed by Samaritans, originally for the news media *but with wider applicability to any public discussion of suicide.*”

22. The difficulty is, of course, with the asterisked phrase.

Of course, those (including Wes Streeting) who will not hear from trans people and support a dangerous ban that even Hilary Cass did not recommend want to stop discussion about what their measures really mean.

23. Wes Streeting’s predecessor was warned repeatedly by her civil servants and the NHS that the ban was dangerous. I have set out some of those warnings in this thread (which he has ignored because it is inconvenient to his case).

https://x.com/JolyonMaugham/status/1812456173259391473

24. But let me single out from that thread, this image from advice given to his predecessor, of “a high risk of self-harm and suicide”.

This is what civil servants were advising, Wes Streeting decided to ignore it, and this point must be made by those who care about trans kids.

25. To fail to point out publicly that measures are generating a “high risk of suicide” when a Minister is bent on introducing them whatever she or he is advised about the risks is now how you diminish the risks of suicide. It just isn't.

26. There is no way to put pressure on people like Streeting without speaking a language they understand: political pain. I have shown the NHS and the Tavistock sought to avoid the evidence coming out. And that Streeting did not engage with it before implementing the regulations.

27. What you are left with is a need to balance risks - of letting ideologues drive through dangerous measures without public pushback or pointing out that the measures are indeed dangerous.

28. But you don’t need to take my word for it because I wrote to the Samaritans about it. Here is my email to them of late 2022: “The 'debate' we seem to be having focuses on the risks of affirming but... ignores the risks of resisting.”

29. And here is their reply: “You are right in thinking that our guidelines are being misunderstood and probably sometimes deliberately so on this particular matter” (again I have deleted names).

30. For what it's worth I have continued to ask for advice on how to deal with the matter responsibly, including this week.

On this occasion, perhaps wisely given that speaking out for trans people generates punishment beatings, they did not engage. thepinknews.com/2022/12/11/sam…

31. It is very hard to balance campaigning to protect the most targeted and vulnerable in the country from wicked ideologues. And to none of us is it given always to get the balance right. But failing to speak of the harm that ideology generates is not the answer.

32. I want to promise to those many, many trans people and families who thank me for my advocacy: I am not going away. Not until Wes Streeting is more interested in what you want than the billionaires and the right wing media he so transparently courts.

33. Where, as will be the case, I have got the balance wrong, to the trans community I apologise. This is a tough tough job: facing down the Trumps and the Putins and the Murdochs and the billionaire and the Rothermeres. And now, devastatingly, a Labour Health Secretary too.

Have you noticed how all the wrong people are clapping, Keir?

(All tweets in my personal capacity.)