This thread offers a brief overview of our Top Ten Tips for parents. Visit our website for more detail.


1/10 Listen to your child: They are telling you something important and meaningful to them, as they try to work out where they belong in the world.bayswatersupport.org.uk/toptentips/ 2/10 Inform yourself: Your child is a reasonable person who is responding to their unease the best way they know how. So get to know what your child is reading, watch the same YouTubers they’re glued to, follow conversations on Reddit.

A healthy response to gender non-conformity is that it is no big deal, at any age. But it is notable how the adolescent-onset cohort of trans-identified children differ from very young children in that GNC behaviour more often FOLLOWS adoption of the cross-sex or NB identity. 1/4 This difference is often overlooked:
* Being GNC as a very young child does seem to be a key driver in rejecting their natal sex category.
* But in adolescents, GNC more often appears to be a by-product of the identity than a causal factor. 2/4

A key problem for the research ethics committee is:
1) "a diagnosis of gender dysphoria ... is not reliably predictive of whether that young person will have longstanding gender incongruence" (Cass)
2) NHSE's PB study nonetheless proposes to select some children for permanent medicalisation with a high risk of infertility and loss of sexual function and unknown cognitive & other health risks. 1/11

thetimes.com/uk/society/art… But that is only the first of many problems.
We know a lot more about puberty blockers since the previous GIDS study began in 2011, but none of this new information supports arguments for further experimentation. 🧵 2/11

Unpicking fact from fiction in the field of gender medicine is time consuming and can sometimes feel like a losing battle. But it has to be done. What follows is a typical example of an apparently confident claim that lacks robust evidence. 1/13 In its report for @DHSCgovuk on the use of GnRH agonists (puberty blockers) for gender dysphoria, the Commission on Human Medicines say:
i) "the majority do not regret [the use of GnRH agonists] when asked 6 to 10 years later"
ii) "one in 18 do regret the decision" 2/13

A new review shows a "clear patient safety risk" due to a lack of "evidence-based guidelines for UK clinicians" for gender interventions, with apparently no plans to produce such guidance. 1/17
mdpi.com/2227-9032/13/4… An audit of 2 CQC "outstanding" GP practices in South-West England reviewed patient records for anyone "with current or historic gender-related diagnostic codes" and found deficient patient monitoring as well as complications following hormones and surgery. 2/17

At a WEC select committee hearing today, when asked why it took so long for the results of the GIDS puberty blocker study to be published, Professor Gary Butler replied "I wasn't directly involved in that study". He was in fact second author on the 2021 published paper.
1/6
(The relevant questioning begins at 15:12)
committees.parliament.uk/event/22659/fo… Evasion and misrepresentation of this kind was a theme throughout the session. Some MPs asked pertinent questions, but none were in a position to assess the veracity of the responses they were given by the three witnesses.
2/6

The following is a long thread, but the questions it raises about the ethics of blocking pubertal development as a treatment for gender distress could not be more important as we await detailed information about NHSE's plans for a puberty blocker trial.
[1/20] All of the issues outlined here must be addressed if we are to avoid a repeat of the historic failings that led Dr Cass to conclude that these children and young people "deserve very much better".
[2/20]

Identity development is a key task in adolescence: developing a healthy sense of self and keeping options open can be hindered by an eagerness to pin down and label one particular aspect of identity: a child's feelings about their social gender role.
1/6 When an individual's feelings about their social gender role are internalised and cemented in the form of a "gender identity" this can generate a sense that their body is "wrong" and an impediment to being seen as desired by wider society.
2/6

Scrutiny of the diagnosis of gender incongruence is long overdue. The NHS uses the WHO ICD-11 definition as the basis for a diagnosis that can mask comorbidities and arguably cements the contentious idea of an 'innate gender' that can be misaligned with a person's body. 1/7 The ICD-11 definition for "gender incongruence of childhood" assumes that an individual has a "gender" to be experienced or expressed, but does not explain what this inner "gender" could be. 2/7

Topics to address with your newly elected MP:
* Implementation of Cass
* NHS review of adult gender services
* Pastoral support & RSE guidance for schools
* Potential for conversion practices legislation to undermine Cass

See thread for more detail on what to ask your MP.
1/14 Do they back full implementation of the Cass recommendations? What do they think is the best way to ensure lessons are learned from the “departure from normal clinical practice” that occurred at GIDS?
2/14

Platitudes about protecting legitimate holistic therapy while introducing conversion practices legislation are not enough. There is ALREADY a harmful chilling effect, and this will inevitably be magnified even if prosecutions are avoided.
1/7 It will not take prosecutions to exacerbate the climate of fear described by Cass.
Her admission that she has “no idea” how to legislate without making the situation worse should be a stark warning to those making glib promises.
2/7
theguardian.com/world/2024/apr…

The potential for conversion practices legislation to undermine implementation of the Cass Review is poorly understood by many policymakers, so here is a summary of questions to ask parliamentary candidates who are pledging support for legislation in this area. 1/10 Since Cass found that false allegations of conversion are ALREADY harming clinical best practice, how will this not be exacerbated by introducing the threat of criminal prosecution? 2/10

There is much to be welcomed in the @educationgov guidance, particularly the clarity around existing legal duties. However, there are key areas that require strengthening. This thread offers a summary & we urge people to respond to the consultation
gov.uk/government/con… Firstly, the guidance must explicitly reference the very serious psychological & physical risks associated with a trans-identity. Otherwise schools will continue to respond simply to the superficial identity rather than considering underlying causes & consequences.

How did a school come to take decisions with such detrimental consequences for its pupils? The answer lies in a Church of England schools policy (issued in 2014, updated 2019) 🧵 1/15
telegraph.co.uk/news/2024/01/2… The CofE's "Valuing all God's Children" had the laudable aim of "challenging homophobic, biphobic and transphobic bullying". Sadly the policy is riddled with inaccuracies, misrepresents UK law, and fails to provide an evidence-based account of paediatric gender dysphoria. 2/15

The new @educationgovuk schools guidance must be underpinned by updates to its statutory safeguarding guidance "Keeping Children Safe in Education" (KCSIE). #edutwitter A thread explaining why: In February 2022, the interim NHS Cass Review presented evidence showing the specific vulnerability of trans-identified children. Cass cites disproportionate rates of mental health comorbidities, neurodevelopmental issues, sexual abuse & other trauma among this cohort.

The @educationgovuk schools guidance contains a long-overdue warning about the consequential nature of social transition and the lack of evidence for this intervention. The urge for caution is a welcome step in the right direction. 1/7
consult.education.gov.uk/equalities-pol… However, schools now need help to understand that the greatest safeguarding threat to trans-identified students comes not from parents who are cautious about social transition but from a failure to ensure a holistic understanding of the child's distress and associated risks.
2/7

Schools, teachers, parents & well-meaning peers often assume that affirming a child's trans identity by agreeing to new name/pronouns is the kind thing to do and that this is associated with mental health benefits.
This is not supported by the available evidence. #edutwitter 🧵 With rumours swirling about @educationgovuk schools guidance, here is a review of why social transition is too important an issue to fudge. Crucially: agreeing to name/pronoun requests comes with significant risks for the student & is a decision beyond the remit of any school.

This Times editorial fundamentally misunderstands the implications of a child seeking to identify outside their sex category.

1/5thetimes.co.uk/article/the-ti… What is innocently framed here as "trying out new identities" conveniently skips over the Cass Review findings of trauma, bullying, mental health issues etc. in this cohort.
2/5

Earlier this year, @BayswaterSG wrote to the CPS with concerns about their domestic abuse guidance, in particular a list of inappropriate examples of 'abuse'. Our concerns are now echoed in a new @Policy_Exchange report by @OHaraMaureen9:
A short 🧵telegraph.co.uk/news/2023/11/0… Annex D of the CPS guidance cites the following as potential examples of domestic abuse:
· Refusing to use [...] preferred name or pronoun
· Threatening or sharing pre-transition images
· Destroying medication or clothes
· Withholding money for transitioning

We are often told that conversion therapy bills have been introduced in other countries with no issues.
Not so, according to Dr Alexander Korte, who describes the detrimental consequences of German CT legislation on clinicians.

Full quote and video link below🧵 Describing legislation introduced in Germany in June 2020, Dr Korte (Ludwig Maximilian University of Munich) says:
"And specifically the German Act on Protection against Conversion Therapy has had a disastrous impact because many psychotherapists —

Proposals to ban "conversion therapy" continue to be blighted by the absence of clarity over what may or may not be covered by legislation. 🧵
thetimes.co.uk/article/rishi-… A broad definition of conversion therapy brings risk of immense harm, where anything other than affirmation of a trans identity could be framed as "conversion".
Parents and therapists from Germany have told @BayswaterSG of the chilling effect of similar legislation there.
2/9