.@BayswaterSG parents feel a profound concern for yet another group of children who will be subjected to an unproven and life-changing medical intervention based on a flawed and uncertain diagnosis.
1/11kcl.ac.uk/research/pathw… Calls for "more data" sound superficially reasonable, but skip conveniently over past failed attempts to find evidence of benefits from puberty blockers, including at the UK's own GIDS clinic.
2/11

A new paper notes that treatment rates (e.g. for cross-sex hormones) are significantly higher than you would expect given well-established data on the clinical prevalence of gender dysphoria. 1/3
tandfonline.com/doi/full/10.10… The authors also note an extraordinary rise in recorded cases of gender dysphoria, raising questions about what the diagnosis means and the extent to which sociocultural influence is at play. 2/3

What approach will this new wellbeing pilot take? Will it be Cass-informed and rooted in an understanding of the multifactorial nature of symptoms presenting as gender-related distress? 1/7
gov.uk/government/new… The same question about safe and effective care applies to the promised "digital mental health support and community-based services". 2/7

A reminder for the new school term: Although there is still no @educationgov guidance for schools on supporting students who identify as trans or non-binary, schools must abide by existing statutory safeguarding obligations and UK law as follows 1/3
#edutwitter Keeping Children Safe in Education (statutory obligations)
Schools "should take a cautious approach" when supporting "gender questioning children", bearing in mind the "many unknowns about the impact of social transition" and these children's wider "vulnerabilities, including having complex mental health and psychosocial needs". Schools must also work "in partnership with the child’s parents"

A failure to act in accordance with KCSIE puts children at risk and is a breach of a school's legal safeguarding obligations.
2/3

Many MPs at this WESC session seem to believe that the only way trans-identified people can be accommodated in society is to conceal their trans status at all costs. We think this has profound, negative psychological consequences ... 1/6

https://x.com/NewStatesman/status/1933781755569348678

We urge MPs to read this section of the Cass Review, reflecting on the drawbacks of living "in stealth". The reference here is to children, but these issues are familiar to many parents of young trans-identified adults. 2/6

The @NYTimes podcast "The Protocol" paints a picture of a golden era in paediatric gender medicine before the arrival of new and more complex adolescent-onset patients. An audit of UK GIDS referrals in 2000 suggests a rather different tale ... 1/11
nytco.com/press/introduc… The 2000 audit of 124 paediatric referrals to the GIDS clinic is described in @hannahsbee "Time to Think": Only 2.5% had "no associated problems", 70% had more than five "associated features", including profound difficulties/vulnerabilities outlined in the next tweet. 2/11

The expert warnings cited here by @hannahsbee about the risks posed by cross-sex hormones were only one factor in @DHSCgovuk setting up its review. Another vital contributor was the evidence about reckless prescribing by private providers.

🧵1/6newstatesman.com/politics/healt… In July 2024 @BayswaterSG wrote to DHSC warning that private providers were exploiting inaction over CSH to circumvent the new puberty blocker ban. A family court case in May 2024 found "dangerous levels" of testosterone prescribed to a child by Gender GP and issued a stark warning about this provider. BSG also alerted DHSC to online parent forums with evidence of CSH being prescribed to minors as young as 12.
2/6

Understanding the full context for trans-identifying children requires an appreciation of the information they have been provided with at school (including at LGBT/Rainbow clubs) & from online social media influencers as well as neurodevelopmental factors
telegraph.co.uk/news/2025/04/2… Archive link here:

The @BayswaterSG iceberg graphic illustrates the complex and multifactorial background to a trans identity. archive.ph/dbLOM

Thoughts on discussing the Supreme Court ruling with trans-identified youth & others:
1. Recognising that sex is real and worthy of legal protection is not a threat to those who identify as trans, nor does it rule out exploring with compassion and curiosity what gender identity might mean to someone. 2. The Equality Act protects a plurality of beliefs on matters of sex and gender identity, it recognises different groups including on the basis of "sexual orientation" and "gender reassignment", and it recognises the pertinence of "sex" with an understanding that trans people do not change sex.

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