Puberty Blockers: The rebuttal the Bristol Cable refused to publish

In January 2021, The Bristol Cable, a media co-op in the city, published an article on puberty blockers. The headline stated that they are safe and reversible.

We wrote to the Cable, asking if they would publish an article by us giving the facts about puberty blockers. Eventually, we received a brief reply which stated that after ‘careful consideration’ they would not run an article taking an alternative view. The Bristol Cable changed the headline and made some amendments to the article - the original can be read here.

Here’s the article the Bristol Cable refused to print - we are very grateful to FiLiA for publishing it.

Bristol Education Research Group | February 2021

Bristol Education Research Group is a group of academics, former teachers, parents, grandparents and feminists concerned with the wellbeing and safeguarding of children in Bristol.

We were alarmed to read the article published in the Bristol Cable on 25th January 2021: ‘Puberty blockers are safe and reversible. So why do campaigners want to deny access to them?’

The article contains many inaccuracies, and its central claim is false. There is simply no evidence which shows that the treatment of children with gender dysphoria with gonadotrophin-releasing hormone analogues (the drugs used to suppress puberty) is safe or reversible.

The treatment of gender-dysphoric children is an off-label use of GnRHa; it is not licensed to be used in this way. The licensed uses include treatment for endometriosis and uterine fibroids in women, prostate cancer in men and severe sexual deviation in men. The article’s author, Sage Brice, acknowledges that medical transition, which for children and young people begins with GnHRa treatment, causes infertility.

Brice’s article includes links to the Tavistock Gender Identity Development Service (GIDS), the NHS service for children and young people with gender dysphoria. However, Brice doesn’t mention that in June 2020 the national NHS website’s section on puberty blockers was updated - the reference to puberty blockers as ‘fully reversible’ was removed.

In December 2020, the Bristol, North Somerset and South Gloucestershire NHS Clinical Commissioning Group followed suit, removing references to the use of hormone blockers in young people from their proposed transgender patients’ toolkit.

For many years, clinicians (including former staff at the Tavistock GIDS), academics, journalists and feminists have spoken out about the health risks and lack of evidence for GnRHa treatment. They also note that the treatment does not even improve patients’ gender dysphoria - the sole rationale for giving children off-label hormone treatment in the first place.

Dr Michael Biggs of Oxford University wrote in response to the Tavistock’s belated publication in February 2021 of its own study on blocking the puberty of gender-dysphoric children:

‘Considered as a treatment in its own right, the suppression of puberty with GnRHa might be the only treatment provided by the NHS for which there is no objective evidence that the benefits outweigh the risks’.

In February 2021 Dr Maja Bowen, Dr Katie Clyde, Dr Ellen Wright, Dr Tessa Katz, Dr Az Hakeem and Dr Lucy Griffin wrote to the British Medical Journal:

‘...there is no evidence [puberty blockers] improve gender dysphoria. There is evidence of harm, such as worsening of psychological symptoms, bone loss, and impairment to cognitive and reproductive development, let alone the adult sexual function that pre-pubertal children cannot understand…other irreversible medical interventions that seek to physically alter their bodies to resemble the opposite sex follow in 98% of cases, although children do not consent for the lifetime package at the outset’.

In December 2020, in the case against the Tavistock to which Brice’s article refers, three High Court judges accepted that puberty blockers are indeed a step onto a ‘conveyor belt’ to cross sex hormones - a process to which children under 16 being offered blockers do not have to capacity to understand and risk-assess in order to be able to give informed consent. The judgement stated:

‘The combination here of lifelong and life changing treatment being given to children, with very limited knowledge of the degree to which it will or will not benefit them, is one that gives significant grounds for concern.’

During the course of its judgement the Court frequently expressed surprise at the Tavistock’s failure to collect basic data.

‘Children have been very seriously damaged’, Dr David Bell, a former governor at the Tavistock, told Channel 4 News in January 2021. ‘Puberty blockers, it's often said, are reversible. But that's a very funny way of looking at the human subject. We're not video machines, in which you can press a pause button, and then release the button three years later.’

In July 2019, Kirsty Entwistle, a former clinical psychologist at the GIDS Leeds branch, wrote in an open letter to Dr Polly Carmichael, director of the GIDS:

‘I think it is a problem that GIDS clinicians are making decisions that will have a major impact on children and young people’s bodies and on their lives, potentially the rest of their lives, without a robust evidence base. GIDS clinicians tell children and families that puberty blockers/hormone blocks are “fully reversible” but the reality is no one knows what the impacts are on children’s brains so how is it possible to make this claim?’

Other GIDS whistleblowers have told BBC Newsnight that ‘some parents appeared to prefer their children to be transgender and straight, rather than gay.’

Since 2015, parenting expert Stephanie Davies-Arai, director of Transgender Trend, has worked to raise these concerns. Transgender Trend advocates for ‘the rights of children to reject gender stereotypes and be who they really are without discrimination, labelling or medical intervention to ‘fix’ them.’

Why has it taken so long for concerns about puberty blockers to be taken seriously, and why has this ended up in the High Court?

Gender identity campaigners believe that everyone has a ‘gender identity’ akin to a soul and that if someone’s gender identity does not ‘match’ their sex it’s possible for them to ‘fix’ their body with hormones and surgery. The term ‘gender identity’ is only ever defined in circular terms, for example: ‘your gender identity is a way to describe how you feel about your gender’.

Many gender identity campaigners actively work to suppress other points of view and smear those who wish to look at evidence and who understand that sex cannot be changed as ‘transphobic’. This includes campaigning, often successfully, for people who hold different views to lose their jobs. ‘GIDS clinicians are afraid of raising their concerns for fear of being labelled transphobic by colleagues,’ Kirsty Entwistle stated in her open letter.

Another method gender identity campaigners use is extreme intimidation - it’s common for them to threaten women with rape and death, and a bomb threat was made to a women’s meeting in Hastings. In 2017, a twenty-something male gender identity activist assaulted a woman in her sixties who was waiting to attend a meeting about the Gender Recognition Act.

Here in Bristol, when Stephanie Davies-Arai and Dr Heather Brunskell-Evans spoke on the subject of children with gender dysphoria at public meetings, they were faced with masked protestors who physically blocked women, chanted misogynist slogans and threatened to let off smoke bombs inside the rooms hosting their talks. Raquel Rosario Sánchez, a feminist writer from the Dominican Republic studying for a PhD at Bristol University, was subjected to a bullying and harassment campaign after chairing the meeting at which Davies-Arai spoke.

Gender identity campaigners place great importance on the lived experience of trans-identifying young people. They claim that female and male children who experience gender dysphoria have the same condition, ‘being trans’, at the root of their experiences, regardless of whether their sex is female or male.

The majority of the children currently at the Tavistock GIDS are female. Since 2011, there has been an astonishing 5,337% rise in the number of girls referred to the GIDS. This is a complete reversal of the sex ratio - pre-2011, the majority of children at the Tavistock were boys.

Clearly, female and male children children with gender dysphoria do not have the same experience or the same needs, and gender dysphoria is not independent of wider society.

The huge rise in referrals of girls to GIDS can be explained as rapid-onset gender dysphoria (ROGD), where teenagers with no childhood history of being distressed by their sex develop dysphoria, often after consuming trans-affirmative social media.

While 2021’s gender-dysphoric child seeking help is usually a girl, many of the gender identity campaigners who want to remove any restrictions on her access to off-label hormone treatment are adult males.

Neither Sage Brice (who self-identifies as trans) nor Brice’s interviewee Jolyon Maugham QC (who does not self-identify as trans) have the lived experience of a girl going through adolescence in our pornified culture. Most of these girls, if left to go through adolescence without medical intervention, would grow up to be lesbians.

The Cable’s headline asked why campaigners want to stop children having access to GnHRa treatment. It is a shame that Brice did not name Keira Bell, the courageous young woman who brought the case against the Tavistock GIDS (alongside Mrs A, the mother of a 15-year-old on the GIDS waiting list), or outline her lived experience as a detransitioner and her motivation for bringing the case.

Keira Bell was given puberty blockers at the age of sixteen, after only three hour-long appointments at the Tavistock, was prescribed cross-sex hormones at seventeen and underwent a double mastectomy at twenty. Her facial hair growth and the changes to her voice are irreversible, and she has described the painful symptoms of her hormone-induced vaginal atrophy. She does not know whether she will be able to have children.

Keira Bell has given many interviews where she has eloquently explained why she wants to prevent children and young people from suffering the harms caused to her by puberty blockers and medical transition:

‘I look back with a lot of sadness. There was nothing wrong with my body, I was just lost and without proper support. Young lesbians or bisexual women, especially those of us who are black or brown, don’t have many role models.

I was and am so desperate to see positive change. I felt that I was in the perfect position to do so – it is my story and I have come out the other side. I clearly see how damaging this issue is, especially because now it has turned into a movement. There are so many girls out there who are just like I was and their true needs for support and care are being ignored. I want justice.’

The Tavistock has been given leave to appeal the High Court judgement, so Keira Bell and Mrs A’s legal case continues. You can support them by donating to their legal fees crowdfunder on their CrowdJustice page.

You can learn more about the Bristol Education Research Group here. You can also learn about the broader context of these matters by visiting the websites for Transgender Trend and the Safe School Alliance.