Puberty Blockers and Sex Hormones on Demand

Amazing news!
An entity called gender dysphoria has been discovered! But it certainly is not a mental disorder, apparently. What is it then?

To try and find out, let’s look at an outfit called GenderGP.

Their website opens with a bold statement: ‘We believe trans people of all ages exist. Full stop. No debate.’

Why the defensive tone? Someone may believe God exists or that the earth is flat. Similarly, I am sure so-called trans people exist – if one defines a trans person as someone who believes that he or she was born in the ‘wrong’ body. For example, a girl may think she is ‘really’ a boy and may seek medical assistance to change her outward appearance so that she can ‘pass’ as a boy – something she is not and never can be.

GenderGP is run by Dr Helen Webberley who is currently under a two-month suspension from the UK Medical Register after being found guilty of serious misconduct in the care of three young patients:

The medical practitioners’ tribunal decided that she had not provided proper follow-up care to two patients, aged 12 and 17, who were prescribed testosterone, and failed to discuss risks to fertility before prescribing puberty blockers for an 11-year-old patient. (Reported in The British Medical Journal, 1 July 2022.)

This misfortune, however, has not prevented GenderGP from moving its operations offshore to get around UK regulations. The doctors now running it are Roxana Mateescu, a geriatrics and gerontology specialist in Bucharest, and Yasmeen El Rakhawy in Cairo. Neither is registered with the UK doctors’ regulatory body, the GMC, yet they prescribe hormonal treatment to teenagers through online consultations. [Dr Webberly was reinstated in 2023 and the information in this paragraph may no longer be current.]

Since the current waiting list for gender dysphoria treatment on the NHS is so long, what’s wrong with desperate ‘trans’ people getting the medication(s) they think they need in a timely manner after this kind of assessment and thence quite legally from UK pharmacies via internet prescriptions? Read on for an explanation.

Revealing answers and dogmatic assertions
We can gain some insight into what GenderGP is up to by going to their Frequently Asked Questions page. I’ll quote from it and add my comments:

What is Gender Dysphoria?

Gender dysphoria is the term used to describe the sense of discomfort experienced by people who do not identify with the gender they were assigned at birth.

Gender is not assigned at birth. The sex of a baby is determined at conception and recognised at birth as being male or female; it is then registered accordingly.

What causes someone to be trans?

It is probably a variety of factors…It is not something that happens because of childhood experiences…It is inherent, in the same way as sexuality or eye colour.

The assertions that being trans is not something that happens because of childhood experiences and that it is inherent are stated without a scrap of evidence. The reality is that the cause of gender confusion is unknown though adverse childhood experiences may well be relevant. Also, experience shows that children often grow out of a phase of gender confusion.

Is there a way of diagnosing someone as trans?

It is a subjective experience…it is certainly not a mental disorder.

Then why does it need diagnosis and treatment? People have subjective experiences about all sorts of things, but trying to change one’s reality by hormonal manipulation and surgery (if undertaken) is an entirely different matter.

What do I need to start hormone therapy?

Hormone treatment can be started once you have gone through things and worked out the best and safest route for you to take. You may already know this is the right time, and that it is safe, or you may need a doctor or some support to help you with this.

Note the assumption that hormone therapy is ‘needed’. And what do they mean, ‘once you have gone through things’? This is careless writing.

Do I need hormones to transition?

Everyone has a different perspective on what they want to achieve in terms of their transition. For some, social transition…is sufficient. For others, looking for physical changes, hormone therapy is enough to give them the inner peace that is missing. For yet others, surgery is their desired route.

And now we have a further assumption: that some children and young people suffering from the delusion that they are in the wrong body will need or want to ‘transition’. This means that although gender dysphoria is certainly not a mental disorder it may need hormone therapy and perhaps surgery so those who suffer from it can gain the inner peace that is missing. Not a word is mentioned about trying to help the young person to accept his or her reality of being male or female, respectively.

At what age do you begin treatment?

We do not classify according to age but rather in line with the onset of puberty. Once an adolescent has reached Tanner stage 2 (the starting phase of puberty), we can work with the adolescent and parent or guardian to support any child suffering with gender dysphoria.

Tanner stage 2 means the beginning of breast development in girls and the appearance of pubic hair in boys. How do the doctors in Bucharest or Cairo assess this? Does the patient have to expose his or her body to the camera or do they just take their word for it?

Are puberty blockers reversible?
This is a very important question. And this is GenderGP’s answer:

Medication to stop puberty is totally reversible [sic]. Please see our myth buster for more information.

So let’s go to GenderGP’s myth buster. Except it isn’t. We find a cherry-picked list of references but if one looks into these they don’t support the assertion that puberty blockers are totally reversible. For example, the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents point out that ‘The long-term impact of puberty suppression on bone mineralisation is currently unknown.’

Then GenderGP claims: ‘The efficacy of puberty blockers in adolescents with gender dysphoria is adequately evidenced and no more experimental than in other areas of paediatric medical care.’ The reference for this is a repetitively titled article by two non-medical academics at Birmingham University: ‘Is puberty-delaying treatment experimental treatment?’ This is mainly a discussion, not to say quibble, about the definitions of ‘experimental’ and ‘off-label’ treatments. (Off-label means using a drug other than for its licensed indications.)

Misleading comparison
In another section of the GenderGP website we find this:

Indeed, the medication used and the monitoring required for gender affirming treatment is no different to that given to patients who are being treated for the menopause, endometriosis, prostate cancer, precocious puberty, and constitutional delay in puberty.

This is misleading. The menopause (when causing unacceptable symptoms), endometriosis, prostate cancer, precocious puberty, and constitutional delay in puberty are well-recognised medical conditions or abnormalities; they cannot be compared with the feeling of being in the wrong body, otherwise known as gender dysphoria. It is, therefore, a huge assumption to talk of gender affirming treatment as if this is the only or best approach to help those who feel unhappy that they were not born as the opposite sex.

Furthermore:

Every one of the dozen or so studies of children with gender dysphoria – discomfort and misery caused by one’s biological sex – has found that most grow out of it as long as they are supported in their gender non-conformity and not encouraged in a cross-sex identification. Many of these ‘desisters’ are destined to grow up gay.

Instead of advising parents to watch and wait with sympathy and kindness, they now work on the assumption that childhood gender dysphoria destines someone to trans adulthood. They recommend immediate ‘social transition’ – a change of name, pronouns, and presentation – followed by drugs to block puberty, cross-sex hormones and surgery, often while the patient is still in their teens. The treatment pathway is a fast track to sexual dysfunction and sterility in adulthood. (Emphasis added.)

The reality is, we are who we are and our outside appearance does not change who we are on the inside.

Puberty blockers, as well as blocking the physical changes that puberty brings, also block the developmental processes whereby gender dysphoria often resolves.

The above quotations are from Trans by Helen Joyce, Oneworld Publications, 2022.

An alternative approach
Now let’s turn to what Sweden’s prestigious Karolinska Institute has to say on this matter. Due to ‘concerns over medical harm and uncertain benefits’ it ‘ends all use of puberty blockers and cross-sex hormones for minors outside of clinical studies’.

A similar stance has been taken in the UK, Finland, Australia, and New Zealand.

And quite right too.

Text © Gabriel Symonds