As usual in her interviews, Keira was calm, articulate and focused on the issues she wanted to get across. Despite being asked the kind of devil’s advocate questions interviewers are always obliged to ask their guests, Keira remains centred on her message. The question she must expect again and again is a version of “what about the people it works for? Aren’t you denying treatment to those who would benefit from it?” In this interview, the version was:
“There will be some adults who’ve transitioned as an adult who wish that they could have transitioned as a child…what would you say to those people though, because they, not everyone’s the same are they, that’s a case in point why these things can even happen isn’t it?”
Keira admirably declined the implied responsibility for the feelings of adults and masterfully brought the subject back to reality and the court judgment:
“Well yeah, I mean everyone wants what they don’t have, you know these older adults I’m sure they would feel that way, but you know as the High Court showed, they ruled that children, they can’t consent to the treatment because of the nature of the treatment and how life-long it is and how negatively it affects our health, and a lot of the effects are also unknown. And so yeah, it’s easy for people who haven’t gone through it to say ‘oh I wish I had that’ but you know, I’ve been through it and it’s not, it wasn’t beneficial in any sense.”
In this interview Keira gave us more insight into the issues that led her to the Tavistock and the nature of the treatment she received there:
“Yeah, during my teens I was really struggling, mental health issues, I was struggling with my sexuality and just struggling generally with not fitting in to the stereotype that girls are supposed to fit in, society says, and so yeah all of this just manifested into gender dysphoria and yeah, I was later seen at the Tavistock.”
“They were very brief appointments, just kind of uh what was my friendship group like as I was growing up, did I prefer to hang out with boys or girls and you know, what did I like to wear, my hobbies, that sort of thing, so it was very much based on stereotypes and yeah, no psychiatric assessment or anything like that.”
It’s a picture of a 16 year-old girl, struggling with mental health issues, unable to fit into the feminine stereotype expected of her and feeling this is her fault, there’s something wrong with her – an increasingly common feeling among adolescent girls in today’s Instagram world of impossible ideals of female perfection. What did she find when she got to the Tavistock? The same stereotypes used to affirm her feeling that the fault lay with her. Affirmation of her wrongness, affirmation that her failure to live up to those stereotypes means she is not a girl, affirmation that her insecurities are well-founded. This is the great lie of ‘affirmation’ as a so-called positive and humane approach. Affirmation that an adolescent is correct in their perception of themselves as ‘wrong’ is not ‘kind’.
Keira’s account confirms the impression we received at an NHS Public Consultancy event in London in 2017, that the NHS has adopted an activist agenda that forecloses any exploration of underlying issues which may have led to the emergence of gender dysphoria. The event was attended by Polly Carmichael along with representatives from GIRES, Mermaids and Gendered Intelligence. It was otherwise dominated by prominent older male trans activists, perhaps among them those who wish they could have transitioned as children. This is what we reported at the time:
“It seems that the NHS has replaced rigorous research and evidence with unquestioning acceptance of certain narratives promoted by trans activists. We witnessed at the meeting the pressure on the NHS coming from a vocal segment of the transgender community, with demands centred on the right to self-refer and the provision of assorted cosmetic procedures not currently offered on the NHS. The insistence that gender dysphoria is not a mental health issue leaves troubled young people in a vulnerable position whereby mental health problems cannot be explored at all in relation to their dysphoria. Psychotherapy is only offered for issues viewed as distinct from gender dysphoria, but not considered as a potential cause.
“This is the problem created when a social justice issue intrudes into healthcare: there is no evidence that the NHS considers that there is any reason behind a young person presenting as transgender, other than that the person is transgender. There is no diagnostic procedure to untangle ‘gender dysphoria’ from underlying issues unconnected with ‘gender’ so that a diagnosis can be made with confidence. A 30 minute assessment is woefully inadequate for young people.”
Now we have testimony of the inadequacy and dangers of that approach by one who was damaged by it. Will the Tavistock GIDS and the NHS now listen to Keira Bell? Here is what Keira said when asked what she would have liked to see done differently that may have helped her:
“Er definitely some intensive mental health care, um you know that’s the fundamental issue here is we’re not receiving proper mental health support and you know this is disproportionately affecting girls at the moment you know. I think there’s been a 4000% increase of young girls being referred to the gender identity clinics and so this is a societal issue, something else is going on and the clinics don’t know…so yeah, mental health help is the biggest, is the key yeah.”
That is very clear. But is it fair to judge the Tavistock based on the account of only one disgruntled ex-service user? Is there evidence that the Tavistock GIDS is more rigorous in their approach than Keira’s account would suggest?
Let’s look at the statement from the Tavistock that was read out at the end of the programme for clues.
The Tavistock Response
This is the full statement from the Tavistock & Portman NHS Trust:
“Our Gender Identity Development Service offers a safe specialist environment for children and young people to explore issues pertaining to their gender identity development.
Only a minority of those referred to the service progress on to a physical intervention pathway.
These decisions are highly individual and made with young people with the support of their families.
We are sorry to hear that Keira feels she was not well supported by us and later by adult services.
Our door is always open to her and others who may be reconsidering their journeys.”
We’ll look at this statement point by point.
Exploring issues pertaining to gender identity development
What does it mean to ‘explore issues pertaining to their gender identity development’? According to Keira’s testimony this meant looking at stereotypes of behaviour and clothing in order to confirm that a girl is indeed really a boy before giving her the green light to try and make her body medically ‘match’ her identity.
‘Exploring your gender identity’ is an activist-invented activity for children. Children never used to have to do this; now it is an idea promoted in every transgender schools toolkit and encouraged in some questionnaires sent out to school children from the Department for Education. Is it helpful for children to ‘explore their gender identity’, is this something that will strengthen mental health or make children anxious and confused? What is ‘gender identity’ anyway and why do you have to have one? Will it help an adolescent girl with mental health problems, struggling with her sexuality, to ‘explore issues pertaining to her gender identity development’ or would it be better to take her away from the subject of ‘gender’ and help her explore and discover what’s really going on?
Should the environment be completely ‘safe’ or would it be better to warn her that some exploration might be difficult or challenging?
This first sentence from the Tavistock encapsulates the activist agenda; it assumes ‘gender identity’ as the issue that needs ‘exploring’, not the underlying mental health problems, nor the understanding, motivation or life experiences of the child. This is a model that stays within an ideology that adolescents are already steeped in, both online and in school. The Tavistock clinic may operate under the name Gender Identity Development Service but how do they find out if ‘gender identity’ is the real issue if they don’t look at anything else, as Keira Bell testifies?
Only a minority progress to physical intervention
The Tavistock recently seem to want to minimise the number of children being referred for puberty blockers. In court they quoted a figure of 16% (this figure was apparently taken from a ‘random sample’). At every conference we have attended the figure quoted has been 45%. At this talk in 2017 Polly Carmichael says 42% of over 12’s and 25% of under 12’s (at around 35.00)
Paul Jenkins in a letter to parents in 2018 stated that 59% of under 15’s choose not to go on to an endocrinology referral, therefore 41% do. While ‘minority’ may be technically correct, it is misleading when the actual figure is approaching half.
Decisions are highly individual
There is something highly incongruent about this statement in the context of medical intervention for children. It sounds defensive (‘we don’t coerce them, they make up their own minds’) and the highly individual ‘decision’ here is not about whether to go to the park or the playground. The ‘decision’ made is whether to embark on a course of experimental medical intervention that will in all probability lead to irreversible effects such as infertility and loss of normal sexual function. Can we really frame this as a ‘highly individual’ decision for a child?
The 2016 documentary The Gender Clinic gave us insight into how this positioning of children as their own authority plays out at the Tavistock GIDS. We wrote at the time:
“The second [theme] was the reversal of roles in the adult-child relationship; the adults occupying a child’s fantasy world of magical thinking as reality (specific examples include references to becoming a “real boy” through hormone treatment and the question put to a natal boy by the narrator “Do you think you’ll be a girl forever?”), while the children occupy the role of fully autonomous mini-adults, capable of making mature decisions on complex issues.”
In our re-visit to The Gender Clinic Susan Matthews analysed the context within which such ‘decisions’ are made at a service thoroughly invested in the use of its new wonder drug:
“With Rachel briefed about the urgency of the puberty blocker decision, the focus shifts to Matt. What we see is a pincer movement as both parent and child are set up to extract agreement from the other. Rachel is told by endocrinologist Gary Butler that she needs to talk to Matt about puberty blockers; Matt is told by clinician Charlie Beaumont that she has to get Rachel on board: ‘You can agree to this, but you have to make sure that your mum agrees.’ (40.55) Given that Matt won’t talk and Rachel doesn’t want blockers, it’s puzzling to locate the source of the urgency.”
Again, the idea that children ‘know who they are’ to the extent that they possess full authority on themselves is a trans activist trope. These are somehow magical children who exist outside the normal bounds of childhood development.
Keira Bell feels she was not well-supported
Keira does not ‘feel’ that she was ‘not well supported’ by GIDS. Keira knows and understands very well that she was completely let down by a service in thrall to gender identity ideology in place of normal patient safety standards and duty of care. Keira will understand this for the rest of her life because the effects on her body are not reversible. To minimise Keira’s intelligence as her ‘feelings’ is just an insult to a very courageous young woman.
Is Keira Bell ‘reconsidering her journey’?
The ‘gender journey’ has been built into the trans activist model from the start and has made its way into the NHS. At the 2017 NHS consultation meeting in London, we reported the response we received to our question about detransitioners and those who regretted their medical transition:
“On the subject of detransition, the concept of regret itself was questioned. We were told that detransition is not necessarily a ‘failure;’ that re-transition may be a better way of looking at it and that many are happy that they transitioned as part of their ‘gender journey’ and have learned about who they are. The NHS does not fund ‘reversal’ of transition although we were told that testosterone-induced facial hair could be removed as part of a ‘second gender dysphoria event’ although it was not clear whether the NHS would fund this. The people who regret medical transition and describe their lives as having been ruined are absent from this picture and without this data the NHS cannot build up an accurate evidence base for medical transition of young people.”
At two of the subsequent Tavistock conferences and events we attended, a panel of ex-service users talked about their experiences at the end. The theme from the female participants was mental health issues, including past trauma, and all had changed their ‘gender identity’ somewhat. Typical was the move from trans man to ‘non-binary’, from young women who had taken, or were still taking, testosterone and had had their breasts removed. Nobody expressed regret, all said that they had made ‘the right decision at the time’. This framing of regret (it doesn’t happen) is clearly built into the NHS approach, as it is in the trans activist model of care. Changing your mind is just another step on your gender journey, a step you have had to reach through medical alteration of your body rather than simply growing up and coming into some understanding about yourself.
In her chapter of the book Inventing Transgender Children and Young People, Susan Matthews examines the ‘gender journey’ through an analysis of gender identity workbooks such as the Gender Quest Workbook: A Guide for Teens and Young Adults Exploring Gender Identity (Testa, Coolhart & Peta 2015).
“Welcome to this journey your very own Gender Quest” announces the foreword to this book which includes activities such as your Gender River where you are encouraged to imagine your life as a river.
“Each bend in the river is a significant moment that led you to your own understanding of your gender today. Each bend is a person, event, book, film, song, encounter, object – anything really that significantly influenced your gender as it is today.”
The Gender Identity Workbook for Kids (Storek, 2018) is aimed at seven year-olds. As Matthews points out: “the task of individual self-invention becomes a duty required of children.” This is what has come into UK schools through transgender schools guides.
The idea is pushed by the most evangelical and extreme ‘gender doctors’ in the US, welcomed by some in the UK. Here’s Johanna Olson-Kennedy on the Gender GP podcast:
“We see about 5 to 7 new trans or gender-questioning, gender journey young people every week.”
Diane Ehrensaft, author of The Gender Creative Child, says in an interview:
“You also grow to understand that establishing an authentic gender self is a journey that may unfold and change over time.”
In another GenderGP podcast, prominent UK Queer theorist Meg-John Barker speaks of detransition:
“This sort of idea of de-transitioning is not helpful because even if somebody makes changes again it’s a further change onwards, on a journey.”
As for the UK transgender organisations coming into schools, here’s what Mermaids say on their About Us page on their website:
“Over the years, we’ve seen many changes in the language and understanding surrounding gender issues but one thing remains the same: transgender, nonbinary and gender-diverse children deserve the freedom and confidence to explore their gender identity wherever their journey takes them.”
Gendered Intelligence offers a mentoring service for trans students in schools and Sixth Form colleges, including a package called Capturing your Journey:
“Package: The service is be [sic] flexible according to the needs of the student and to the institute. It always involves an initial “needs assessment” which we call ‘Capturing your Journey’ as well as interim staff meetings.”
And finally, from the most extreme gender evangelists in the US, via the most extreme transgender activist organisations in the UK, the journey metaphor arrives at the Tavistock GIDS. A 2016 blog written by Polly Carmichael was entitled “Every individual is different, every journey is different: A look at gender identity services in London.”
“The take away messages from our service would be: every individual is different, every journey is different”
In whose world could unnecessary life-changing medical intervention with lifelong effects both known and unknown, including possible infertility and loss of sexual function, ever be considered to be part of any child’s ‘journey’? Only in the world of gender ideology.
Keira Bell and other detransitioners are not ‘reconsidering their journeys.’
To frame their regret in this way is an attempt to keep them within an ideology they have rejected and escaped, with relief and horror that they ever got caught up in it in the first place and anger that they were not protected from it or given any alternative way of understanding themselves at the GIDS.
Keira Bell is not ‘reconsidering her journey’. Keira Bell took the Tavistock to court and won her case, in order to protect other children from the experiment conducted on her.
The Tavistock statement reveals that they are still steeped in this ideology and they are unable to step outside it as Keira has done, in order to see the reality. This, despite a court case that laid out all the evidence of the medical harms created by treating patients according to a belief system rather than clinical research and evidence-based practice.