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A High Court judge has granted permission to a local authority to withdraw care proceedings against a foster family with two young boys socially transitioned as girls. The full judgment can be seen here.

The older child (“Child R”) is the couple’s own child. Now aged 13 this child was fully socially transitioned at age 7. The second child (“Child H”) is adopted and at age 6 is also fully socially transitioned. Another foster child (age unknown) who was with the family for three and a half years and left in 2007, also had gender identity issues.

Care proceedings were instigated by Lancashire County Council based on concerns from social workers about the treatment of the children with gender identity issues, along with a referral to children’s services by the school regarding concerns of fabricated and induced illness in respect of four of the children. There was also a catalogue of hospitalisations for one child. Lancashire CC subsequently sought to withdraw care proceedings, which was what this hearing was about.

The judge, in assessing further evidence from experts, concluded that there was no case to answer: the hospitalisations were the result of normal childhood accidents and parents of fostered or adopted children could be expected to seek professional help for behavioural and emotional problems in children who had suffered previous abuse and neglect.

A case involving three children with gender identity issues is unprecedented in itself, but the facts of this case raise further serious questions. It is important to analyse the information available from the court hearing because the case is likely to set a precedent in the family courts on cases involving parents who socially transition their very young children. The court report gives us much information about the two children as well as the approach and the beliefs of the parents.

Child H was born in 2012 and placed with the family as a baby in December that year. Three months later, in April 2013, Child R, the couple’s youngest son, was referred to the Tavistock gender identity clinic at age 7. In that same month the parents cemented the new identity by changing the child’s name by deed poll.

In August 2013 an anonymous referral was received by the local authority from a member of the extended family under the heading ‘preoccupation with and encouragement of gender dysphoria in 3 children.’ Child H at this point must have been under two years old and had been with the family for only eight months.

This gives us a picture of parents who practice a “gender affirmative” approach out of a strongly-held believe in the concept of innate and immutable “gender identity” even to the extent of legal name change at age 7. The fact that Child H was so young suggests that they were on the lookout for any signs of gender non-conformity right from the start. By any measure, this places the parents at an extreme end of a spectrum of possible parental approaches to gender non-conformity or confusion in a child.

The couple’s own child, Child R, had “a variety of developmental and health concerns” and in September 2013 told a member of the school staff that she did not think life was worth living. Child R was under the care of the local CAMHS and “was also having some ongoing contact with the Tavistock and with the Mermaid Group (a support group recommended by the Tavistock).”

So it appears that the parents were acting on the advice of Mermaids. This family court hearing therefore also gives us insight into the parenting methods and approach advocated by this charity.

In December 2014 Child R “continued to present with a variety of issues including a possible eating disorder and inattention and hyperactivity” and in 2016 “R continued to present with various issues related to eating, her gender identity and other concerns.”

A subsequent report from a consultant paediatrician, Dr Ward, who had previously been a designated doctor for safeguarding for a number of clinical commissioning groups, states:

“R…has a complex medical history. She has a history of physical medical problems…R has complex neurodevelopmental problems. She first presented with developmental language disorder but subsequently was diagnosed by a multidisciplinary CAMHS team as having comorbid autism spectrum disorder and ADHD.”

In other words, Child R perfectly fits the profile of a current cohort over-represented at the Tavistock clinic: a child with various developmental problems including ASD/ADHD. Given Mermaids’ support and promotion of disgraced GP Helen Webberley and US gender-evangelist Johanna Olson-Kennedy, who believe that an autism diagnosis is just a mis-diagnosis of gender dysphoria, the parents may believe that transition is exactly the right “treatment” for their child. It is unlikely that Mermaids would be encouraging them to think more deeply or be a little more cautious, given that nobody knows why the referrals of autistic children are so high, and there’s a possibility we might be getting this terribly wrong for these children.

If autism has become a recognisable symptom of the gender dysphoric child, other groups who have become recently over-represented at the Tavistock include children in the care system, with troubled backgrounds and previous trauma, which leads us neatly on to Child H. The level of previous trauma experienced by this child is unimaginable.

Before being placed with the family Child H “had sustained very serious injuries including skull fractures and associated subdural bleeding arising from shaking and impact mechanisms. He had also sustained spinal fractures, rib fractures and intra retinal haemorrhages.“

On 28 January 2014 H was taken to A&E by ambulance having sustained an injury to his forehead in a fall. There were concerns that he was falling a lot and a physiotherapy assessment showed some instability. In December 2014 at a two-year developmental check no concerns were identified other than ongoing physiotherapy.

So this case involves two children from the same family with presentations typical of the current cohort of children who are being referred to the Tavistock. To tell any boy in this age group that he is a girl is to fail to recognise him as a child, but in this case an assumption of an adult developmental level of understanding is being applied to a very young and traumatised child. When there is underlying trauma or neurodevelopmental difficulties we have an added responsibility to recognise significant vulnerabilities in a child.

Strikingly, there is no mention of the relationship between the two children in the judge’s report. It may have been included in the detailed reports from professionals and the judge did not feel it was important enough to include in his overview, nevertheless it seems like a crucial factor. What was the impact on Child R of the arrival of a new baby who required “consistent, positive and nurturing care” according to the consultant paediatrician? Did the older child influence the younger; was Child H imitating the older sibling? These are obvious questions which the “gender affirmative” approach prevents us from asking. According to this ideology, these are just two girls who were born in male bodies.

On 7 January 2016 the school made a referral to children services regarding concerns of fabricated and induced illness in respect of four of the children, prompted by a conversation that took place between the mother and a teacher in relation to Child H who was being dressed in girl’s clothes. The mother was reported to have said ‘here’s another one for the Tavistock’ and the strategy meeting was then scheduled by the local authority. In June 2017 the school requested that Child H attend in a boy’s uniform but in September he came in a girl’s uniform. In February 2018 it was noted that Child H was presenting fully as a girl.

The imposition of adult ideas on a child is quite rightly a red flag warning for childcare professionals. There must be no exception to this rule, notwithstanding the magic word ‘transgender.’ What is significant in this case is the fact that all professionals called to review the case, even when providing evidence to exonerate the parents in other areas, raised concerns about the transition of the two children. This included two consultant paediatricians and designated doctors for safeguarding, an independent social worker and the family Guardian.

The judge recorded: “Clearly the gender identity issues were a central component of the concerns.”

All of the expert witnesses were concerned, that is, except one. Dr Vickie Pasterski is a Harley St doctor running a private clinical practice providing referrals for “gender affirming medical interventions” and has helped more than 500 individuals transition. She is recognised by the UK Ministry of Justice as a ‘Gender Specialist’ and provides reports for Gender Recognition Certificate applicants. According to this Mumsnet researcher, she approved the third application of a dangerous criminal (which would enable him to be housed in the female prison estate). The original court document has since disappeared from the Cloisters website. Her CV shows that her research has focused exclusively on ‘intersex’ or DSD conditions and from the evidence of this radio interview she clearly confuses people with DSD with transgender people and thinks that biological sex is a confusing spectrum.

As reported in the Sunday Times, Dr Pasterski is a supporter of Dr Helen Webberley, the criminally convicted GP who has given cross-sex hormones to twelve year-olds in breach of NHS guidelines.

The judge concedes that Dr Pasterski’s evidence was key in settling the case:

 “It is recognised that the issue of emotional harm because of the gender identity issues is balanced between the opinion of the psychologist who met [the parents and the children] twice, and the independent social worker, who met them 5 times and has looked at the issues more widely and challenged [the parents].” 

Dr Pasterski’s report was relied on by the mother as evidence that the parents had acted appropriately.

Solicitors Ms Cook QC and Mr Ameen also “rely largely on the report of Dr Pasterski.”

The Local Authority was also reported to have accepted “the expert evidence, in particular that of Dr Pasterski.”

Solicitors Ms Cheetham QC and Mr Gilmour state that “the evidence both from R’s treating service and from Dr Pasterski more than rebut any concerns expressed by Dr Ward.”

“R’s treating service” is Tavistock GIDS. The judge reports:

“In relation to paragraphs 29 (a) and (b) they highlight particular aspects of the evidence relating to R’s engagement with the Tavistock centre and subsequent guidance that the Tavistock have provided. In particular I was referred to letters from the Tavistock of 23 February 2016 and 2 July 2018. The change in approach identified by Dr Pasterski is evident in the 2-year gap between those letters. The contents are generally supportive of the approach taken by [the parents] to [the children] in particular in relation to younger children making full social transitions.”

This raises questions. What was it that prompted the change between 2016 – 2018 in the Tavistock’s view of younger children making full social transitions?

In February this year an internal report by David Bell exposed “very serious ethical concerns” from Tavistock clinicians that GIDS was exposing children to “long-term damage” because of its inability to stand up to highly politicised campaigners and families demanding fast-track transition and that GIDS had tried to “placate” lobby groups such as Mermaids.The subsequent response from the Tavistock prompted the resignation of governor Marcus Evans.

In April the Times published a report detailing the concerns of five former clinicians over the treatment of vulnerable children who come to the clinic presenting as transgender:

“All five said they believed that transgender charities such as Mermaids were having a “harmful” effect by allegedly promoting transition as a cure-all solution for confused adolescents.”

In a published article in Sage Journals in April, Consultant Clinical Psychologist Bernadette Wren robustly contradicts the idea that Tavistock GIDS supports the full social transition of young children:

“Good clinical practice with gender diverse children – and good ethical debate on these matters – needs, in my view, to be fine-tuned with respect to developmental stage. The younger the child, the more likely they are to hold inflexible and innate conceptualisations of gender (Taylor, Rhodes, & Gelman, 2009). Before the age of around 10 years, they predictably hold to rigid gender stereotypes (Biernat, Manis, & Nelson, 1991) and are less aware of the possibility for further change in gender-related behaviour. This is why at GIDS, we would prefer that young children (below 10 years of age, say), while receiving plenty of genuine support and affirmation for their gender preferences (in play, clothing, etc.), not make a full, legally confirmed social transition to the ‘other’ sex at a young age..”

and emphasises the point:

“…it is the case that children from 4 to 5 years of age are referred to GIDS, with parents who are contemplating a full social transition for their child, sometimes by stealth. It is my belief that we need to make creative opportunities for the open, accepting exploration of the gender experience and gender expression of these younger children; my fear is that to proceed to a full emphatic social transition may hamper their development.”

and again:

“As we see it, younger gender atypical children are likely to be more easily influenced by their parents’ view about gender, even to the point of assuming an absolute, long-term commitment to a binary gender identity and a social transition, if it is the parents’ solution to their gender variance.”

What was the evidence presented by Dr Vickie Pasterski which was so persuasive in this case? According to the judge’s report it was this:

In her report she identifies that there have been recent changes to the diagnostic criteria for gender dysphoria and that research on mental health and transgender children have shed light onto critical historical misunderstandings related to clinical presentation in gender dysphoria. Firstly, that children who present with gender dysphoria are likely to desist in their cross-gender identification and secondly that gender dysphoria is inherently associated with high rates of comorbid psychopathology. She notes both have been shown to be false. She identifies that these misunderstandings arise from two particular factors. Firstly earlier studies which showed that up to 80% of children desist in gender dysphoria included children who presented with gender incongruent behaviour but did not necessarily state the wish to be or that they were the other gender. Thus children displaying gender variance may have been wrongly diagnosed with gender dysphoria. As a result of this treatment protocols previously incorporated a watch and wait approach which had prevented truly dysphoric children from transitioning which had likely resulted in increased rates of depression and anxiety. As Dr Pasterski puts it ‘Put simply, many who have shown to desist were likely not dysphoric and psychopathology in those who persisted was likely due to forbidden expression of their true gender identity.’ Current guidance suggests that supporting a child who clearly and consistently states that they wish to be the other gender in their preferred gender role is associated with improved mental health and well-being.

This is standard trans activist propaganda: children who desisted in the past were never really transgender and psychopathology is attributable only to suppression of true identity. The “current guidance” referred to comes from transgender lobby groups such as Mermaids and other activist organisations. The evidence that transition leads to improved mental health is by no means conclusive and is drawn from selective studies of carefully selected cohorts.

Dr Pasterski makes the further claim that gender dysphoria has “a basis in neurological or biological functioning which cannot be affected by interpersonal influence or environmental interference.” There is no scientific evidence to support this claim. It is simply a belief that a child is ‘born trans’ and is immune to any parental or environmental influence, a belief also held by Mermaids. No wonder the social worker observed that the parents “presented as closed to the prospect of either R or H reverting back to their assigned gender.”

The judge is convinced by this “expert” evidence and reports that Dr Pasterski “compellingly rebuts” the concerns of paediatricians and social workers:

“Her evidence in respect of the ‘2 critical historical misunderstandings‘ not only explains the approach of [the parents] but provides clinical justification for that approach.”

The judge concludes:

“Taken together with the panoramic evidence of the child focused approach of [the parents] it is overwhelmingly obvious that neither H nor R have suffered or are at risk of suffering significant emotional harm arising from their complete social transition into females occurring at a very young age. The evidence demonstrates to the contrary, this was likely to minimise any harm or risk of harm.”

We are left with the question of who selected this particular “expert” to present evidence, and to reflect on how easy it is to sweep aside all normal safeguarding and child protection concerns when the issue is ‘transgender,’ with evidence that would not stand up in any other circumstances. Likewise, behaviour from parents which would arouse suspicion in any other case, is transformed into ‘best practice’ uniquely in the case of ‘transgender children.’

Safeguarding and child protection was an issue highlighted by the Tavistock clinicians who spoke anonymously to David Bell, and was reflected, albeit in a watered-down version, in the recently published Tavistock GIDS Action Plan:

14. I recommend that the trust is unequivocal in holding the position that simply bringing a child to the service for exploration of gender dysphoria does not constitute a safeguarding issue. However, it is reasonable to acknowledge that this can often be a complex population with presentations that can require the need for further deep exploration.

One of the clinicians who resigned from the Tavistock for ethical reasons gave us this comment:

“In my experience, whenever a case got too close to child protection issues, I was just advised to step back and let the local teams take over – i.e. to offer no advice either way. We weren’t supposed to offer an opinion on whether the gender identity might be related to child protection issues, even when it very clearly was.”

This family court decision sets a dangerous precedent. There must be no area of childcare handed over to ideologues, no approach which casts aside established knowledge of child development and psychology, and no treatment of children given a free pass because in this one area we have decided that normal rules do not apply. No child should be placed outside normal safeguarding and duty of care. Put simply, this judgment creates a loophole and puts vulnerable children at risk.