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Schools rushing ‘on whisper’ to label pupils as transgender

A psychologist at the only NHS gender clinic for children in England says some may be making choices they could regret

Children as young as 11 are being offered medical treatments that could leave some infertile, according to a psychologist at the only NHS clinic in England and Wales for children seeking to change their gender.

Bernadette Wren, consultant clinical psychologist at the Gender Identity Development Service (GIDS) clinic in London, said some schools were moving too fast in allowing young girls to be treated as male pupils and vice versa — simply at the child’s request.

She said schools were rushing to allow pupils to change their names, uniforms and gender pronouns as soon as they “got a whisper that a child might be querying their identity” and this was not in every child’s best interests.

The GIDS clinic is part of the Tavistock and Portland trust in London which has pioneered medical treatment for young transgender people but is now being overwhelmed by referrals.

In nine months last year more than 2,000 children were referred by GPs, schools and support groups to GIDS, the only NHS clinic offering medical treatments such as hormones to suppress puberty and cross-sex hormones to develop different sexual characteristics.

The figure is a 20-fold increase in seven years — in 2009 it was 97. Last year’s figures included two three-year-olds, nine four-year-olds, 21 five-year-olds and 23 six-year-olds. Some are being offered treatments not accessible in the past and for which there is no long-term research data available about risks.

Wren said future generations might condemn the way such children were being handled: “Of course you have to think that in another generation we will have done something which is not regarded as having been wise.” She also acknowledged that some youngsters could regret their decision to change gender when they grow up and that there were risks involved, including the loss of the ability to have children, particularly for those born as boys.

“Perhaps the choices they make when they are 16 look different when they are 30,” said Wren, speaking in advance of a conference next month about improving support for children who question their gender. “You can accept their feeling about gender difference but you do have to say alongside that — and without being transphobic — that there are really difficult treatment choices to be made.

“You could be the most transgender friendly service in the world and you would still have to consider some very, very grave issues. The timing of puberty suspension, for instance. Whether they can tolerate enough treatment to develop the lower part of the body so they develop physical sensations.

“And fertility. They can consider the loss of their ability to have genetic children. This is becoming a big issue for us. For natal males — their capacity to produce sperm is more fragile in the face of these treatments.”

Her comments follow remarks by the fertility expert Lord Winston, who said he was seeing transgender adults who had lost their ability to reproduce and were very “damaged”.

Wren said the youngest child receiving medical intervention at the clinic was a girl aged 11, who identifies as a boy and is receiving hormone treatment to suppress early puberty.

While nearly half of older children referred to the clinic opt for possible medical treatment to change gender, only about a quarter of five to 12-year-olds made the same choice.

“In the younger age group we may get kids who are gender fluid but not going to pursue this into later life. That is why we are a little more cautious about early social gender identity,” she said.

“Schools might wait for the parents to approach them before changing things like names in the register, uniforms, pronouns, toilets, sports.

“If a school just gets a whisper of a child who may be querying their gender and within minutes they are doing everything to make sure that child is regarded as a member of the opposite sex right from the word go — that may not be the best for that child.”

Wren also disclosed that:

● Of children referred to the London clinic, 10% change their minds and opt out of the treatment programme

● Transgroup activists are pushing for children to be allowed to change gender identity more quickly and some feel the GIDS service is too cautious

● The clinic has no data following up what happens to its child patients once they become adults.

Wren said the clinic had applied for money for a study tracking 600 children from the start of treatment over many years, including those who change their mind. Despite the risks, she compared the work of the clinic — and of others in America and Holland — to pioneering advances in oncology.

Several transgender support groups declined to comment.