Keira Bell has won her case against the Tavistock and Portman NHS Foundation Trust. As a transgender person, I am delighted for her but I am also relieved for the thousands of children who are chasing the impossible dream that it is possible to change sex.
Bell's victory is an important one for teenagers and pre-pubescent children who are not old enough to make decisions that will affect them for the rest of their lives. The High Court judgement made it clear that it is 'highly unlikely' that children aged 13 or under would be competent enough to give consent to the administration of puberty blockers. The judges went further and expressed doubt that children aged 14 and 15 could understand and weigh the long-term risks and consequences. Remarkably, they even voiced caution in the case of 16 and 17-year olds, where there is usually a statutory presumption of competence to give consent. Make no mistake: this was a profound judgment and a victory for common sense.
My own experience differs from Bell’s. I am the opposite sex, for one thing; I also have no intention of reversing a medical transition that I made as an adult. What’s done is done, and there are parts of me that can never be put back. Gender surgery is a one-way process.
But, crucially, that treatment was never available to me as a child and for that I am eternally grateful. If it had been an option, I would have obsessed over it and, had I managed to get to the clinic, I would have pressed for puberty blockers, cross-sex hormones and gender surgery at the first opportunity.
I know this because that is what indeed happened to me when I realised that treatment was available. The internet has been both a blessing and a curse. It taught me that I was not alone in wanting to be a woman, and I met people who had gone through the process of transitioning and were seemingly living the dream. I wanted that too, and I wanted it desperately. The chronic gender dysphoria I had lived with for 42 years fulminated inside my mind. The want became a need, which became an obsession and my world narrowed in. My mental health collapsed as gender dysphoria took over my mind.
At no stage did I understand what was causing this insatiable need to transition. Instead, I bought into pseudo-science. I convinced myself that I had a female gender identity but I had the misfortune to have been born into the wrong body. It is tantalising in its simplicity, but just because something is simple, or even popular, does not mean that it is true.
People once thought that the Sun went round the Earth, and those who thought otherwise were persecuted with a passion. Now we know differently: the scientific enlightenment dawned and we learned to judge ideas on facts and evidence, rather than feelings and opinions.
But I do wonder if we are now reversing out of the enlightenment. It’s not traditional religious dogma that is captivating society – not in the West at least – but postmodern ideologies that are every bit as strong. Ideas such as gender identity are presented as accepted truth with little in the way of evidence to support them. Indeed, gender identity cannot even be defined without circular reasoning, and reference to sexist stereotypes. Dissenters are persecuted by the true faithful with an evangelical zeal that bears an uncanny resemblance to religious persecutions of the past, as JK Rowling and Rosie Duffield found out earlier this year. The Trans Inquisition is no joke; it is all too real.
If I – as a middle-aged teacher, with a PhD in atomic physics even – could fall for this, then children setting out in the world have little hope of resisting it. For them, becoming transgender is not only a promise of salvation from their troubles but, crucially, a cause of further troubles. Why? Because humans cannot change sex. Human beings – like all other mammals – are sexually dimorphic. We are either male or female, and that is determined by our biology. It is certainly not 'assigned at birth' by some mysterious process, perhaps involving one of JK Rowling’s sorting hats. We may be unhappy with our bodies but changing sex is not the answer because changing sex is not possible.
The treatment given to Bell, and others like her, is effectively a cosmetic process that can change sex characteristics to resemble, rather than function, as the opposite sex. For an adult like me, already a father of three and whose fertility had been curtailed by a vasectomy, this was a loss. But for children setting out in life, it can prove catastrophic. We don’t recommend children have vasectomies or hysterectomies because, whatever they might tell us about not wanting to have children of their own, they cannot understand what it means to be a grown-up and the emotions that come with adulthood. We allow for the possibility that they may one day change their mind.
For that reason alone, we should not be providing treatment for gender dysphoria that can have such a profound impact. Yes, gender dysphoric children need our help. Not to change their minds, as quacks have tried in previous generations, nor to change their bodies. Rather, they need to understand themselves. We must ask them: where does the need to transition come from?
And we should not start by assuming that it is the same for everyone. Nobody is born in the wrong body, we are born in our own bodies. But we can still be oppressed by the expectations that come with those bodies; expectations that arise in our own heads as much as anyone else’s, and I say that with experience.
The judgement yesterday is a good start, but this is a global phenomenon that won't vanish overnight. As long as treatment is being provided, perhaps by private clinicians operating from foreign jurisdictions, Keira Bell will not be the last child to have treatment which she later comes to regret. Rather than change ourselves we need to find ourselves, and that is more difficult. It’s also more expensive: drugs are cheaper than psychotherapy, but the judgment yesterday is a step in the right direction.