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Transitioning Children – Exploring the Cass Review with Dr Jenny Cunningham · UK Column Radio

0:07
Speaker 1: Hello everyone. This is Diane Rasmus and Macatty with UK column.
0:11
Speaker 1: I'm happy to be here today to be interviewing doctor
0:14
Speaker 1: Jenny Cunningham, who's a colleague of mine. We work together
0:17
Speaker 1: on the Scottish Union for Education editorial board, which is
0:20
Speaker 1: how we got to know each other. Jenny has a
0:23
Speaker 1: long career as a retired pediatrician and with that, I
0:28
Speaker 1: would just like to introduce doctor Cunningham yourself and I'll
0:31
Speaker 1: let you tell your story in your background and how
0:34
Speaker 1: you kind of came to be working on this topic
0:37
Speaker 1: of the Cat Review and the issues of gender ideology
0:40
Speaker 1: and children.
0:41
Speaker 2: Hello. Everyone, Well, I came to this country in nineteen
0:47
Speaker 2: eighty one. As far back as that I was South
0:52
Speaker 2: African exile. I but came up to Scotland a little
1:00
Speaker 2: bit later in nineteen eighty three and having done pediatric
1:09
Speaker 2: training and I became a community pediatric pediatrician in Glasgow
1:16
Speaker 2: some thirty harty years ago. And I've been involved by
1:24
Speaker 2: community pediatric pediatrics. You're involved really with children outside of
1:31
Speaker 2: the hospital. You're involved with children from the point of
1:34
Speaker 2: view of those that have particular developmental delays for whatever reason,
1:40
Speaker 2: all particular neurodevelopmental problems and worked in a child development
1:47
Speaker 2: centered together with a multidisciplinary team involving physiotherapists, occupational therapists
1:54
Speaker 2: and so forth, and began to specialize as in autism
2:01
Speaker 2: diagnosis and set up an autism diagnostic team in Glasgow
2:08
Speaker 2: which then got rolled out across the city. So I
2:12
Speaker 2: suppose my expertise really is in the area of autism
2:16
Speaker 2: diagnosis and in euro developmental problems. But also as a
2:22
Speaker 2: community pediatrician, you're very involved with children starting school, going
2:28
Speaker 2: into school, going into education and so forth, and so
2:32
Speaker 2: I have some experience of that quite fraught business of
2:37
Speaker 2: children starting school, integrating and particularly children with special needs,
2:42
Speaker 2: those children who have significant developmental problems, like the children
2:46
Speaker 2: with autism and euro developmental problems, and became involved with
2:54
Speaker 2: colleagues of mine in this Scottish Union for Education. Being
3:01
Speaker 2: in Scotland we've been particularly hard hit. I think in
3:07
Speaker 2: education a government led, really a government led a problem
3:18
Speaker 2: of really indoctrinating children and adolescents, and transgender ideology has
3:29
Speaker 2: been writ large in this respect. So it's that brought
3:37
Speaker 2: us to have a look at the whole question of
3:38
Speaker 2: who is influencing you know, education. Why is Scottish education
3:46
Speaker 2: that used to be so strong, Why has it seemed
3:50
Speaker 2: such a deterioration, you know, in the twenty plus years
3:56
Speaker 2: of the Curriculum for Excellence and why is it that
4:00
Speaker 2: it is so strongly influenced by transgender ideology which is
4:05
Speaker 2: pushed through the sex education a curriculum in Scottish schools.
4:13
Speaker 2: And of course a similar kind of thing has happened
4:16
Speaker 2: in English education and that's what brought me to write
4:23
Speaker 2: a pamphlet on is actually critiquing the Scottish government's guidance
4:30
Speaker 2: for supporting transgender pupils in Scottish schools.
4:35
Speaker 1: How much influence do you think it has had so far?
4:38
Speaker 1: I've read the pamphlet. I think it makes everything very clear.
4:42
Speaker 1: Do you think it's made a difference or have you
4:44
Speaker 1: still met resistance talking to parents or obviously through the
4:49
Speaker 1: government you will have. But how's the response to it
4:52
Speaker 1: been so far?
4:53
Speaker 2: I think parents are glad to have something which is
4:57
Speaker 2: fairly accessible but also explain a lot of the terminology,
5:02
Speaker 2: a lot of the debate around these issues, and also
5:07
Speaker 2: links it to the sex education curriculum which really does
5:12
Speaker 2: worry most parents. They are particularly worried about the idea
5:16
Speaker 2: of sexualizing young children and also promoting the idea of transgenderism,
5:26
Speaker 2: you know, which which for some families has you know,
5:30
Speaker 2: has had a very very big impact because their children have,
5:35
Speaker 2: you know, have declared that they wish to change sex basically,
5:41
Speaker 2: and so for parents who are worried about these things,
5:46
Speaker 2: I think the pamphlet came as a help and I
5:49
Speaker 2: think you know, most parents have responded very positively to it.
5:57
Speaker 2: There's tremendous resistance really, I think Scottish government and all
6:02
Speaker 2: of the people that gathers around it to listening to
6:06
Speaker 2: any critical voices at all. However, there are a few
6:11
Speaker 2: Scottish MSPs who are sympathetic and have really begun to
6:21
Speaker 2: question the Scottish government's very upfront involvement in this question
6:28
Speaker 2: and the fact that they really have been at the
6:33
Speaker 2: forefront of pushing gender ideology in schools. So some of
6:41
Speaker 2: those MSPs are supportive and have begun to really try
6:46
Speaker 2: and organize some opposition in the Scottish government.
6:51
Speaker 1: Do you think that's coming from the Tory side, because
6:53
Speaker 1: we don't have too many of those, Which is it
6:56
Speaker 1: from any particular party that is starting to tried to
7:00
Speaker 1: work on this.
7:02
Speaker 2: Yes, it is predominantly from from the scott from the
7:05
Speaker 2: Tory party in Scotland, although there are certainly some labor
7:11
Speaker 2: in his pies who have been supportive and spoken Art
7:17
Speaker 2: and Ashwig and who who's in with the Salmon's her party.
7:25
Speaker 2: So he's a handful of labor people and and and
7:31
Speaker 2: and certainly the Tories, but they're remind you remember.
7:37
Speaker 1: That's really exactly so, you know, thinking back to you know,
7:41
Speaker 1: and this is this is not about children, but thinking
7:44
Speaker 1: about the Isla Bryson situation that Nicolas Sturgeon got herself
7:48
Speaker 1: in with the man who decided the rapists convicted rapist
7:53
Speaker 1: who wanted to suddenly be identified as a woman to
7:56
Speaker 1: put into a female prison. That was that was a
7:59
Speaker 1: breaking point for me. And it just kind of just
8:03
Speaker 1: goes to show you though, how fart spreads throughout the
8:08
Speaker 1: s and p at least that seems that way to me.
8:10
Speaker 1: We'll see what happens in our a Scottish election two
8:13
Speaker 1: years time and if they're still there. But they certainly
8:17
Speaker 1: lost some seats in the general election as we know,
8:20
Speaker 1: which was interesting and I don't know you'll know better
8:23
Speaker 1: than I do, probably in terms of party support for
8:27
Speaker 1: or against gender ideology. But it certainly seems to me
8:29
Speaker 1: that the S and P has definitely been in favor
8:32
Speaker 1: of pushing this through the schools and has seemingly no
8:37
Speaker 1: concerns about any age group of anybody experiencing anything, which,
8:42
Speaker 1: as you know, as a librarian, I'm working on that
8:46
Speaker 1: that we shouldn't be having, you know, sex manuals and
8:49
Speaker 1: drag Queen's Story Hours and these sorts of things for
8:53
Speaker 1: primary skilled children or any children. I don't care what
8:58
Speaker 1: people read or what they go what kind of entertainment
9:01
Speaker 1: they go to as adults, but it's the children that
9:04
Speaker 1: I'm particularly concerned with, and that's why I really wanted
9:09
Speaker 1: to talk to you about this, because you'll have a
9:10
Speaker 1: much deeper understanding of how things tell development and how
9:15
Speaker 1: these medications and potential surgeries and so on will impact
9:20
Speaker 1: their developing bodies throughout their lives. And that seems to
9:23
Speaker 1: be like a concern that I certainly can't understand, which
9:27
Speaker 1: is why I'm really happy that you're here to talk
9:29
Speaker 1: to us today to explain a little bit more about it.
9:32
Speaker 2: I think possibly it's it's it's worth just throwing into
9:36
Speaker 2: the discussion about the Scottish Government that it's it's guidance
9:43
Speaker 2: two schools on supporting so called transgender pupils. It was
9:50
Speaker 2: really just a modified version of an LGBT Youth Scotland document.
9:59
Speaker 2: Now LGBT t Youth Scotland is ostensibly, if you like,
10:06
Speaker 2: the junior wing of Stonewall. It is meant to represent
10:15
Speaker 2: lgbt A young people from thirteen to twenty five years
10:21
Speaker 2: of age. It really, as I say, it was the
10:27
Speaker 2: blueprint for the Scottish government's guidance. And it also has
10:34
Speaker 2: really carte blanche to go into schools, set up LGBT
10:40
Speaker 2: youth clubs in schools at lunch times, and it has
10:47
Speaker 2: an awards scheme just like Stonewall has, and it then
10:54
Speaker 2: gets schools to try and earn bronze, silver and gold wards,
11:01
Speaker 2: which primarily involves them opening their schools and their staff
11:07
Speaker 2: to training by these LGBT youth trainers. So it's it
11:20
Speaker 2: is if you like, it goes well beyond just recommendations
11:25
Speaker 2: from the Scottish government. It also goes to really allowing
11:30
Speaker 2: or facilitating these sort of transactivist groups coming into schools
11:39
Speaker 2: and influencing teaching.
11:41
Speaker 1: And we saw just a few days ago. Was it
11:43
Speaker 1: the second or the third case of someone either providing
11:48
Speaker 1: content for or working for LGBT Scotland as being a
11:52
Speaker 1: pedophile and finding evidence. I think that just came out
11:55
Speaker 1: a few days ago. They found very disturbing images front
12:01
Speaker 1: of children and the worst ways possible saved on this
12:05
Speaker 1: person's phone or computer or something. It's just absolutely appalling
12:10
Speaker 1: to me. And you know, when I spoke out to
12:13
Speaker 1: my now former library professional body, since I've sort of
12:16
Speaker 1: been disciplined out, Scotland still has LGBT Youth Scotland as
12:22
Speaker 1: a resource for LGBT youth library services on its website.
12:29
Speaker 1: And when I called that out, you know, the sort
12:31
Speaker 1: of disciplinary processes that they put me through. They told
12:34
Speaker 1: me I wasn't being inclusive. So it's just amazing how
12:38
Speaker 1: big this gets when you start to look at all
12:41
Speaker 1: the people that are in support of it, and if
12:42
Speaker 1: you try to say anything to protect children, you are
12:48
Speaker 1: the one who seems to be the problem. And it
12:50
Speaker 1: really is. It's larger than people think. And sometimes I realize,
12:55
Speaker 1: you know, is that the reason that people don't realize
13:00
Speaker 1: I think it is a problem because it's so widespread.
13:02
Speaker 1: It's just kind of people just kind of go along
13:05
Speaker 1: with it. There's not enough of us speaking up, I
13:07
Speaker 1: don't think, and that's a real, real sad day for
13:12
Speaker 1: children when we can't speak out for them.
13:15
Speaker 2: Absolutely, I mean, one of the disturbing things about LGBTU
13:20
Speaker 2: Scotland is that it's been enabled to set up clubs
13:25
Speaker 2: within schools at lunch times. Now. These clubs seem to
13:30
Speaker 2: attract the children or young people who are really what
13:37
Speaker 2: I consider the most vulnerable. They're often children who've got
13:41
Speaker 2: problems like autism, They're often children with mental health problems.
13:46
Speaker 2: Very often they're looked after, children, children in the care system.
13:52
Speaker 2: They're often children with a background of social difficulties, dysfunctional families,
13:59
Speaker 2: child sex abuse. So and in fact lgbt you Scotland
14:07
Speaker 2: are quite open about the fact that and and proud
14:10
Speaker 2: of the fact that their club their clubs, both in
14:13
Speaker 2: schools and online and in various areas you know, are
14:19
Speaker 2: are catering for for pupils you know, with with with
14:25
Speaker 2: these kinds of difficulties. But this is this is precisely
14:30
Speaker 2: the group of children who are so attracted to the
14:34
Speaker 2: idea that perhaps by changing sex, so called the changing gender.
14:41
Speaker 2: Should I say that this will, if you like, be
14:45
Speaker 2: the answer to their own happiness, their insecurity, you know,
14:50
Speaker 2: their feelings, they don't belong and so forth. So so, yes,
14:56
Speaker 2: it is. It is a very serious problem.
14:59
Speaker 1: Yeah, And you know it's interesting because you know, when
15:03
Speaker 1: I think back to my childhood, and I certainly was
15:06
Speaker 1: not I guess you could say it was not a
15:09
Speaker 1: typical girl in the sense that I had no interest
15:12
Speaker 1: in playing with dolls. I liked science, I liked hanging
15:15
Speaker 1: out with my father. I was outside, you know, playing
15:20
Speaker 1: on my bike. You know, all of the barbies and
15:23
Speaker 1: everything that I've bought me never stuck. And I think
15:26
Speaker 1: back to that, and sometimes I wonder if I were
15:28
Speaker 1: growing up now, would they try to sort of tell
15:32
Speaker 1: me that I was actually a boy, which really goes
15:35
Speaker 1: into what I think are very backward views around gender
15:38
Speaker 1: stereotypes and well, you like this, so you must be
15:42
Speaker 1: a boy, you must be a girl because you like
15:44
Speaker 1: the color pink or whatever. You know, that is actually
15:47
Speaker 1: putting us backwards in terms of acceptance of people and
15:51
Speaker 1: what we like and what we don't like. And we
15:53
Speaker 1: should have the freedom to make those choices, and those
15:55
Speaker 1: are things we explore as we grow up, and they
15:58
Speaker 1: might even change when we get older. It doesn't necessarily
16:01
Speaker 1: mean that we should be doing these things to our children.
16:05
Speaker 1: And I don't know. I mean, I didn't grow up
16:07
Speaker 1: in a disadvantage situation like you're describing. But I almost
16:11
Speaker 1: wonder if that wouldn't have come up if I were
16:14
Speaker 1: ten years old now, as opposed to know in the
16:17
Speaker 1: nineteen eighties.
16:19
Speaker 2: Well almost certainly, because actually if you look which perhaps
16:24
Speaker 2: we may cover in the discussion, if you look at
16:27
Speaker 2: the criteria for the diagnosis of gender dysphoria in children,
16:36
Speaker 2: some of the criteria are precisely that this child shows
16:40
Speaker 2: a very strong desire to play with the things that
16:45
Speaker 2: are of the opposite sex of interest or engage in
16:48
Speaker 2: their activities, you know, and a strong desire to be
16:54
Speaker 2: like the opposite gender in you know, so certain fact,
17:02
Speaker 2: this whole area is definitely despite the you know, the
17:08
Speaker 2: arguments that you know, gender can exist in a variety
17:11
Speaker 2: of forms, you know, seventeen genders and all of this,
17:15
Speaker 2: despite that, in actual fact, when you come down to
17:20
Speaker 2: gender transitioning, which is really the topic I suppose of
17:25
Speaker 2: the Cast report, in fact, they're very very stereotypical views
17:32
Speaker 2: and ideas, not only in the heads of the children
17:36
Speaker 2: and young people putting the heads of clinicians the people
17:40
Speaker 2: who are assessing them, and a very stereotyped view of children.
17:47
Speaker 1: Yeah, and I guess it just goes to show you.
17:50
Speaker 1: I mean, there are some things about me that have
17:52
Speaker 1: changed over time, and just like with everyone in some
17:54
Speaker 1: things that don't change. One thing that hasn't changed is
17:58
Speaker 1: that I don't think like everyone else, and I like
18:00
Speaker 1: to speak my mind. That hasn't changed. But that doesn't
18:04
Speaker 1: necessarily mean that I'm not who I wasn't born the
18:07
Speaker 1: way I was supposed to be or wasn't supposed to be, right.
18:10
Speaker 1: It just I really think that those stereotypes are very,
18:14
Speaker 1: very dangerous, and I think it also has and this
18:18
Speaker 1: is just my opinion, personal opinion, that the idea of
18:22
Speaker 1: feminism has changed over time. Right that I grew up,
18:26
Speaker 1: you know, by the time I was in university and
18:29
Speaker 1: thinking about what my life might look like in the future,
18:31
Speaker 1: that I just wanted to have the same opportunities as
18:34
Speaker 1: everyone else. It wasn't about getting you know, put ahead
18:39
Speaker 1: because I was a woman. And now you know, that's
18:41
Speaker 1: been the thing that's been coming out now while men
18:44
Speaker 1: are acting like women, you know, and sporting and so on,
18:47
Speaker 1: thinking that they'll get ahead and they'll win because they
18:50
Speaker 1: have still bigger bodies, even if they decide that they
18:54
Speaker 1: are going to compete as a woman, and so they're
18:57
Speaker 1: really you know, going into what should be women's spaces
19:02
Speaker 1: that are meant for us to be able to feel
19:04
Speaker 1: safe if we need that, and taking that over and
19:09
Speaker 1: then just saying, well, you know, why is it that?
19:14
Speaker 1: Why is it different that you want to be in
19:17
Speaker 1: a woman's space? You know what I hear, at least anecdotally.
19:20
Speaker 1: I guess what I'm thinking about as well, is that
19:24
Speaker 1: this is all given feminism a bad name. Like I said, right,
19:27
Speaker 1: like it's it seems like feminism means down with men,
19:32
Speaker 1: down with the patriarchy. I've never thought that way, but
19:36
Speaker 1: I think that also puts women backwards because it makes
19:39
Speaker 1: us look like if we say we're a feminist, but
19:42
Speaker 1: that makes it look like we hate men, or we
19:44
Speaker 1: want something bad to happen to men or something. But
19:47
Speaker 1: that's not it. We just want to have the same
19:49
Speaker 1: choices as anyone else had. We can all be parents
19:53
Speaker 1: or not be parents, we can all have careers or
19:55
Speaker 1: not have careers. Right, It's it's still so something about
19:59
Speaker 1: this saying that this is a progressive thing is actually
20:02
Speaker 1: regressive to me. Does that make sense?
20:06
Speaker 2: Yes, certainly, although I mean I don't align myself with
20:11
Speaker 2: any feminist group or grouping because obviously feminism is very
20:16
Speaker 2: very heterogeneous group group. I mean, in my experience, those
20:26
Speaker 2: feminists who have taken an interest in transgenderism and its impact,
20:33
Speaker 2: it's negative impact on children and adolescents, you know, have generally,
20:39
Speaker 2: I think been on the right side in terms of
20:42
Speaker 2: condemning you know, the fact that children and adolescents are
20:47
Speaker 2: being encouraged onto a medical pathway which is going to
20:51
Speaker 2: have very very significant life change in you know, impacts
20:56
Speaker 2: on their lives. And most feminists that certainly I have
21:01
Speaker 2: experience of, you know, has spoken art about this and
21:08
Speaker 2: you know, being supportive really of of of criticisms you know,
21:15
Speaker 2: of of you know, transgender ideology, and being fairly supportive
21:23
Speaker 2: of the cast review.
21:25
Speaker 1: Yeah, so what I guess we should talk about the
21:29
Speaker 1: cast review as well, because I think it's been something
21:31
Speaker 1: that's kind of been thrown around the last few months
21:36
Speaker 1: in different ways, and it's not something that we've really
21:39
Speaker 1: had a chance to cover really in depth here. In
21:42
Speaker 1: U could column, and so I think that our viewers
21:45
Speaker 1: would appreciate kind of a deeper look at it, especially
21:48
Speaker 1: from someone who can take the perspective in the background
21:52
Speaker 1: that you have. So, you know what, can you basically
21:56
Speaker 1: explain what the caust review was and why it has
22:01
Speaker 1: had such an impact? And I know it's gone around
22:04
Speaker 1: the world because I've seen it all over the media
22:06
Speaker 1: in different countries. So why has this been so monumental?
22:11
Speaker 2: Well, obviously the Cass report started four years before it
22:16
Speaker 2: was published this April, and it started really as, if
22:24
Speaker 2: you like, an inspection of the Gender Identity Development Service
22:30
Speaker 2: down in England, which was based in the Tavistock important
22:36
Speaker 2: NHS service and NHS England had asked Hilary Kass, who
22:44
Speaker 2: is a very well known and very well respected pediatrician,
22:49
Speaker 2: to have a look at the service because obviously it
22:52
Speaker 2: was a service involving children and teenagers, so very much
22:59
Speaker 2: within the realms of pediatrics. So it started off as
23:04
Speaker 2: her investigation of that service and in her initial report
23:11
Speaker 2: she made it very clear that she was very disturbed
23:15
Speaker 2: by what was happening in that service and basically saying
23:21
Speaker 2: that it was operating like no other pediatric service at all,
23:27
Speaker 2: whether you're talking about medicine or psychiatry, in which the
23:33
Speaker 2: children or adolescents arrived with an idea in the head
23:37
Speaker 2: of what the diagnosis was, and that diagnosis of being
23:43
Speaker 2: disturbed by their gender was being acknowledged by the Conlenacians
23:49
Speaker 2: accepted unequivocally. That was their starting point, and then they
23:56
Speaker 2: were being evaluated for a medical transition to their preferred gender.
24:05
Speaker 2: That was what she said. She found this affirming. I mean,
24:11
Speaker 2: no other pediatric service does the patient arrive, tell you
24:16
Speaker 2: what the diagnosis is and expect you then to proceed
24:20
Speaker 2: with treatment. Obviously not and particularly because clearly a lot
24:27
Speaker 2: of these children and young people were arriving with all
24:32
Speaker 2: sorts of problems, not just gender incongruence as it's called.
24:38
Speaker 2: So she was alarmed and she then proceeded to initiate
24:45
Speaker 2: an investigation of that service in particular. But it became
24:49
Speaker 2: clearer and clearer that that service was replicated throughout the UK,
24:56
Speaker 2: and that type of service was being recommended internationally, and
25:02
Speaker 2: it had really embedded in America in particular, and was
25:07
Speaker 2: very far advanced. What was called gender affirmative care or
25:13
Speaker 2: affirmative gender care for young people and adolescents, and so
25:21
Speaker 2: with the blessing of NHS England. Fortunately, she then proceeded
25:26
Speaker 2: to put to roll out a proper research project. So
25:33
Speaker 2: they commissioned the University of York to do seven very
25:39
Speaker 2: detailed systematic reviews of the evidence for the treatment of
25:48
Speaker 2: children and young people. I remember it was really just
25:52
Speaker 2: children and young people that she was asked to do.
25:57
Speaker 2: So they had a look systematically stematic review of the literature,
26:02
Speaker 2: which is really the best kind of of of of
26:06
Speaker 2: evidence you can find. Looked at all aspects of the service,
26:13
Speaker 2: So looked at the care pathways, looked at the treatment
26:19
Speaker 2: through puberty blockers, which was the first step, then looked
26:24
Speaker 2: at the efficacy of cross sex hormones, mascularizing and feminizing hormones,
26:31
Speaker 2: and also had a look at at, you know, some
26:35
Speaker 2: of the broader questions like the social transition of children,
26:44
Speaker 2: what was happening in schools and parents were socially transitioning
26:48
Speaker 2: their children before they got referred in and she also
26:53
Speaker 2: this one of these reviews, had a look at carefully,
26:57
Speaker 2: had a look at which children and young people were
27:01
Speaker 2: being referred what was the nature of this group of referrals,
27:07
Speaker 2: And then She also evaluated whether psychotherapeutic in other words,
27:13
Speaker 2: just a counseling approach would actually be a better starting
27:19
Speaker 2: point for it. So what she's achieved really is probably
27:25
Speaker 2: the most comprehensive scientific evaluation of the evidence for the
27:32
Speaker 2: treatment of children with a confusion or a feeling that
27:38
Speaker 2: their genders as sex as as we would more correctly
27:44
Speaker 2: refer to, was out of step with what they felt
27:49
Speaker 2: was their real gender. This, of course, children don't arrive
27:54
Speaker 2: at that spontaneously. This, of course is the basis of
27:58
Speaker 2: gender ideology which has been pushed by transactivist organizations, the
28:04
Speaker 2: fact that they feel they've gottenn innate gender which is
28:09
Speaker 2: in conflict with their sex. And so, having had a
28:16
Speaker 2: look at all of that careful study, she concluded, and
28:24
Speaker 2: to use her own words, the evidence space for all
28:28
Speaker 2: of these aspects of the service was very weak and
28:34
Speaker 2: she found that in all the areas they found that
28:37
Speaker 2: through all the systematic reviews. And she then concluded that
28:46
Speaker 2: the service had to change, and NHS England concluded, yes,
28:51
Speaker 2: indeed it did along the way. If you look at
28:57
Speaker 2: really what she has achieved, I would say that she
29:01
Speaker 2: has completely discredited affirmative gender care. She said, Look, you
29:07
Speaker 2: cannot run a service that says the patient arives with
29:12
Speaker 2: the diagnosis, you accept the diagnosis, and do you then
29:16
Speaker 2: proceed to put in place treatment for which there is
29:21
Speaker 2: really very very poor evidence. How can you justify that?
29:28
Speaker 2: So completely discredited that idea of gender affirmative care. At
29:34
Speaker 2: the same time, she's completely discredited the international organizations which
29:41
Speaker 2: put out guidelines for this kind of transgender care. Right,
29:48
Speaker 2: so in particular the World Professional Association for Transgender Health
29:55
Speaker 2: or WPATHS. People may recognize that that abbreviation, and the
30:03
Speaker 2: other group which is very influentials Endocrime Society because of
30:07
Speaker 2: course they're responsible for the hormonal side of transgender treatment.
30:15
Speaker 2: And her study, her research or the research of the
30:22
Speaker 2: York University researchers, found that actually they had developed guidelines
30:28
Speaker 2: with a very very dubious set of of of of
30:36
Speaker 2: systematic reviews themselves, reviews which rarely had been discredited by
30:42
Speaker 2: York researchers. And yet those guidelines were very influential internationally.
30:52
Speaker 2: So gender services throughout the world were basing their approach
30:57
Speaker 2: on w PATHS and the End of Crime Societies guidelines.
31:04
Speaker 2: So they have been completely discredited. Actually w PATH has
31:10
Speaker 2: been even further discredited by the fact that their most
31:15
Speaker 2: recent standards of care have actually abolished any kind of
31:20
Speaker 2: age limit for these treatments. In other words, they say
31:26
Speaker 2: that any child, however young, could actually be put onto
31:31
Speaker 2: this medical pathway. That's fine. They also I mean it,
31:37
Speaker 2: it is they argue for the use of puberty blockers,
31:44
Speaker 2: you know, in children as young as five or nine.
31:50
Speaker 2: I mean it. It really is appalling and yet very
31:55
Speaker 2: influential even now, so that that has been her real achievement.
32:03
Speaker 2: And then I suppose you could say that at the
32:06
Speaker 2: level of services in this country and she achieved. Really
32:13
Speaker 2: what I think was the aim of NHS England was
32:17
Speaker 2: to discredit the service and to say, look, you've got
32:20
Speaker 2: to reorganize the service on a completely different basis. You've
32:25
Speaker 2: got to establish regional services that are more accessible. You've
32:30
Speaker 2: got to establish the principle that this would be run properly,
32:34
Speaker 2: whereby children adolescents were properly evaluated before they went anywhere
32:40
Speaker 2: near treatment. And NHS England went ahead and banned the
32:46
Speaker 2: use of puberty blockers for children and young people under
32:52
Speaker 2: sixteen years of age, and in fact, in Scotland, although
32:58
Speaker 2: very tardily it responded to cass It kept arguing, oh, no, no, no,
33:03
Speaker 2: this is concerns English, the English services, but in a
33:08
Speaker 2: very tardy way they accepted that the service being run
33:12
Speaker 2: out of the Sandyford Clinic in Glasgow, which is National
33:16
Speaker 2: Service for Children Adolescents in Scotland, was run on exactly
33:21
Speaker 2: the same principles of affirmative gender care, and in fact
33:27
Speaker 2: NHS Scotland went even further and has banned the use
33:32
Speaker 2: of puberty blockers and cross sex hormones, masculinizing and feminizing
33:37
Speaker 2: hormones in children in young people under the age of sixteen,
33:44
Speaker 2: and that has been endorsed by the present government UK
33:50
Speaker 2: government who've extended that ban to cover all gender services,
33:58
Speaker 2: in other words, those coming from prime clinics, whether they're
34:02
Speaker 2: based in the UK or internationally. So that has been
34:07
Speaker 2: a very important move because what it means is that
34:12
Speaker 2: has stopped gender affirmative care at least for children and
34:18
Speaker 2: young people until the service is reorganized on a better footing.
34:25
Speaker 1: That's really impressive. I mean, I guess you know, when
34:30
Speaker 1: it comes to grown up people, you could make the
34:32
Speaker 1: argument that it's their bodies and they can do what
34:34
Speaker 1: they want with them, right it doesn't affect me, but
34:38
Speaker 1: at the same time, it also makes me think about
34:42
Speaker 1: all the waiting lists for other treatments in the NHS
34:45
Speaker 1: right now, you know, things like cancer care and things
34:48
Speaker 1: that are really essential, and even just getting GP appointments
34:52
Speaker 1: is a struggle for people now, and so it makes
34:55
Speaker 1: me wonder how much of that is taking away from
34:58
Speaker 1: other resources for other issues that people would want to
35:01
Speaker 1: access the NHS for, especially with the findings of this review,
35:07
Speaker 1: that whatever they think is going to help is really
35:10
Speaker 1: not going to help, and then you know the amount
35:13
Speaker 1: of resources that's going to it anyway, it's an interesting question.
35:17
Speaker 2: I think if I could just add that, unfortunately, there
35:23
Speaker 2: are still children who've already been started young people rather
35:28
Speaker 2: than children, in other words, over thirteen years old. There
35:32
Speaker 2: have been young people put on to puberty blockers and
35:37
Speaker 2: cross sex hormens. You've already been started on them, and
35:43
Speaker 2: the recommendation is that those children won't have their treatment interrupted,
35:50
Speaker 2: they can continue. So that's one of the issues. The
35:55
Speaker 2: other problem is that as soon as children reach the
35:59
Speaker 2: age of a team, they are transferred to the Adult
36:05
Speaker 2: Gender Services, and unfortunately that's where they will be hurried
36:14
Speaker 2: onto a medical pathway ormone treatment and of course surgical
36:21
Speaker 2: interventions you know, which are extremely radical, involving amputations, reconstructions,
36:31
Speaker 2: mistect amazing girls and even worse castration boys. So the
36:40
Speaker 2: problem hasn't been solved. It's been abated for the younger
36:46
Speaker 2: children and adolescents, but not out of the woods at all.
36:53
Speaker 2: And remember there is still a very very large waiting
36:57
Speaker 2: list for children adolescent gender services, very large waiting list
37:04
Speaker 2: of children who have been referred, and some of those
37:09
Speaker 2: were obviously graduate to adult services. And for a lot
37:14
Speaker 2: of those children who've been told that this will be
37:18
Speaker 2: a life saving and life changing opportunity for them, you
37:23
Speaker 2: can imagine they're very unhappy on that waiting list. So
37:27
Speaker 2: it's I wouldn't like to suggest that everything has been
37:32
Speaker 2: solved by the cast report. It has had some important influences,
37:37
Speaker 2: and I think it has had a couple of other
37:42
Speaker 2: important effects which perhaps I could elaborate on, please okay,
37:50
Speaker 2: I mean a certain terms of the strengths of her report, right,
37:56
Speaker 2: remembering though that is in a medical framework a report.
38:01
Speaker 2: She doesn't venture very far into the sociopolitical questions of
38:06
Speaker 2: gender ideology. But I think one of the very important
38:13
Speaker 2: thing was that her review did is that it actually
38:18
Speaker 2: looked in detail at which children and young people were
38:22
Speaker 2: being referred. She looked in detail because she and others
38:28
Speaker 2: had noticed that this was a very very different cohort
38:34
Speaker 2: of children to those that had been referred to services earlier.
38:41
Speaker 2: And what she and others had noticed, right was that
38:45
Speaker 2: you got a dribbling of referrals from about two thousand,
38:49
Speaker 2: you know, two thousand and nine, ten, you got an
38:54
Speaker 2: increase in referrals, and then about two thousand and dean,
39:01
Speaker 2: you've got an exponential rise in the number of young
39:08
Speaker 2: people being referred to the gender identity services, a huge
39:13
Speaker 2: increase literally from about twenty and fifteen. And this was
39:19
Speaker 2: completely different to the children and a handful of young
39:24
Speaker 2: people who'd been referred before this in the late nineties
39:28
Speaker 2: and early you know, two thousands. Then back then it
39:34
Speaker 2: was predominantly little boys who were referred, very small numbers,
39:38
Speaker 2: very small numbers of little boys who persistently has said
39:44
Speaker 2: they were girls. Insisted, and they insisted in fact right
39:49
Speaker 2: the way up generally until they got to puberty. And
39:53
Speaker 2: then after puberty they decided they were actual boys and
39:59
Speaker 2: were quite with that. Now, that was the story right. Gradually,
40:04
Speaker 2: with the increase, girls started to be referred as well
40:08
Speaker 2: as the boys. But with this exponential increase in about
40:13
Speaker 2: twenty and fifteen, the gender ratio changed completely. It was
40:21
Speaker 2: no longer a predominance of boys or young young teenagers,
40:30
Speaker 2: male teenagers. It was now predominantly females. About seventy percent
40:36
Speaker 2: of the referrals were actually teenage girls, but a significant number,
40:44
Speaker 2: you know, a good you know, twenty eight percent were boys.
40:50
Speaker 2: So this was a completely different cohort to what was
40:56
Speaker 2: previously referred to as children with gender this you know,
41:01
Speaker 2: this dysphoric disorder. And the other important thing about this
41:08
Speaker 2: group was that they hadn't often, they hadn't experienced any
41:17
Speaker 2: gender dysphoria or confusion about their gender when they were young,
41:23
Speaker 2: when they were children. It was only after puberty really
41:29
Speaker 2: that they suddenly started reporting this gender asymmetry, this this
41:36
Speaker 2: gender inconcruences, it's called between their sex and what they
41:42
Speaker 2: felt was there there innate gender. So this this again
41:50
Speaker 2: was totally different. Are You're looking at a completely different
41:53
Speaker 2: group of young people here. And the other thing about
41:58
Speaker 2: this group, and Cass went into great detail on this,
42:02
Speaker 2: was that they are a very complex group. It was
42:06
Speaker 2: a very high proportion of them who had mental health problems,
42:11
Speaker 2: but not just you know what's labeled as mental health
42:15
Speaker 2: problems now, you know, not just mild anxiety or mild
42:19
Speaker 2: depression and significant depressive illnesses, psychiatric problems like an orexia, neversa,
42:29
Speaker 2: other psychiatric problems like obsessive compulsive disorder and so forth,
42:34
Speaker 2: So significant mental health problems. The other group, which was
42:38
Speaker 2: disproportionately represented with children with autism, young people with autism
42:44
Speaker 2: or children on the autistic spectrum, and other developmental problems
42:50
Speaker 2: ADHD four was one, but again a significant number were
42:57
Speaker 2: looked after children or children who have had a really
43:01
Speaker 2: significant background of adverse childhood experiences. So you've got this
43:10
Speaker 2: group of children who are being referred to the gender
43:14
Speaker 2: identity clinics. So that was an extremely important thing to
43:19
Speaker 2: identify because you're not talking about the same condition, right,
43:26
Speaker 2: You're talking about a new phenomenon. And this was a
43:31
Speaker 2: mistake that a lot of clinicians were making that they
43:34
Speaker 2: were just assuming it's just the old disjunction between your
43:40
Speaker 2: sex and what you imagine you'd like to be. The
43:45
Speaker 2: other important thing that she focused on was that actually,
43:52
Speaker 2: could these what are called comorbid conditions. Could all these
43:57
Speaker 2: complicating factors act be responsible for the gender dysphoria? Could
44:04
Speaker 2: they be what was leading them to seek referral? Their
44:08
Speaker 2: unhappiness was due to these problems rather than to any
44:14
Speaker 2: kind of dysphoric thing. And the other thing in that
44:21
Speaker 2: respect was that if you didn't if you didn't check
44:26
Speaker 2: and see whether these problems were there, you wouldn't know.
44:30
Speaker 2: You wouldn't know what was contributing to it or causing
44:34
Speaker 2: you know, the problem in the first place. So she
44:38
Speaker 2: identified a real lack of clarity about what was being
44:44
Speaker 2: diagnosed here. She also pointed out that they weren't defining
44:51
Speaker 2: either the cause or whether the treatment would would actually
45:00
Speaker 2: you know, be successful in these complicated cases, or for
45:05
Speaker 2: how long you would treat children. None of these things
45:08
Speaker 2: were being clarified. And lastly, there was a real lack
45:13
Speaker 2: of follow up. That these children were not being followed up,
45:17
Speaker 2: so you didn't know what was going to happen. You
45:21
Speaker 2: knew that there were some children who were detransitioning who
45:27
Speaker 2: five or six years later were saying, I made a
45:30
Speaker 2: horrible mistake and they had stopped their hormone treatment. Of course,
45:40
Speaker 2: some of them had already had surgical interventions and couldn't
45:46
Speaker 2: go back. You can't go back from a mistake. To me,
45:50
Speaker 2: you can't go back from growing a beard. You know.
45:55
Speaker 2: You can't go back from you know, being castrated, to
46:01
Speaker 2: a normal sex life. You know that that was true.
46:05
Speaker 2: So she noted this lack of follow up and that
46:09
Speaker 2: they didn't know. Nobody knows to this day how many
46:13
Speaker 2: detransisions there are. There's certainly hundreds of thousands on online groups,
46:22
Speaker 2: if you take internationally, we don't know how many. So
46:28
Speaker 2: all of these things meant that you weren't even you know,
46:35
Speaker 2: assessing properly. You didn't have the tools or the follow
46:40
Speaker 2: up to assess these children. So I think that was
46:44
Speaker 2: another strength to point out the other negative side of this.
46:50
Speaker 1: I've heard just sort of little snippets over the past
46:53
Speaker 1: several months of saying, well, the cater re view didn't
46:56
Speaker 1: go far enough. Is that what you mean by that?
47:00
Speaker 1: Is there more to it? That are some other weaknesses
47:03
Speaker 1: that we should be aware of.
47:05
Speaker 2: I think it might actually be worth cass does not
47:11
Speaker 2: really go into the questions of why this particular group
47:17
Speaker 2: of adolescents were being referred in, why this new cohort
47:23
Speaker 2: was being referred in. But she did hazard some ideas.
47:28
Speaker 2: I remember, this is a medical report about a service,
47:32
Speaker 2: so she doesn't get very far. But if I could
47:36
Speaker 2: just read out what she does say, it gives you
47:39
Speaker 2: an idea of the fact. She was aware that there
47:43
Speaker 2: were issues outside of the actual service that we're influencing this.
47:51
Speaker 2: So she said, well, I can't be sure, but I
47:54
Speaker 2: think that there could be a biological predisposition. Got doctors
48:01
Speaker 2: love to say that there must be some kind of
48:03
Speaker 2: biological predisposition, genetic predisposition, So that's kind of almost obligatory.
48:09
Speaker 2: I think we can ignore it. She said, early childhood
48:13
Speaker 2: experiences sexuality in other words, with the UK lesbian or bisexual,
48:21
Speaker 2: and expectations of puberty. You know, probably once expectations of
48:27
Speaker 2: puberty were frightening orful lot of children. And then she
48:32
Speaker 2: said for some, of course, the mental health influences were
48:38
Speaker 2: hard to disentangle. And then she says the impact of
48:42
Speaker 2: a variety of contemporary societal influences and stresses, including online experience,
48:51
Speaker 2: remain unclear. Pure influence also has a very powerful effect
49:00
Speaker 2: during adolescence. We know this that peer influence and adolescence
49:06
Speaker 2: are very very important. So she hints that obviously there
49:11
Speaker 2: are societal influences at play here, and probably there is
49:17
Speaker 2: peer group influence in particular, and that's where she leaves it.
49:24
Speaker 2: But of course what's really striking, right, you know, for
49:30
Speaker 2: anyone sort of looking at this period, these teenagers are
49:35
Speaker 2: being referred from two thousand and fifteen, right. And then
49:40
Speaker 2: I don't know if many of you may remember, back
49:44
Speaker 2: to two thousand and fourteen, the BBC ran a very
49:48
Speaker 2: very interesting documentary. It was the first time that they
49:54
Speaker 2: had touched on the subject, and there was a documentary
49:58
Speaker 2: called I Am Leo and I can't remember actually what
50:05
Speaker 2: he was. Originally I think he was Lucy, but might
50:09
Speaker 2: have got that wrong. But basically it was all about
50:12
Speaker 2: a young boy who was at that time twelve, who
50:17
Speaker 2: was in the process of being advised about trans transitioning
50:25
Speaker 2: his sex from being a girl to being a boy.
50:32
Speaker 2: And he was being advised by the Tavistock Clinic down
50:37
Speaker 2: in London, of course, so that was the first inkling
50:42
Speaker 2: of this being a broader discussion, if you like, in society.
50:48
Speaker 2: And then hey, presto. In two thousand and fifteen stone
50:54
Speaker 2: Wall add the t to LGB, so it adds transgenderism
51:04
Speaker 2: onto lesbian, gay and bisexual and transgender to its remit okay,
51:14
Speaker 2: and it turns itself into a transgender activist group. So
51:22
Speaker 2: that is extremely important. That spawns the emergence of a
51:28
Speaker 2: number of transgender activist organizations and charities, you know, charities
51:36
Speaker 2: like Mermaids and others, innumerable charities, and of course in
51:41
Speaker 2: Scotland LGBTU Scotland. And in addition to that, because Stonewall
51:51
Speaker 2: has such wide influence, following years and years of fighting
51:56
Speaker 2: for equality for get gay, lesbians and bisexuals, it had
52:03
Speaker 2: set up huge networks of people who were one over
52:08
Speaker 2: you know, at all levels government and everybody had been
52:13
Speaker 2: one over to supporting the rights of gays, lesbians and bisexuals,
52:21
Speaker 2: and gosh it has used those networks, extensive networks, to
52:29
Speaker 2: the effect of being transgender activists. So not surprisingly, gender
52:39
Speaker 2: ideology and transactivism has spread very, very widely in a
52:45
Speaker 2: very short space of time. We're talking about twenty and fifteen,
52:51
Speaker 2: you know, less than ten years, and of course around
52:57
Speaker 2: that time, round about this time, I'm twenty and fourteen,
53:01
Speaker 2: twenty and fifteen, the Tavastock and the Sandyford Clinics to
53:11
Speaker 2: national services adopt affirmative gender care. So you can really
53:22
Speaker 2: see that the background to the emergence of this new
53:28
Speaker 2: cohort of young people being referred has been enormously influenced
53:34
Speaker 2: by transgender activism. And I think, you know, that's that's
53:44
Speaker 2: a that's a very important thing. Perhaps I don't know,
53:48
Speaker 2: I could come onto the whole question of whether gender
53:53
Speaker 2: inconcruence or gender dysphoria is actually a reputable dieosis.
54:01
Speaker 1: I have a basic knowledge of psychology and the DSM
54:06
Speaker 1: and kind of DSM terms change over the years and things,
54:10
Speaker 1: and so I guess is that a relatively new DSM
54:14
Speaker 1: term or has that been around for a while.
54:17
Speaker 2: It's fairly new. I think this was the other weakness
54:21
Speaker 2: in a CAST report that people have pointed to the
54:26
Speaker 2: fact that some people would actually argue, in fact, a
54:30
Speaker 2: lot of feminists argue that gender dysphoria or incongruence doesn't exist, right,
54:37
Speaker 2: it's just, you know, a figment of young people's imagination
54:43
Speaker 2: and a figment of transgender activists imagination. I think that's
54:48
Speaker 2: slightly wrong though, because CAST does so the fairly unquestioning
54:57
Speaker 2: accept that there is such a thing as gender dysphoria
55:02
Speaker 2: or gender incongruence. But of course accepting that means that
55:09
Speaker 2: you also have to in a way accept a lie, right,
55:15
Speaker 2: the lie that you can actually be in the wrong body,
55:21
Speaker 2: that you can in fact be a boy and a
55:25
Speaker 2: girl's body, or a boy in a girl's body. And
55:30
Speaker 2: it means accepting. If you accept that gender dysphoria is
55:34
Speaker 2: a diagnosis which can then be treated medically or through psychotherapy,
55:43
Speaker 2: you are accepting the other aspect of you know, of
55:47
Speaker 2: that that you can you know, transform your sex, which
55:52
Speaker 2: of course you can't, right. You can certainly adopt the
55:57
Speaker 2: secondary sexual characteristics through hormone treatment and gender realignment, so
56:04
Speaker 2: you can, but you know, you cannot say that you know,
56:08
Speaker 2: a transgender man is a woman, you know, or a
56:14
Speaker 2: transgender woman is a man. That's nonsense. You have a
56:18
Speaker 2: masculinized woman or a feminized man. But to some extent,
56:27
Speaker 2: by sort of accepting the terms of a psychiatric diagnosis,
56:33
Speaker 2: you are in some ways pandering or allowing yourself to adopt,
56:42
Speaker 2: you know, what is essentially a scientific untruth. But be
56:48
Speaker 2: that as it may, it's worth remembering that gender dysphoria
56:55
Speaker 2: isn't the only psychiatric condition, which is a bit do
56:59
Speaker 2: be right, you see, if you have a medical condition,
57:04
Speaker 2: and do you have a medical patient come to you
57:07
Speaker 2: with symptoms, right, just just say they'll often be very
57:13
Speaker 2: general symptoms, very very you know, well obviously they're they're
57:23
Speaker 2: very real to you, but nevertheless they're you know, self
57:28
Speaker 2: if self generated symptoms.
57:30
Speaker 1: Right.
57:31
Speaker 2: So it can be tiredness, it can be pain in
57:35
Speaker 2: various places, it can be lethargy, you know, it can
57:40
Speaker 2: involve all sorts of physical manifestations, right, And so what
57:45
Speaker 2: doctors have to do is they will look at the symptoms,
57:49
Speaker 2: but they will then have to look for signs, right,
57:53
Speaker 2: They'll have to examine signs, objective evidence for what might
57:59
Speaker 2: lead them to a diagnosis. So they will do a
58:03
Speaker 2: full examination, examine, examine all the painful bits or whatever,
58:08
Speaker 2: examine all the swollen bits or whatever. It is a
58:11
Speaker 2: physical examination. They'll measure blood pressure and so forth. Then
58:17
Speaker 2: they'll do blood tests or urine tests. They'll then take
58:22
Speaker 2: tissue samples and so forth, and they will get the
58:26
Speaker 2: results of these investigations or how evidence signs and fit
58:32
Speaker 2: them into a pattern, a disease pattern that has actually
58:37
Speaker 2: been if you like, developed through research, right, so through research,
58:42
Speaker 2: you can define a problem of diabetes, say, and it
58:46
Speaker 2: will have these characteristics, and you'll do those tests and
58:51
Speaker 2: you'll arrive at a diagnosis. But things don't work like
58:56
Speaker 2: that in psychiatric diagnoses, right. You get symptoms, you get
59:03
Speaker 2: self reported symptoms, which again could be of a very
59:08
Speaker 2: general nature, could apply to any number of different psychiatric conditions,
59:16
Speaker 2: but you don't rarely have means of testing for these.
59:23
Speaker 2: You know, there are no objective tools that you can
59:26
Speaker 2: use to make this diagnosis. So what's happened in psychiatry
59:33
Speaker 2: is that you have got a committee of experts in
59:39
Speaker 2: this particular field or whatever that has sat down and defined,
59:45
Speaker 2: if you like, behavioral evidence of certain conditions, and they
59:52
Speaker 2: will arrive at a diagnostic ellict of criteria that you
59:58
Speaker 2: will need to meet for a psychiatric diagnosis. But of course,
1:00:05
Speaker 2: when you have something like that that cannot be really objectively.
1:00:11
Speaker 2: You cannot find a biological cause, if you like, for
1:00:15
Speaker 2: the problems, and I mean I don't think you've got
1:00:20
Speaker 2: time to sort of go into that, but you can't
1:00:23
Speaker 2: really find really objective measures of most of these things.
1:00:28
Speaker 2: So you've had international experts set up these frameworks. Of course,
1:00:34
Speaker 2: that makes it very liable to expansion. So when DSM,
1:00:40
Speaker 2: which is the American system a Diagnostic and Statistical Manual
1:00:45
Speaker 2: of Mental disorders, when it's set up originally, it has
1:00:50
Speaker 2: a very sort of narrow range of problems that perhaps
1:00:54
Speaker 2: a maximum of about one hundred I think with DSM
1:00:57
Speaker 2: two or three, But of course it's and didn't expanded
1:01:01
Speaker 2: and expanded, so by the time you get to d
1:01:03
Speaker 2: s M five, which is a fifth edition, it has
1:01:07
Speaker 2: over four hundred different psychiatric problems, huge range of problems,
1:01:13
Speaker 2: one of which in the new d s M five
1:01:18
Speaker 2: is gender dysphoria. And and you know it defines what
1:01:23
Speaker 2: what what this you know the problem is or or
1:01:28
Speaker 2: gender incongruence. I'm using d s M five. There is
1:01:33
Speaker 2: there is another international system which operates in the same way,
1:01:39
Speaker 2: an international panel of experts on all the different disorders,
1:01:46
Speaker 2: and it's put out by the World Health Organization. It's
1:01:50
Speaker 2: called the International Classification of Diseases and it's nine and
1:01:55
Speaker 2: eleventh edition. Okay, it's used more often in the UK then,
1:02:03
Speaker 2: but certainly the DSM is more influential, certainly when it
1:02:08
Speaker 2: comes to such psychiatry, and certainly when it comes to
1:02:13
Speaker 2: gender dysphoria, so that most of the papers that Cass
1:02:17
Speaker 2: examined would have actually been you know, the diagnosis would
1:02:23
Speaker 2: have been made under DSM. But even that's changed because
1:02:26
Speaker 2: ds M four still had uh, gender gender dysphoria as
1:02:36
Speaker 2: a as a problem, so it was called gender dysphoric disorder,
1:02:43
Speaker 2: so it was considered a disorder. They've dropped the disorder
1:02:46
Speaker 2: side of it and they just call it gender dysphoria,
1:02:51
Speaker 2: and they then define what it is, and they they
1:02:57
Speaker 2: will define it as what what they call a marked
1:03:01
Speaker 2: incongruence between one's express gender and one's assigned gender. Now
1:03:10
Speaker 2: already you will recognize a very very well known transgender
1:03:16
Speaker 2: activist trope Trope there right, because of course, the transgender
1:03:22
Speaker 2: activists argue that when we are born, we're assigned a gender,
1:03:28
Speaker 2: you know, just as if it's some kind of arbitrary
1:03:31
Speaker 2: judgment made by health profession actually love sensitive saying you're
1:03:40
Speaker 2: in an assigned sex, which all of us are pretty
1:03:45
Speaker 2: much about from them, the tiniest fraction of people. Yes,
1:03:53
Speaker 2: so there's this disjunction between a. Cass actually also does
1:03:58
Speaker 2: but she does make the point that it's you know,
1:04:04
Speaker 2: you're not assigned a gender you are a recorded gender
1:04:10
Speaker 2: actually makes that conception anyway, that's just beside the point.
1:04:14
Speaker 2: So you get this marketing concruence between your expressed gender
1:04:19
Speaker 2: and assigned gender, manifested by a strong desire to be
1:04:25
Speaker 2: rid of one's secondary sexual characteristics, or a strong desire
1:04:30
Speaker 2: to prevent the development of the anticipated secondary sex characteristics,
1:04:38
Speaker 2: or a strong desire to be the other gender, or
1:04:42
Speaker 2: a strong conviction that you have the typical feelings and
1:04:47
Speaker 2: reactions of the other gender. I mean, whatever the typical
1:04:53
Speaker 2: feelings and reaction of the other gender may be. I mean,
1:04:56
Speaker 2: I haven't a clue about the male side of this,
1:04:59
Speaker 2: But anyway, there we go, and they do make the
1:05:04
Speaker 2: point it has to be associated with clinically significant distress,
1:05:11
Speaker 2: now that I see. D eleven, by the way, doesn't
1:05:14
Speaker 2: even need distress to make the diagnosis. It just needs
1:05:19
Speaker 2: this incongruence between your expressed gender and your assigned gender.
1:05:28
Speaker 2: So you say to yourself, well, what's incongruence. Well, it's
1:05:33
Speaker 2: simply a mismatch, isn't it. That's all it can mean
1:05:37
Speaker 2: as some kind of mismack. And what does a strong
1:05:41
Speaker 2: desire mean? I mean, how can we measure it? You know?
1:05:46
Speaker 2: You can't. It's immeasurable because it's a wholly subjective experience.
1:05:54
Speaker 2: And as I say, how can you know what the
1:05:56
Speaker 2: feelings and reactions of the opposite sex are? And then
1:06:02
Speaker 2: what is significant distress? How do you measure it? Again,
1:06:07
Speaker 2: it's wholly subjective and the circular reasoning involved here as well. Right,
1:06:17
Speaker 2: So I could say, how do you make the diagnosis? Well,
1:06:24
Speaker 2: you use these features that are stipulated by the expert panel.
1:06:29
Speaker 2: You use those features to make the diagnosis. And then
1:06:33
Speaker 2: you could say, well, how do you know somebody has
1:06:38
Speaker 2: gender dysphoria? Well, they show these features. So you see
1:06:45
Speaker 2: the kind of the circularity of the argument. Anyway, this
1:06:49
Speaker 2: applies to a majority of psychiatric conditions. As it happens,
1:06:55
Speaker 2: you could make the same case, but particularly the case here.
1:07:00
Speaker 2: So then it raises question, well, are the people who
1:07:04
Speaker 2: say gender dysphoria just doesn't exist? Are they right? I mean,
1:07:09
Speaker 2: does it simply amount to these comorbid features, or is
1:07:15
Speaker 2: it an anxiety related thing that relates to fears about
1:07:21
Speaker 2: your body, you know, something like a body dysmorphic disorder.
1:07:30
Speaker 2: I would say no, I would say the thing that
1:07:33
Speaker 2: really gives gender dysphoria a material reality is affirmative gender care.
1:07:46
Speaker 2: You see, that is what actually makes gender dysphoria a
1:07:53
Speaker 2: material reality. That a child or a young person will
1:07:59
Speaker 2: have hormones, whether to block puberty or to go on
1:08:05
Speaker 2: to cross sex women's hormones that will have an absolutely
1:08:09
Speaker 2: material effect on their bodies for the rest of their lives,
1:08:15
Speaker 2: and surgical interventions that make us strengthen them or give
1:08:21
Speaker 2: them as steptams. That gives gender dysphoria its material reality.
1:08:30
Speaker 2: So it's a subtle argument to make, because I've already
1:08:36
Speaker 2: said that you discredited if you like, the diagnosis of
1:08:41
Speaker 2: gender dysphoria, But it is the one condition in the
1:08:46
Speaker 2: DSM five that actually involves treatment. Many of the psychiatric
1:08:55
Speaker 2: conditions involve you know, treatment with drugs, you know, four
1:09:00
Speaker 2: different periods of time. But this is the one condition
1:09:05
Speaker 2: in the DSM five where you have not just drug treatment,
1:09:12
Speaker 2: you have hormonal treatment which transforms bodies with lifelong impacts,
1:09:19
Speaker 2: and you have surgical interventions which transformed bodies with huge
1:09:26
Speaker 2: side effects for the rest of their lives.
1:09:28
Speaker 1: That is quite profound. Thank you for that. That's a
1:09:31
Speaker 1: really that's a very thought provoking explanation, but it actually
1:09:37
Speaker 1: helps me a bit. Hopefully it helps the viewers as well.
1:09:41
Speaker 1: Just to wrap up here, we're almost out of time unfortunately,
1:09:45
Speaker 1: but if you I always like to maybe try to
1:09:48
Speaker 1: leave viewers with either a bit of hope or maybe
1:09:53
Speaker 1: a bit of action that they can take to make
1:09:56
Speaker 1: sure that their children and grandchildren other children in their
1:10:00
Speaker 1: lives are protected. Is there any sort of some positivity
1:10:07
Speaker 1: that you can maybe leave us with for today?
1:10:10
Speaker 2: I think to start with the CAST Report is very important.
1:10:14
Speaker 2: It's a kind of a reach to thing. Right. You
1:10:19
Speaker 2: say you're a transgender activist that oh, there's every kind
1:10:25
Speaker 2: of evidence that you will save children and young people's
1:10:30
Speaker 2: lives if you put them through a transition program. You
1:10:35
Speaker 2: know that that in fact it will it will put
1:10:41
Speaker 2: transgender children at risk if they don't get these sort
1:10:45
Speaker 2: of treatments. Well know the CAST Report, right, everybody can
1:10:51
Speaker 2: reach for that and say, look, this is the best
1:10:54
Speaker 2: evidence we have that there's no evidence to support this.
1:11:01
Speaker 2: And the other thing, which I think is a very
1:11:03
Speaker 2: very positive thing is I think the CASTS Report has
1:11:08
Speaker 2: enabled us to see things like the complete novelty of
1:11:14
Speaker 2: the new cohort of people. So we need to actually
1:11:20
Speaker 2: say no gender affirming approaches are absolutely should be off
1:11:28
Speaker 2: the record, right, we shouldn't have anything to do with them,
1:11:33
Speaker 2: and therefore I think what the starting point should be
1:11:36
Speaker 2: for parents is to question what's happening in schools. Right
1:11:43
Speaker 2: in Scottish schools there are teachers who are accepting children's
1:11:49
Speaker 2: diagnosis and are transitioning these children socially. Now, Cass couldn't
1:11:56
Speaker 2: be absolutely sure one way or the other about social transitioning,
1:12:01
Speaker 2: but there is no doubt at all that children who
1:12:03
Speaker 2: do socially transition in school will land up on one
1:12:07
Speaker 2: of these waiting lists for gender identity services. So we
1:12:13
Speaker 2: need to oppose that and we can do that right
1:12:17
Speaker 2: because there is no way that teachers who are completely
1:12:23
Speaker 2: unqualified should be involved in something which is going to
1:12:27
Speaker 2: have medical repercussions. So we must campaign as parents and
1:12:35
Speaker 2: as grandparents against schools having anything to do with transision
1:12:42
Speaker 2: transitioning children and get very very angry if it's happened
1:12:49
Speaker 2: behind our backs, which is the case that it has happened.
1:12:54
Speaker 2: So I think more and more is to try and
1:12:59
Speaker 2: have the courage of if you like, the CAST report,
1:13:04
Speaker 2: and to have the courage to challenge where our children
1:13:09
Speaker 2: are being exposed to these dangers. So I think certainly,
1:13:16
Speaker 2: if Sue has been able to get together groups of parents,
1:13:20
Speaker 2: we've begun to start this challenge. It's a difficult thing
1:13:24
Speaker 2: because no parent wants to put themselves out on the
1:13:28
Speaker 2: limits of troublemaker or whatever. Nevertheless, collectively, I think we
1:13:34
Speaker 2: can do a great deal to try and reverse this
1:13:37
Speaker 2: sort of thing. I think we can campaign against transactivists
1:13:42
Speaker 2: being allowed into schools. I think that should be a
1:13:46
Speaker 2: very central part and something that everybody can join through
1:13:49
Speaker 2: social media, through writing, through popularizing opponents of this ideology,
1:14:02
Speaker 2: and just remembering, you know, we're not against you know,
1:14:09
Speaker 2: people have taken that decision as adults. Right, people have
1:14:13
Speaker 2: taken that decision. That's fine. I think all of us
1:14:16
Speaker 2: will be right at the forefront to say they should
1:14:19
Speaker 2: have equal rights, you know, as everybody else in society
1:14:25
Speaker 2: should be protected from any kind of bullying or anything
1:14:30
Speaker 2: anything deleterious because of their status. But it's a totally
1:14:35
Speaker 2: different question when it comes to young people and children,
1:14:40
Speaker 2: and there I think again i'd put the emphasis rarely
1:14:47
Speaker 2: on starting with schools and starting to get other parents
1:14:53
Speaker 2: together and they can be armed with you know, information
1:14:59
Speaker 2: and ideas to the people out there goodness sake, research
1:15:04
Speaker 2: the issue, see what's happening in your area, See what
1:15:08
Speaker 2: you can do about counteracting the ideology, and see if
1:15:15
Speaker 2: you can actually pick up a campaign or start forming
1:15:20
Speaker 2: a campaign yourself to clear the stuff out of schools
1:15:25
Speaker 2: where I think is the real problem starts, but also
1:15:29
Speaker 2: from Himber carries on in universities and colleges. It can
1:15:34
Speaker 2: be very difficult in that climate to challenge people have
1:15:39
Speaker 2: paid a heavy price, I think for challenging it. But nevertheless,
1:15:46
Speaker 2: the more of us that do it, the more of
1:15:48
Speaker 2: us that take a stand and support people who are
1:15:52
Speaker 2: being threatened with cancelation for these views. I think there's
1:15:58
Speaker 2: everything to everything to play for, and everything to win.
1:16:03
Speaker 2: Now come back to the fact the cast has given
1:16:06
Speaker 2: us a good basis on which to challenge some of
1:16:11
Speaker 2: these ideas.
1:16:13
Speaker 1: Thank you, Yes, I completely agree we have to stand up.
1:16:18
Speaker 1: I have stood up. I have paid that with my
1:16:21
Speaker 1: own cancelation from my own profession, but I certainly would
1:16:25
Speaker 1: never look back, and at least I can sleep better
1:16:29
Speaker 1: at night knowing that I am standing up for the
1:16:32
Speaker 1: right people for the right reasons. Then thank you for
1:16:35
Speaker 1: being part of that, along with the rest of us
1:16:37
Speaker 1: who are doing what we can. Doctor Kenny, I want
1:16:40
Speaker 1: to thank you so much today for your time and
1:16:42
Speaker 1: your expertise and your insights. It's been really helpful and
1:16:46
Speaker 1: I believe this we will all learn a lot from
1:16:48
Speaker 1: what you've shared with us today, So so thank you again.
1:16:51
Speaker 2: It's a pleasure, it's being a pleasure. Thank you.