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We have legal age limits for driving, voting, and having sex, why not for transgender treatment?

Tomasz Pierscionek
Tomasz Pierscionek
is a medical doctor and social commentator on medicine, science, and technology. He was previously on the board of the charity Medact and is editor of the London Progressive Journal.
is a medical doctor and social commentator on medicine, science, and technology. He was previously on the board of the charity Medact and is editor of the London Progressive Journal.
We have legal age limits for driving, voting, and having sex, why not for transgender treatment?
Vulnerable children and adolescents are being influenced by PC culture that elevates rights over responsibilities, teaches children there are over 100 genders, and where a fear of offending others trumps common sense.

Western democracies preach tolerance and require its citizens to accept progressive ideas; the more unconventional the better. A particular idea or course of action may even go against common sense and lead to harm, yet an overriding fear of causing offence or being labelled a [insert blank]-phobe thwarts open discussion about important issues. 

There are, however, those who speak out and remind us to think carefully about embarking down a slippery slope from which it is difficult to return.

Susan Evans, a mental health professional and former employee of the UK’s only Gender Identity Development Service (GIDS), is asking the High Court to undertake a judicial review and raise the age at which individuals can consent to receiving puberty blockers and cross-sex hormones to 18. Ms Evans is joined by the parent of a 15-year-old adolescent on the GIDS waiting list. 

Although individuals in the UK cannot undergo gender reassignment surgery until the age of 18, children and teenagers suffering from gender dysphoria (uncomfortable feelings brought on by a person’s gender identify differing from their birth sex) may receive medications to slow the onset of puberty and thus delay development of physical characteristics associated with their undesired sex. Later, from the age of 16, either testosterone or oestrogen (cross-sex hormones) are given to help an individual’s physical characteristics better align with those of their preferred gender identity.

Evans wants to raise the age of consent for children with gender identity issues receiving puberty blockers and other cross-sex hormones on the basis that under 18s are unable to provide informed consent for potentially life changing procedures. The former nurse expressed concerns that children, some aged as young as nine, are too hastily prescribed puberty blockers, reportedly the first step on the path towards gender reassignment.

Evans commented: “It’s about informed consent. Under [18s], we don’t think, are sufficiently mature enough to consent to a treatment that is going to potentially affect their adult life, because they go on a pathway. They start the blockers and then they go on the cross-sex hormones. [The trust’s] own research shows that virtually 100% of children they started on the blockers go on to the cross-sex hormones.”

She added“My experience with staff is that they’ve become fearful of doing anything that disagrees with a patient. The important thing in mental health work is to keep an open mind, it’s not to jump to the same conclusion that your patient comes to.”

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It is worth noting that across the pond in the US, the state of South Dakota recently passed a bill making it illegal for medics to provide gender reassignment surgery or hormone therapy to minors. Similar bills could also be introduced across a number of other US states.

Puberty is confusing at the best of times, we’ve all been there. No one doubts that children and teenagers are more susceptible to external influence than adults and are less capable of considering the future impact of major decisions. Granted, there are exceptions to the rule but it’s safe to say that on the whole adolescents lack knowledge, life experience, forward planning, and an awareness of consequences in contrast to adults. That is partly why we have legal age limits for driving, voting, and having sex. The frontal lobes of the brain – those parts responsible for planning, self-regulation, exercising good judgement, and preventing unwise decisions – are not fully developed in children and adolescents. Evidence even suggests that the frontal lobes may not fully mature until the mid 20s.

An adult has the right to take cross-sex hormones after weighing up the pros and cons, and coming to an informed decision. Part of that right involves accepting the risks and possible regrets that may accompany their decision. Adolescents typically lack the maturity to commence treatments that interfere with their natural development, a decision they may later regret when they find themselves less physically and sexually developed than their peers. Those suffering from gender dysphoria should indeed be supported and offered psychotherapy to help them manage their distress. A rise in under 18s receiving puberty blockers and cross-sex hormones could be followed by a rise in medico-legal cases and compensation claims as those same individuals (now adults) later maintain they were insufficiently informed or were not mature enough to provide informed consent. In such cases lawyers would be the only winners.

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There has been an explosion in the number of under 18s referred to the GIDS, rising from 94 in 2009-2010 to around 2500 in 2018-2019. Of particular concern are reports that children as young as five have been referred. It is also likely that vulnerable children and adolescents are being influenced by a culture that elevates rights over responsibilities, teaches children that there are over a 100 genders, and where a fear of offending others trumps common sense. As it happens, due to the growing number of referrals, a child or teenager referred to GIDS today might have to wait until early 2024 for their first appointment, giving them plenty of time and opportunities to change their mind.

In the US the gender reassignment industry is now worth over $1.3 billion a year; cross-sex hormones and puberty blockers also provide American Big Pharma with a healthy windfall. It seems that both identity politics advocates and the pharmaceutical industry have a common interest; they wish to exert greater (socio-ideological or financial) influence over future generations. In the battle for profits and minds, neither group is going to step aside without a fight.

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The statements, views and opinions expressed in this column are solely those of the author and do not necessarily represent those of RT.

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