Ireland has seen a surge
Golly, look what RTÉ has just broadcast and published:
Leading doctors report HSE to HIQA over transgender care
The two most experienced clinicians involved in transgender healthcare in Ireland have made a formal complaint to the Health Information and Quality Authority (HIQA) about the Health Service Executive’s (HSE) treatment of children with gender identity issues, Prime Time has learned.
Professor Donal O’Shea and psychiatrist Dr Paul Moran of the National Gender Service (NGS) allege that the HSE has been directing children to services overseas that adhere to a so-called ‘gender-affirming’ Model of Care.
Prof O’Shea and Dr Moran say that the gender-affirming model can damage children and is associated with a greater readiness to start on inappropriate medical treatment for patients presenting with gender identity issues.
How very interesting.
What we’re supposed to think, you know, is that being trans is a wonderful thing, and that no one should be discouraged or slowed down from embracing it. We’re supposed to think it’s only social disapprobation that makes being trans less than fun, and if only everyone everywhere embraced it like a long lost puppy, all would be peaches and cream.
Ireland, along with other countries, has seen a surge in cases of gender-questioning adults and especially children in recent years.
A Children’s Ombudsman survey last year of children aged 12-17 suggests that one in 25 identifies either as non-binary or as being a gender different to their biological sex.
Good god. That’s a lot.
How these children should be treated is at the core of the dispute which is often heated.
The gender-affirming Model of Care, favoured by transgender activists and some clinicians internationally means accepting a patient’s own view of their gender identity.
This approach is supported by World Professional Association for Transgender Health (WPATH), an organisation made up of both activists and clinicians specialising in trans healthcare. The WPATH model is supported by the Irish Government.
I wonder how separate the clinicians who specialize in trans healthcare are from the activists and their activism – in other words I wonder how activist those clinicians are. My guess is more than zero%.
Dr Moran and Prof O’Shea argue that an exploratory Model of Care based on “probing assessment” should be used. They argue that this approach has a stronger role for psychiatry and is more comprehensive and safer.
Niamh Ní Féineadh from Trans Healthcare Action says that instead of causing harm, the gender-affirming model relieves distress for those needing healthcare.
Circular, mate. How do we know those needing healthcare do need healthcare? How do we know they “need healthcare” in the form of gender affirmation? We don’t. That’s the point.
Ms Ní Féineadh supports a gender-affirming model of care over an exploratory model.
“The patient-centred gender-affirming model means that doctors, patients and their parents should work together as a team. They should have a trust relationship. They should understand the patient’s needs at any one given moment,” she said.
The doctors should then present the treatment options and information to the patient, she said.
“The patient should be supported in whatever decision that they make. It’s kind of like supporting a child who wants to learn a language or an instrument,” she said.
Yeah no it’s not. It’s not like that at all. It’s not remotely like that. Learning a language or an instrument pretty much never does anyone any harm. It certainly never alters their bodies in drastic ways that can never be fully undone. It may bore them or tire them but that’s pretty much the worst that can happen. Trying to change sex via surgery and/or hormones? Not so much.
For adults to be referred for gender confirmation surgery in Ireland through the NGS, up to three further interviews can take place, she said.
“Those are very in-depth, and they talk in very specific and graphic detail about your sex life, what sex acts you enjoy, and how the surgery is going to impact those…That depth of conversation is unnecessary.”
“What other medical procedure do you have multiple in-depth interviews before you proceed with it? Do you have an in-depth interview with a clinical psychologist before you get an appendectomy?” she asked, describing as a “pathologising of transgender healthcare.”
But trying to change someone’s sex isn’t a “medical procedure.” It’s quackery intended as a kind of psychic or mental procedure, but it entails ruining the body. Trying to change someone’s sex is in no way like an appendectomy unless the patient has no need of an appendectomy – in which case it’s stark malpractice. Refusing to ruin a patient’s body, not so much.
Prime Time understands that the complaint made by Dr Moran and Prof O’Shea highlights concern over a clinic in Belgium and England’s Gender Identity Development Service (GIDS) based at the Tavistock and Portman NHS Foundation Trust in London, where clinicians generally follow a gender-affirming Model of Care.
Ah good – the Tavistock is internationally famous for its destructive haste in these matters. What an accolade.
The Tavistock was shut down for new referrals last year, leaving children in need of specialist gender assessments in the lurch. Children already being treated by the Tavistock continue to receive treatment there.
The closure of the Tavistock to new patients came after reviews by the Care Quality Commission (CQC) and paediatrician Dr Hilary Cass revealed unsatisfactory levels of care and a service overstretched by a 26-fold increase in referrals from 136 in the year to March 2011 to 3,585 in the year to March 2022.
The Cass review found that some Tavistock staff felt “under pressure to adopt an unquestioning affirmative approach and that this is at odds with the standard process of clinical assessment and diagnosis that they have been trained to undertake in all other clinical encounters.”
In other words just the approach Ms Ní Féineadh assures us is the only right one. Quick, slice out those genitals before she/he changes her/his mind.
Funnily enough, I did have several, in-depths conversations about my hysterectomy, with a great deal of choice which is why I had to have two operations. With pre-cancerous tumours on both ovaries, it was vital that the surgeon remove as much of the ovaries as possible, and I was the one who – after a couple of decades of endometriosis, agonising and prolonged periods, and already having five children from increasingly fraught pregnancies – asked if the uterus could be removed at the same time. I also asked that as much ovary as was possible and safe be left in situ, so that I wouldn’t have to have a sudden early menopause (I was 37). The surgeon managed to rescue much of my left ovary, but none of the right. As it happens, I became menopausal anyway; and, within the year, there were tumours on the remaining ovary and I had to have that removed too. Both operations were difficult, as was a previous one to fix a uterine retroversion, owing to a large amount of scar tissue on all my internal organs (from the endometriosis) and my as-yet-undiagnosed heart and connective tissue disorders. It was a hellish couple of years, made bearable only because, having lost an aunt and a great-aunt to ovarian cancer, I wanted the chance to live!
The fact that these people understand that holding multiple, lengthy discussions concerning a future sex life with children is wildly inappropriate, but refuse even to consider that making that future sex life difficult-to-impossible without any warning is even worse, is horrifying.
And this is what trans identifying people themselves are told they should believe, to push down their doubts and unease and stay the course.
No surprise when transness has become flavour of the
monthyeardecadeand captured media publicizes, celebrates, and valourizes “transness” without any real mention of the physical and emotional costs. “HEY KIDS, HERE’S YOUR CHANCE TO BE CENTERED, SPECIAL, BRAVE AND STUNNING! YOU GET A NEW NAME, YOUR OWN FLAG, A MILLION SPECIAL COMMEMORATIVE DAYS, AND A SHOUT-OUT ON DR. WHO!” With the intensity of the publicity and media attention given to what amounts to a recruitment drive, I’m surprised the number isn’t higher.Never ask a barber if you need a haircut, or a plastic surgeon if your nose is too big. It’s not in their interests to say “No.”
But is your support neutral? Or are you hyping one direction in particular? The fact that you’re downplaying the seriousness and permanence of the path being offered tells me “No.”
It might be if you’re never going to be able to enjoy some of those sex acts ever again. Not doing this would deprive the patient of vital information. Why do you want to do that? Are you afraid that on hearing the truth, they’ll change their minds and decide not to get the haircut or nosejob you’re offering? Do you want informed consent or not? Exactly whose interests are you serving?
You numpty. The exploratory model of care also requires the interested parties to work as a team, under a fiduciary duty of trust. They should all understand the patient’s needs, not just at the present moment of mental distress, but also be mindful of future moments, when the patient’s needs are bound to be quite different. The doctors should then present the real, the practical, and the medical treatment options and information, including the honest truth that changing one’s sex is literally impossible, the high rate of surgical complications, the probability of lifelong painful surgical care, the lifelong consequences of so-called “transition” “treatments,” and the myriad deleterious effects on overall health, not just sexual activity. It’s hard to “have a trust relationship” with people who tell you lies.
Well, quite. Show me a house with children and I will almost certainly show you a house with a recorder; guitar; keyboard; maybe a violin hidden away at the back of a closet or wardrobe: Or maybe I’ll show you a pile of first-stage foreign language tutorial books, neatly boxed and consigned to the loft. What I will very rarely show you is a piano virtuoso or a concert violinist or a fluently tri-lingual teen.
Books and instruments are easy to stuff away when the kids realise that their interest wasn’t that great, after all; more a passing phase because their friends were doing it and they made it sound so cool. Far trickier to discard those freshly mutilated bodies, though.
Brilliant analogy.
Thank you.