Oh look, a sharp rise in referrals
More on the no more puberty blockers news:
Children will no longer be prescribed puberty blockers at gender identity clinics, NHS England has confirmed. The government said it welcomed the “landmark decision”, adding it would help ensure care is based on evidence and is in the “best interests of the child”.
Makes you wonder why care wasn’t already based on evidence and in the best interests of the child.
It used to be widely understood that “in the best interests of the child” very very often meant “not what the child wants in the moment.” It used to be widely and well understood that children don’t always know what’s best for them. I still wonder how that understanding vanished so fast and thoroughly in so many people.
It follows a public consultation on the issue and an interim policy, and comes after NHS England commissioned an independent review in 2020 of gender identity services for children under 18. That review, led by Dr Hilary Cass, followed a sharp rise in referrals to the Gender Identity Development Service (Gids) run by the Tavistock and Portman NHS Foundation Trust, which is closing at the end of March.
In 2021/22, there were over 5,000 referrals to Gids, compared to just under 250 a decade earlier.
Wouldn’t you think that would alarm the people in charge? Wouldn’t you think they would pause to try to figure out why referrals skyrocketed like that? Wouldn’t you think they would not just assume it’s because a real need is at long last being met? Wouldn’t you think they would want to make sure they hadn’t simply created a market just as advertisers create markets for particular movies or shoes or cars? If you build it they will come along to get their bits cut off.
Two possibilities come to mind, and there are no doubt many others: 1. Someone has had a Eureka moment, or 2. Someone has realised that the game’s up, and that they’v all been sprung.
It didn’t help that they reified a poorly evidenced hypothesis that posits the existence of entities that nobody can locate or define. Anyone walking in the door of a place called the “Gender Identity Development Service” is going to have (or be duly issued) a “gender identity” that they will happily assist in “developing” for them. Barbers and haircuts. They’ve reached their conclusion before you’ve crossed their threshold. Saves time that way.
It never ceases to amaze me the rationalizing people do. People want moral certainty and simplicity, and that means they can’t bear to be seen to be challenging anything with a rainbow sticker stuck on it, because in a simple model of the world, only Bad People do Bad Things to the Rainbow People. The walls of fear and caution and panic I have had to dig around to get people to acknowledge — even in private, just one on one — some basic, obvious problems with pediatric “transition”…
It has made me realize that gay rights wasn’t primarily achieved through analysis and understanding, much of it happened through rote learning. Society didn’t come together and think the issue through and conclude that there’s no harm in homosexuality among consenting adults; rather, society was conditioned, like Pavlov’s dog, to associate challenging the Rainbow with future social punishment and shame. They simply memorized a rule: if you don’t get on board with the Rainbow’s demands, you risk finding yourself on the wrong side of history, sullied and shamed.
I can see it clear as day, that this is the calculus everyone’s doing. Not one fucking drop of critical thinking applied to the question of gay people’s well being, even as adolescent gay people’s bodies are being carved up. They’re hung up on the only question that matters to them: will I come out looking ok in this social shift? and they conclude that the safest bet is to just go with the flow and give the Rainbow whatever it wants. There’s an added rationalization, too, that this is “inside-the-rainbow” business — the Rainbow lobby is demanding this, and transition is being done to Rainbow people (set aside the circular logic there, that once you assign a child a trans identity you rationalize away your own responsibility because now they’re “one of them”), so the responsibility will ultimately land on the rainbow people themselves. Sort of like how many white Americans treat so-called Black-on-Black crime like it’s not their concern.
And that calculus has become so apparent to others — it’s become so obvious that a rainbow sticker is a license to do whatever the fuck you want — that people with malevolent intentions, or secret agendas or desires, or mental problems they’re running from, or just a yen to gain an edge or some social cred, have come flooding in, so much so that the Rainbow has swollen to ten times what it’s supposed to be. (Science says only about 2 to 3 percent of people are LGB, but upwards of a third of young people are now calling themselves “2SLGBTQQIA+”.)
My guess, and it’s only a guess, is that someone (or someones) very high up had been observing the whole trend with increasing disquiet and for years let it run hoping that the clinicians and mid-level administrators would have a come to Jesus moment and pull back. When that didn’t happen they sent in an adult to investigate (Cass), and are now cleaning up.
Rob, I think I’m just restating your point a slightly different way, but I suspect that there’s been a bit of a “to a man with a hammer, everything looks like a nail” situation.
Doctors who develop a specialty in trans medicine are going to be disposed to believe that (1) there is something “real” going on with their patients, and (2) there is something that medicine and/or surgical can and should do about it. I’m not even talking about people having ideological or monetary motivations here, just the ordinary human impulse to believe that what you do is important and effective.
In a medical profession where there are very few specialists in the field, and where the average GP maybe doesn’t even know where to begin, “watchful waiting” was probably an easy recommendation to follow, especially since patients weren’t likely to argue. But once every major hospital has a gender medicine practice group, and every doctor in the land has a list of referral options, that’s less likely to be the case, especially when patients and their parents are convinced that Something Must Be Done.
Meanwhile, the nonspecialists and high-level administrators are likely to shrug and say “I dunno, seems strange that there’s so many kids with gender dysphoria now, but I’m sure the Gender Medicine folks know what they’re doing.” Until finally the reasons to suspect that Gender Medicine isn’t policing itself become too big to ignore.
The rainbow has been stolen.
Arty, I think this is a really important point for the medium to longer term…
Already we’re seeing the homophobes in the Republican Party seeking to roll back hard won gains of the LGB community by lumping them in with the trans community. It’s not like they need much of an excuse to punish and discriminate at the best of times. If they can swing the mood of a generally unthinking populace, things could easily get really ugly again in the future.
To Arty’s point about the mechanism of change: It’s always been that way, no matter the subject. Whether we’re talking sexism, racism, classism, pseudoscience, religiosity, opposition to homosexuality, or whatever, what progress is made is not by means of critical thinking. It is by social pressure that people’s behavior changes, and along with it their professed beliefs. As we’ve observed, the more people profess a belief, the more they come to Believe it. Unfortunately, that belief develops independently of justification. It forms without justification aside from fear. The attitudes and intuitions that motivate the various bigotries and chauvinisms remain unaltered under the pleasant veneer of progress.
This neatly explains how people can consider themselves opposed to sexism and yet say manifestly sexist things, how they can be “antiracist” and yet be racist, for the rainbow and yet support the sterilization of confused gay boys. They still think like sexists, racists, and homophobes. It’s just that some of the final steps in their reasoning have a kludgy function call to look up socially approved ideas in a mechanical, rote way. If you can find a way to circumvent that additional line of code, you can see the real inner workings in all their ugliness.
@Nullius,
Yes. Well put. I agree entirely.
[…] a comment by Artymorty on Oh look a sharp rise in […]
Same, with the quibble that I think the social pressure can be a useful place to start, especially when the prejudice at issue has no real legs but is just habit or contagion or the like.
This is a really good discussion. Yer all on fire.
@Rob #7
That’s such a good and important point. I may have somewhat oversimplified my point about rote learning, but the greater point stands: we’re living in a time of broken “trust networks.” These are the channels that branch out from intellectual authorities to the masses on any given subject, which are important for the lay people who rely on the experts’ intellectual resources to know what to think on any given subject, because they themselves are busy applying their own intellects towards their own points of expertise in society.
Because of the cuture war, we’re seeing a split, in which a lot of lay people with their own busy minds focussed on some other aspect of human existence — maybe they’re farmers or clergymen or carpenters or accountants, whatever — these people should have a “trust network” connection to gay rights “authorities” who they can rely on to give them the digested “approved” views on homosexuality and gender nonconformity and their related ideas.
But because those gay authorities have become soured with gender nonsense, there are new “authorities” springing up to feed new ideas into the network, which threaten to inject new “digested, approved” ideas about gays — ones which aren’t so friendly to us.
One thing that’s always been obvious to me is that a lot of people change their minds (or maybe just their behaviors) after someone they know or admire comes out as gay. The more gay people came out of the closet, the more likely people were to recognize that they knew…and liked…people who were attracted sexually to individuals of the same sex. They often found it harder to dismiss the morality of the people they knew than those they had no connection with.
That’s what I fear trans is trying to do: trans so many people (especially kids) that pretty soon everyone will know someone trans, and decide they are not a problem. They just want to pee.
“Trying” is probably the wrong word…