Dear Mr Streeting
We are pleased and, above all, relieved that the puberty blocker trial has been paused on the grounds of safety. We are writing to ask you to ensure that it is not reinstated in any circumstances. We also want to thank you for laying an order to progress the Data Linkage Study, which can potentially provide much more useful information as it is a larger cohort over a much longer period of time. Despite these excellent measures, we want to raise other concerns about the treatment of children and young people who might be experiencing gender distress.
Our organisations represent and advocate for lesbian rights. Lesbian Persistence is a Scottish organisation, working to increase the visibility of lesbians socially, politically and culturally. Lesbian Labour is the voice of lesbians in the Labour Party and wider Trade Union movement.
The safety grounds for halting the Pathways trial have been well set out in the current judicial review proceedings brought by Keira Bell, James Esses and the Bayswater Support Group, which you will be familiar with, so we will not repeat the arguments here. It is, however, shocking that the welfare of hundreds of children and young people depends on the bravery of these three litigants to point out what has been widely known – and equally widely ignored – for some time.
However, our main purpose in writing to you is our concern that the administration of puberty blockers and, for older children, wrong-sex hormones, is a form of conversion therapy, targeting young lesbians and gay men. We know from the Cass review that almost all young people prescribed PBs went on to take wrong-sex hormones. We also know from Cass that 68% of the young women attending GIDS were same sex attracted, and a further 21% were bisexual. So an astonishing 89% of young females being treated were not heterosexual. (The figures for boys were similar, 42% and 39% respectively, making a total of 81% who are not heterosexual.) The purpose of puberty blockers and wrong-sex hormones is to enable these young lesbians to halt their pubertal development as women and grow up as ersatz “men”. It is, of course, literally impossible to change sex. Despite this, the purpose of this medication and any associated surgeries that may be done at a later date, is intended to allow the young woman to live “as a man” (although there is no definition of what that might mean). Nor do those young lesbians go through male puberty although the provision of wrong-sex hormones will irretrievably mimic some of the effects, such as a lower voice, facial hair and the development of an Adam’s apple.
The administration of puberty blockers and wrong-sex hormones does not affect who the patient is sexually attracted to. The young lesbians become young “men”, who remain attracted to women. Thus achieving the conversion of a lesbian into a “heterosexual man”, or a gay boy into a “heterosexual woman”.
This is not simply a case of “transing the gay away” – bad enough in itself. Hormonal treatment is also extremely likely to lead to sterility. This is recognised even by the proponents of the proposed puberty blocker trial, and fertility counselling was intended as a key part of the consent process (though we question whether pre-pubescent children as young as 11 or 12 can possibly give informed consent to loss of their fertility.) Young women who take testosterone often experience uterine atrophy and in many cases this will require a hysterectomy, even if that had not been an initial desire. This medical sterilisation is irreversible, and ensures that lesbians cannot pass lesbianism (either through nature or nurture) on to their own children. Such manipulation of reproductive capacity has horrendous undertones.
We therefore see the risks of puberty blockers and other “gender-affirming” medical care to young lesbians as being much wider than the medical risks currently being considered by the MHRA. In addition, the transitioning of lesbians into “heterosexual men” and the loss of reproductive capacity is an attack on the very existence of lesbians. That “gender affirming care” can even be considered in light of this is, in our view, unconscionable.
In conclusion, the provision of puberty blockers, wrong-sex hormones or surgical interventions must all be considered as aggressive forms of conversion therapy. Now that you have demonstrated your willingness to stand up for young people through the two measures already implemented, we hope you will commit to opposing the proposed ban on transinclusive conversion practices that would, in effect, make it impossible for professionals and carers to so much as discuss the risks of medical and surgical interventions with a young person.
We look forward to hearing from you
Lesbian Labour and Lesbian Persistence
