Rated inadequate
Speaking of teenagers and puberty blockers and cross-sex hormones…the Tavistock is in a bit of a pickle.
In January, England’s only NHS gender clinic for children and young people was rated “inadequate” by the country’s health watchdog – the lowest rating, meaning it is performing badly.
The findings make for sobering reading with inspectors raising “significant concerns” about the way the Gender Identity Development Service (GIDS) works.
Nearly 5,000 children are waiting – sometimes for up to two years – for an appointment, and the management team has been disbanded following the inspection.
Well at least the children who are waiting aren’t getting blockers or hormones, so maybe it’s not such a bad thing? Maybe the longer you wait to get into the Tavistock the better off you are?
Now BBC News has had exclusive sight of an external report written in 2015 which recommended GIDS take drastic action. It argued the service was “facing a crisis of capacity” to deal with an ever-increasing demand and strikingly it should “take the courageous and realistic action of capping the numbers of referrals immediately”.
Why is demand ever-increasing? Could it possibly be because the whole idea of changing sex is a new and constantly accelerating fashion?
It could, instead, be that gender dysphoria is a real thing, and that it wasn’t seen as such until recently because of insufficient knowledge or attention or research or all those.
Or it could be both. It could be that lots of people find puberty alien and disconcerting, and that some adjust to it over time while some don’t. On the other hand if kids uncomfortable with puberty are all encouraged to think they’re “in the wrong body” and that they’re stunning and brave and should probably transition, then a lot of kids who would have adjusted over time will instead make a mess of their bodies and brains because of a fashion. That’s not a good outcome.
Just thinking out loud here — I wonder if this backlog has inadvertently created a “natural experiment” that could be studied. In other words, if you compared the patients who got appointments with the ones who didn’t (or ran a regression based on waiting period), would there be a difference in rates of transition or desistance? Or (and this is grim and I’m not trying to be flip about it) a difference in rates of suicide or other measurable psychological problems?
Of course, I guess that depends on what determined which patients got seen and who didn’t. If they were prioritizing the most urgent cases, which I suppose is likely, then that would obviously be a confounding variable.
I get why it’s hard to suddenly come up with a large number of trained specialists to deal with a condition growing patient numbers by over 1000%, not to mention that apparently there is no specific training to deal with this, but more experimental guesswork and common or accepted practice.
What I don’t get is the implication that features in all these articles that, if the distressed child can’t get the appointment with the so-called specialists, that nothing else can or should be done.
If I needed a hip replacement, and couldn’t get an available surgeon, I think I’m better off waiting, even in pain, rather than turning to a dentist to either attempt the surgery or prescribe medication to help me.
But attempting to ease the distress of confused children is not an exclusive specialist skill that only gender clinicians have. It’s what counsellors, child psychologists and psychiatrists and support groups do. Heck, it’s what teachers, social workers and parents do.
Telling a child that their body won’t limit their presentation choices, mannerisms, career options or hobbies. That it is impossible to be born in the wrong body – their body is perfect and functioning exactly as it should. That lots of people hate their bodies for lots of reasons but that hatred can be overcome. That puberty is not only normal and natural, it is essential for growing children into adults. That “being who you are” is what you’re already doing – having surgery and artificial hormones would be the opposite. Ground them in reality with what cannot change, and that is biological sex. Tell them they can rely on that. Tell them they can also rely on the support and love of their family.
So get those kids some counsellors and advise their families and schools on how to be actually supportive, and that means affirming that yes, I can see you feel bad, but you will be okay. Not “affirming” that the child can become the opposite sex (or no sex) if they want.
While I was waiting for shoulder replacements that couldn’t be done right away, they gave me cortisone shots while I waited. Some risks with that, yes, but at least the risks are known, unlike with puberty blockers.
Not always. I have yet to overcome my body dysphoria, and I’ve been in and out of therapy for over 30 years. But…you live with it. You learn how to cope. Avoiding mirrors helps. Then you can imagine your body to be what you think it should be.
[…] a comment by Arcadia on Rated […]
It does seem to be the latest in a line of conditions which once were relatively little-known but started to get publicity either because of improved methods of diagnosis or because new conditions were being identified.
Oddly, despite being medical and/or psychological conditions people began self-diagnosing the latest ‘in’ condition. For example, people who had never before had dietary problems suddenly ‘developed’ severe nut allergies, seafood allergies, lactose intolerance, gluten intolerance and so-on. Yes, I’m aware that for some people these allergies are both real and often life-threatening, but allergies are not something that one suddenly ‘gets’, they are generally present from birth. If a person discovers later that they are allergic to something it is because they have encountered the allergen for the first time, not because they have become allergic to something they have eaten or encountered regularly with no previous problems.
Then it was mental health issues, with people self-diagnosing with ADHD, or declaring themselves to be on the Asperger/autism spectrum. Not everybody who has problems communicating with others is on a mental health disorder spectrum, but once these conditions became better known about, ill-mannered, rude and short-tempered people were saying they couldn’t help it, they don’t mean to be whatever, it’s just the autism flaring up, y’see, or they’re just a bit ‘spergy’ today or it’s their intermittent Tourrette’s to blame. And this despite such conditions not coming and going or varying in intensity from day-to-day*. ADHD was a God-sent condition for parents of what were simply badly-behaved brats; they weren’t bad parents after all, the kids had a condition.
Again, I’m not denying that there are genuine sufferers of such conditions, but there were and are plenty of people labelling themselves with the newest condition, and even some, of which I personally know several, who will drop one when a more interesting one comes along, or when it becomes inconvenient, or who grant themselves certain exceptions: Oh, God! I have a serious shellfish allergy, can’t even eat food if the pan it’s cooked in has previously been used for shellfish. Well, apart from lobster. Damn lucky, really, ‘cos I bloody love lobster (yes, I have heard this said).
So, I think that maybe the surge in transgender identities could be both a fad and improved knowledge and recognition of genuine gender issues as a psychological phenomenon, but I strongly suspect that just as with the previous trends, the self-diagnosed, the attention-seekers, the fetishists, et al by far outnumber those for whom the condition is real. In fact, I could almost guarantee that if trans-speciesism found itself some champions within academia – a Butler or-two for the Furries, if you will – along with a few woke and/or obnoxious biologists with blogs (!), transgender identities will suffer a sharp decrease in line with an equally sharp increase in…well….trans otters, for one.
*Actually, a sure way to spot the self-diagnosed autist, Asperger’s sufferer and so on is if they claim their symptoms are intermittent, like it’s backache or migraines they suffer from.
I have heard that a broad examination of history and cultures around the world reveals that madness takes different forms. In one era, the insane spin around; in one country, the paranoid fear losing their male organs. The underlying mental disorders are consistent, but the manifestations aren’t. Human beings are very good at internalizing popular scripts, and performing roles which feel completely self-generated.
Sastra, Charles Mackay’s 1841 book Extraordinary Popular Delusions and the Madness of Crowds gives a lot of good examples of how fads and crazes, from the harmlessly ridiculous to the more serious stuff, can take hold in an instant only to disappear just as suddenly.
AoS, I second that recommendation.
As for fad diseases, I certainly see that. Everyone I know it seems has gone from having yeast allergies to having ADHD to having dyslexia to having autism…it just keeps on keeping on. And everyone who ever does something from habit will say “Oh, it’s just my OCD”, as if OCD is just this sort of habit thing. No. As an OCD sufferer, I can testify that it is not just a habit thing. It’s real, and can severely impair one’s life. I have developed techniques for achieving some control of mine, but still find myself working myself to death because I can’t stand a document that isn’t straight or formatted right, or whatever. And when your students have no idea how a document should be formatted, let alone how to do it in Word, or whatever program they use, it means additional hours fixing their documents so I can stand to read them. So naturally I see red when someone says, “Oh, I’m a little OCD this morning.”
And even if gender dysphoria is a legitimate disease for some number of people, small or large number, that conclusion still does not warrant invasive treatment or society remaking itself around a delusion. It requires treatment, but chopping off bits of oneself or going on life-changing hormones should be the last possible resort. My doctor didn’t rush to replace my shoulders the minute they started hurting; we started with physical therapy, medication, exercise, and other treatments. Cutting away healthy body parts, IMHO, should never be a solution. If you cannot get a person to at least a tolerance of their body, there should be other things you do before mutilating someone. And anytime a person undergoes surgery, there is a risk. Therapy should be the first choice before surgical intervention. But saying that apparently is the same thing as committing genocide. Common sense, scientifically based thinking is the same thing as hate speech in our weird, upside down, bizarro world.
The trans identity phenomenon is confounded by those activists who insist that it is not a medical diagnosis, it’s just the way they are; plus, they can’t coherently describe what it is that is “the way they are”. So I’m not sure the phenomenon even rises to the level of “self-diagnosed condition’. There are some with diagnosed gender dysphoria, there are some with self-diagnosed gender dysphoria, and there are trans-identifying people who do not claim to have any dysphoria of any sort.
And the definition issue: he’s not a boy who’s unhappy as a boy, he’s actually a girl, and it’s not a boy’s body, it’s a girl’s body, or he’s nonbinary, so it’s a non-binary body, and it’s not a diagnosis, but he still needs to receive hormones and surgery, that’s “gender affirming”.
iknklast
A lot of this comes down to getting over the misguided idea that the normal state of human existence is free of suffering, dissatisfaction, discomfort and is instead characterized by pleasure, joy, and luxury. “I’m unhappy with some aspect of myself or my life, so there must be something wrong with me,” seems to be the general attitude. Sorry, kid, welcome to human existence. Being unhappy with yourself, your life, and the world around you is just what it means to be mortal, a fragile and flickering candle fighting to remain alight in a winter windstorm that will eventually, inevitably win.
Maybe I’ve just known too many Russians.
AoS @5,
Oh hell yes. This is a pet peeve of mine.
Sometime around 2005, it turned out that there were no assholes in the world! Everyone who said or did something obnoxious or selfish was just “socially awkward,” and probably “on the spectrum.” Including many people who self-identified as having Asperger’s, which in their minds meant “I have poor social skills but I am really really brilliant.” Interestingly, people who felt like this was the key thing to know about themselves, and something that everyone else needed to know to interact with them, had never thought it important enough to get a professional diagnosis. They took a quiz online, what more do you want?
I remember seeing some posters in a discussion forum for the show House, M.D. speculating that the lead character had Asperger’s. Then the show did an episode that completely mocked that premise, pointing out that House was acutely aware of subtle social cues, he was just an asshole.
I know that many people who have actually been diagnosed as being on the spectrum hate that stuff.
iknklast:
There’s a good article at Lesbian & Gay News by Lauren Black about living with gender dysphoria:
https://lesbianandgaynews.com/2021/03/lauren-black-i-am-a-butch-lesbian-i-live-with-gender-dysphoria-i-do-not-believe-my-deep-discomfort-with-my-female-body-means-that-i-should-take-steps-to-change-it/
Lesbian & Gay news is turning out to be good despite their habit of putting almost the entire text of the article in the URL. Check out the article by James Dreyfus currently on the front page, for example (I won’t link to it or I’ll end up in moderation prison)
AoS:
Monkey butlers!
re self-fulfilling conditions: in addition to all the above, I’ve certainly noticed that since COVID, it’s no longer sufficient to say you’re lonely or you’re a bit pissed off or something; you are now “struggling with your mental health.”
There’s a hideous fashion in the UK to insert the word “obviously” into every single spoken sentence as often as possible. I detest it, partly because it’s so obviously a distracting verbal tic but mostly because it’s both a symptom and a cause of lazy thinking.
It leads to people saying things like “I’ve been stuck at home for nearly a year which has obviously harmed my mental health.”
Wait, it’s obvious? Obvious that it’s happened (are you literally chewing the walls)? Obvious that it’s bound to happen and you’re an inevitable victim of a mental health crisis? What? And how has your mental health been harmed, exactly? Do you really have a mental health issue or are you a bit sad that you can’t do some of the things you really, really want to?
Like AoS, I’m not denying that people suffer from mental health issues, I’ve done so myself. And I’m not denying that people have suffered from mental health issues which have been brought on or exacerbated by conditions of living in a pandemic. Clearly, that is the case. What I’m denying is that every condition of imperfection in a person’s life is a mental health issue and especially that it is obviously a mental health issue. So obvious, presumably, that diagnosis by a medic is not necessary.
Grow up, you bunch of whiny babies. There are people struggling far more than you are. They were struggling before the pandemic, many of them are struggling much more because of it, and they will continue to struggle when it’s gone. My friend’s son with (actual) Asperger’s, for example, has suffered terribly during the pandemic and his family have suffered right along with him, dealing with weekly suicide threats, outbreaks of violence and wildly unpredictable behaviour. Think about that next time you’re complaining about how the pandemic has damaged your mental health because you can’t go to the fucking spa or something.
I think a large part of the massive increase in demand for gender dysphoria treatment really is about “gender” dysphoria. That is, girls know to their bones that they are less-than, if not hated and completely expendable. They get the shit end, and not just the short end, of the stick. Offer girls a chance — even a false one — of being able to opt out of the oppressed caste, and it’s not a bit surprising to me that they would flock to the promise of salvation.