An image of apparently perfect

James Kirkup at the Spectator says it’s a difficult time to be a girl:

In 2019, the Lancet published research showing girls’ rates of self-harm had tripled since 2000. Other studies show girls are much more likely to be depressed or anxious than boys.

I would hate to be a girl in this climate. Porn, “sex work,” giant testosterone-filled “girls” taking all the good parts – no thank you.

On the surface things look pretty encouraging.

They’re more likely than boys to go to university. They have better economic prospects than any generation of females that went before them. Empowered female role models are more visible than ever before, in culture, sport, media, science, business, even politics.

Yet at the same time, girls are growing up in the digital age, where images of what women and girls can (or perhaps should, depending on your view) be are everywhere. From the earliest age, many of those images are strongly sex-based, assigning roles and characteristics to girls because they are girls. You can tell a story here that starts with pink unicorns for toddlers and ends with Instagram and YouTube influencers who can make millions selling an image of apparently perfect, glossy femininity.

Not to mention an image of apparently perfect glossy fucakbility.

Across western societies, the last decade or so has seen a sharp rise in the number of girls presenting with gender-related conditions, sometimes receiving treatment from gender clinics.

Or not so much treatment as “treatment” – interventions that can’t be fully reversed if the girl changes her mind a year or two down the road.

The use of such treatments is controversial and contested. As a result, NHS England in 2019 launched an independent review of those treatments for children and young people, a review later expanded to take in the services that deal with children and gender, mainly GIDS. That independent review is led by Hilary Cass, a retired consultant and former president of the Royal College of Paediatrics and Child Health.

An interim report came out this week.

To me, the truly disturbing message that emerges from the interim report is confirmation of just how little is known about the female-born children who are now most of the gender-clinic caseload, and about their treatment and its consequences.

And that is because most of the patchy evidence base on gender issues and treatment is based on people who were born male. And to state a fact that shouldn’t need to be stated, male humans and female humans are different, physically and developmentally. The interim report notes:

Much of the existing literature about natural history and treatment outcomes for gender dysphoria in childhood is based on a case-mix of predominantly birth-registered males presenting in early childhood. There is much less data on the more recent case-mix of predominantly birth-registered females presenting in early teens, particularly in relation to treatment and outcomes.

What could go wrong?

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