SUE REID: When an autistic teen asked to change sex, the school, GP and psychologist agreed

A mother of a teenager with autism and former nurse Susan Evans (pictured) have joined forces to take legal action against the NHS children’s gender clinic, the Tavistock

This is a case snagged in one of the thorniest controversies of our time.

A mother of a teenager with autism, born ‘Katie’ but who now prefers to be called ‘Jon’, has joined forces with a former nurse to take legal action against the NHS children’s gender clinic, the Tavistock, over its use of ‘experimental’ puberty-blocking treatments for youngsters.

The mother, who is known only as Mrs A to protect her child’s identity, and the nurse, Susan Evans — who herself worked at the Tavistock — believe the clinic is unlawfully administering hormone blockers which halt puberty in gender-confused children but whose long-term physical and psychological effects are unknown.

The pair are asking the clinic to stop treating children with these drugs unless a court decides in each case that it is in their best interests.

The two women have accused the Tavistock and Portman NHS trust, which runs the gender identity development service (Gids) in North London, of misleading families over the treatments, arguing that children and their parents are not adequately informed of the risks.

If their proposed action is unsuccessful, they are demanding a judicial review (where a judge examines the actions of a public body) into ‘unlawful’ hormone-blocking treatments at the clinic.

The Mother’s story

My teenage daughter wants to be a boy, for us to call her Jon, and to wear male clothes. She hopes to take powerful drugs to stop the growth of her breasts, already flattened with a cloth binder worn night and day which she bought online.

In her quest to stop being female, she is to go to the Tavistock clinic, where thousands of children are referred for hormones which, I suspect, harm their fertility, future sex lives and developing brains. No one really knows the truth about these drugs, even in the medical world.

My love for my dear daughter is unconditional. But our family is in turmoil, torn apart over what to do next. Her nine-year-old cousin is so traumatised by my child’s distressed behaviour that she has asked if she, too, has to become a boy when she reaches her teens.

The pair believe the Tavistock clinic is unlawfully administering hormone blockers which halt puberty in gender-confused children but whose long-term physical and psychological effects are unknown (stock image)

The pair believe the Tavistock clinic is unlawfully administering hormone blockers which halt puberty in gender-confused children but whose long-term physical and psychological effects are unknown (stock image)

I have no problem with girls wanting to climb trees, fix cars, ride motorbikes, have tattoos and become engineers. But when your daughter tells you she wants to be called by another name because their own female one, Katie, is ‘dead’, then it hurts more than anything.

When Katie tried to kill herself not long ago, a psychologist told me I was part of the problem and could ‘alleviate’ her suffering by going along with what I believe is a lie: that she can change her sex.

She has completely altered from a quirky, opinionated, strong-willed little girl with a heart of gold and a love of animals, into an aggressive, violent and self-centred teenager.

THE LEGAL CASE 

The Tavistock and Portman Trust says it cannot comment in advance on forthcoming legal proceedings.

But it insisted the children’s gender identity development service has an internationally renowned reputation for being cautious and considered, while NHS England monitors its services ‘very closely’.

According to court papers filed for the mother and nurse psychotherapist, the clinic says in publicly available documents: ‘The blocker is a physically reversible intervention: if the young person stops taking the blocker their body will continue to develop as it did previously.

‘However, we don’t know the full psychological effects of the blocker or whether it alters the course of adolescent brain development.’

The papers warn that research by the Central London Research Ethics Committee, in 2010, into blockers also concluded: ‘It is not clear what the long term effects of early suppression (of puberty) may be on bone development, height, sex organ development and body shape and their reversibility…’

Therefore, say the pair’s lawyers, for the clinic to describe blockers as physically reversible is ‘inaccurate and potentially misleading’.

They add that young people and their parents cannot give adequately informed consent about treatment if they are not ‘fully appraised’ of the risks.

The court papers demand the Tavistock and NHS England agree to ‘desist from the further prescription of hormone blockers to under-18s, unless an application is made to a court to rule if it is in the child’s best interests’.

‘If no such agreement is forthcoming, it is our intention to commence proceedings for judicial review to challenge the continued use of under-18s hormone blocking treatment which we consider is unlawful…’

Her friends and teachers at school call her by the name Jon and use the pronoun ‘he’, instead of ‘she’.

But we, her family, have drawn a line in the sand. At home we use her birth name, although she has fought us for doing so.

We felt, as a family, that she could be called whatever name at school. But at home she was Katie. It was what her brothers and sisters knew and understood. I was not going to turn their worlds upside down when I didn’t know if it would last.

The younger three already had to try to understand why the police were at our house in the middle of the night, bringing back their sister after she ran out after an argument with us, her parents, because we wouldn’t call her Jon.

They had to wonder why I hadn’t come home to put them to bed on the day she took an impulsive overdose when we dared to ignore her demands. I was with her, frantically worried, at the hospital while she was sick for hours.

I have been accused of being transphobic, mostly by my daughter. On social media, teenage trolls (who must have heard about me from her posts and those of her friends) say I am an unfit mother for opposing her wishes, for making her unhappy.

At school, I felt I was all alone in still seeing my little girl in front of me; when everyone was calling her ‘he’ and a name I didn’t recognise as hers, because they accepted her new identity.

And our problems still haven’t gone away. Now Katie, with the approval of our GP, is on the waiting list for assessment and treatment at the gender identity development service. Our daughter hopes to get puberty blockers to stop her female development.

Medics she has seen in our local area say she must be allowed to live as a boy. My knowledge of my own child, or thoughts about what might have led to her feeling this way, are ignored. I have deep concerns. I believe that she will be given an experimental treatment that is not adequately regulated and without sufficient safeguards.

There are lots of girls who are seen at the Tavistock and who, like Katie, have autism, or other disabilities, or are simply gay. Are their needs being properly assessed before they are put on puberty blockers? That is what keeps me awake at night.

Katie was first diagnosed with autism at nine, nearly five years ago. She was having behaviour problems at school and had intense one-to-one friendships with girls which, once they broke down, resulted in several parents banning their children from associating with her.

She began to spend more and more time around boys. Her relationships with girls became volatile. They seemed to enjoy putting Katie in situations where they would provoke her, watch her explode, and then say it was her fault.

The boys became her sanctuary. They accepted that she loved football, running around and climbing trees. She was often the first to the top of the tallest tree, leaving the boys on the ground in awe. 

But one day she came home from primary school in tears. The boys had mocked another boy because Katie — a girl — had tackled him at football so skilfully.

I believe it was the first time she realised that life might be better if she was a boy.

The mother and the nurse are asking the Tavistock clinic (pictured) to stop treating children with these drugs unless a court decides in each case that it is in their best interests

The mother and the nurse are asking the Tavistock clinic (pictured) to stop treating children with these drugs unless a court decides in each case that it is in their best interests

Although her floppy hair hardly reached her ears, she suddenly asked for it to be cut really short. She wanted to have boys’ trousers for her school uniform. Then she insisted on an all-boys’ uniform. We were reluctant at first, yet we gave in. After all, they were only clothes.

Just before Katie went to secondary school, she asked a male hairdresser to clip her a boy’s short back and sides. She was very pleased, while, out of sight, I cried.

In the first year at secondary school, she didn’t correct teachers when they mistook her, with her short hair, for a boy, although she was still called Katie. However, the children soon realised she was a girl trying to pass as a boy. They distanced themselves from her.

It was around this time that she had a number of romantic relationships with girls, although two ended badly when they took up with boys in the year group instead. If she had said she was gay then, we would have worried about her broken heart — but not that she was a lesbian. But, around this time, Katie bought herself a cheap chest binder to hide her breasts for a few pounds from her pocket money on the internet.

As her body began to change, she began saying she was a boy, to call her Jon and use male pronouns.

She became distressed about her female self. She said she was fat, ugly. When she had a tantrum and injured me, we called the police. She was referred to a mental health service, which went well until the therapists spoke to Katie alone.

They used her chosen name, Jon, and, after the solo interview, asked why I would not recognise her male identity. One medic suggested Katie, or now Jon, should attend a nearby trans-support group, in the north of England city where we live, and gave me the website name.

On the site, there was no information about how to cope with body dysphoria. It had only pages on how a girl could pass as male, including the use of chest binders and packing (padding in a girl’s trousers to mimic male genitalia).

It seemed I, as her parent, had no say although she was just a child.

Worse was to follow when Katie wanted to use male toilets. After a row over this issue, she took some pills from our medical cupboard. She was rushed to hospital and a psychologist later said it was a cry for help because I would not accept her gender identity.

I told him that we were not happy for her to be in male toilets alone. Astonishingly, I was told my young daughter would not be in danger alone in male toilets anyway. In other words, I was causing a fuss.

The current wave of thinking in society and the medical world is that anyone believing they are in the wrong body, even during the naivety of childhood, even if autistic, must be accepted as such.

Those who de-transition (of which there a growing number who say they made a mistake, even after multiple operations to remove their genitalia) are told they weren’t really trans anyway and hounded on social media by the trans lobby groups.

I recognise that my daughter has dysphoria about her body. It might be strong enough for her to demand hormone blocker treatment to stop her female body developing and then cross sex hormones, followed by a double mastectomy, or even more invasive surgery. But will this stop her distress?

What if it is no panacea, what next? If the Tavistock clinic gets it wrong, it will be catastrophic.

My daughter is now opening up to me about her feelings and — as we wait for the appointment at the Tavistock — she seems to accept that we, as a family, still call her Katie and believe she can never change her sex.

How I wish I had a crystal ball to see if she will be all right — and above all, contented — in the end.

Names have been changed to protect the child’s identity

The Nurse’s story

Susan Evans, a former nurse psychotherapist at Gids, has long been worried about the use of hormone blockers on young patients

Susan Evans, a former nurse psychotherapist at Gids, has long been worried about the use of hormone blockers on young patients 

Susan Evans, a former nurse psychotherapist at Gids, has long been worried about the use of hormone blockers on young patients.

She left her job in 2007 by choice but with growing disquiet after what she perceived as a comparatively short period of time between the children’s assessments and their referral for puberty-halting drugs. Now she is speaking out.

At home in the London suburbs and now in private practice, Susan, 62, told the Mail: ‘I raised my concerns after seeing what I considered to be the short period given a child between their assessment and going to an endocrinology clinic which prescribes hormone blockers.

‘There was an internal investigation, but little changed.

‘Several staff, parents and patients at Gids have since expressed worries, too. There are now a huge number of girls attending the clinic wanting to be boys. The statistics prove that a high percentage, like Katie, have autism.

‘Children with gender identity problems expect hormone blockers to be handed out quickly. They think these drugs will solve all their concerns: such as how they look, a lack of friends, physical changes and typical teenage angst.’ Susan says some parents have been known to encourage their children to take the puberty-blocking hormones, a first step towards cross-sex hormones and surgery, perhaps because they would rather their child becomes a transgender boy or girl than gay.

With determination, she adds: ‘I think the risks of blockers are long-term, such as potential loss of fertility. There are worries that they can even interfere with the full development of adolescent brains.’

No one can doubt the concern of the mother, or the experienced nurse, in this delicate case.

But the teenager at the centre of the matter is determined to live as a boy — and grow up to be a man.

Yet central to the legal action is the question of the safety or otherwise of the drugs given out to youngsters at the clinic with, critics say, some alacrity.

This is the issue that may now be sorted out once and for all.

For more information, see: crowdjustice.com/case/ protect-children

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