Mick Hartley

Alex Massie in the Times on Sandyford…Scotland's Tavistock:

The Tavistock calamity is a disgrace. But, thanks to whistleblowers and journalists determined to reveal the truth, it is at least a scandal subjected to the pitiless glare of scrutiny.

In Scotland, matters are arranged differently. Here it is considered scandalous to even raise these issues. The pretence that there is nothing to be examined must be maintained, no matter how ridiculous — and even wicked — that may be.

For Scotland has a Tavistock of its own. A decade ago, just 37 children were referred to the specialist Young People’s Gender Service at the Sandyford clinic in Glasgow. In 2021 that figure was 521. The Sandyford clinic operates on the same basis as the now discredited Tavistock clinic.

“We must take these issues seriously,” Nicola Sturgeon said last year, “but we owe it to everybody also to treat these issues incredibly sensitively”. This is code. “Sensitively” here really means “these issues should not be discussed in public”. See nothing, say nothing, think nothing.

The first minister argues that this is a fuss over nothing because only a “small” number of children will be prescribed puberty blockers and, eventually, hormones. It is difficult to imagine any other policy issue in which the life-changing effect of experimental, unproven, medical treatment would be dismissed in such a cavalier fashion. The insouciance on display is as startling as the recklessness.

The lack of curiosity is also extraordinary. According to the Scottish Pathway for Trans Healthcare (Spath), updated last September, “best practice” has “moved away from psychiatric assessments that focus on evaluating how ‘gender dysphoric’ a person is”. Instead, treatment should consider a patient’s “readiness for initiating particular aspects of gender-affirming healthcare”. The conclusion is thereby established before the evidence supporting it.

Counselling should not be considered “a prerequisite for any gender-affirming healthcare”. There is no need to explore the depth or conviction or provenance of a person’s gender discordance. On the contrary, their declared sense of themselves should simply be affirmed. By such means, even those who do not obviously need medical intervention should nevertheless receive it.

According to Spath, “access to hormones and surgeries can act as a prophylactic measure against distress” and “a trans person can have persistent gender incongruence without distress and can still benefit from gender-affirming hormones or surgeries”. Entirely healthy people, that is, should have major body- and life-altering surgery. How can this possibly be right? How can it be remotely ethical?

Little is known about the long-term impact of puberty blockers but there are concerns they may affect the development of children’s brains as well physical growth. Because of this uncertainty, the use of puberty blockers is a matter of increasing concern in England and other countries. In Scotland, though, we pretend there is nothing to see, discuss, or be concerned about. Evidence from elsewhere mysteriously becomes inapplicable as soon as it enters our airspace.

Nicola Sturgeon believed gender ideology would be a good way of demonstrating her more progressive credentials in comparison to the reactionary English – but it's backfired.

Update: according to the Herald, Sandyford Clinic is now closed to new patients, due to “significant pressure” on the service and "could be hit by a funding cut".

Update 2: and, she's off.