Mick Hartley

A Scottish mental health clinician speaks out, in today's Sunday Times:

I have worked for 20 years with mental health patients in Scotland. Before the pandemic I saw only two people who were transitioning. Both were men who identified as women.

My caseload is small because my patients have complex problems. Over the past two and a half years, however, I have looked after nine female patients who wish to be men. Most are in their late teens to early twenties. Emotionally they are quite young.

They are in fact among the most vulnerable patients I have seen, often struggling with multiple mental health issues after difficult childhoods.

Dr Hilary Cass, who wrote the report on the Tavistock Gender Identity Development Service in England, addressed the Scottish parliament last week.

Just as she says, some of my patients are on the autistic spectrum, others have survived childhood trauma including neglect and sexual abuse. Among those transitioning are patients with eating disorders, patients using self-harm to cope and patients with borderline personality disorders who struggle with distress.

During our appointments some patients have described growing up without clean clothes or help with basic personal hygiene. They have talked about their poor social circumstances and being unable to afford the normal things most children have. They grew up feeling they were on the outside, ostracised by their parents and their peers.

They have endured all of this, pouring their energy into surviving at the cost of maturing. And then, with little idea of their own identity, they have found the camaraderie of a trans peer group and embraced the idea that they were born in the wrong body.

They now believe it is their body that is wrong and needs to change. This view has then been endorsed by the NHS, schools and even politicians. No one has said to them: “You are fine just the way you are. Let’s help you.”…

Professionals seem too frightened to question whether changing gender is what these patients really need….

I worry that many will look back at the NHS in a few years and think: “What have you done to me? I have no breasts and I cannot have children. My life is wrecked just like my childhood was wrecked.” I feel I am seeing a medical scandal unfold before my eyes.