The King’s Speech is tomorrow and we wait with bated breath to see if any of the things we are concerned about in the Labour Manifesto appear in this first legislative programme of the new Government.
In the meantime, the new Secretary of State for Health, Wes Streeting seems determined to continue the ban on private clinics prescribing puberty blockers to children. See further below.
Thanks to a wonderful reader for suggesting today’s entry in The Western Season and an excuse for me to show one of my favourite scenes , namely the opening sequence in possibly the best of Sergio Leone’s operatic westerns, Once Upon A Time In The West. Three thugs are sent to meet ‘Mr Harmonica’ (Charles Bronson) at a train station. The build up is superb - the annoying fly, drinking water from the brim of your stetson, the squeaky windmill. Why does he play a harmonica? Well, if you haven’t seen it, you’ll just have to watch it to find out 😎
“You bring a horse for me?
Looks like we’re shy one horse.
You brought two too many.”
Thanks to two wonderful readers for providing suggested pieces.
Stop Press
The King’s Speech includes a commitment to a Conversion Practices Bill which is to be ‘trans-inclusive.’ I have searched through the Speech and can find no reference to loosening the requirements for gender recognition certificates or ramping up hate crime (which were also Labour Manifesto commitments). If you spot anything please let me know. I will be looking at this new Bill and its implications in my next update. All thoughts, of course, gratefully received.
Get your armour on!
Puberty Blockers
I discussed the current judicial review challenge to the private clinics puberty blockers ban here:
https://dustymasterson.substack.com/p/the-man-who-shot-liberty-valance
Martin Beckford in The Mail Online ( Health Secretary Wes Streeting insists puberty blocker ban WILL stay as revolt grows in Labour ranks 14 July) reports:
The new Health Secretary today defended continuing the ban on puberty blockers following a backlash from fellow Labour MPs.
Wes Streeting said he was ‘treading cautiously’ because the long-term impact on young people taking the drugs is unclear [ Dusty - I think it is pretty clear actually].
He also hit out at ‘highly irresponsible’ statements by critics, after barrister Jolyon Maugham claimed his decision to keep the restrictions in place would ‘kill trans children’ [ Dusty - this man is a disgrace to the legal profession].
Mr Streeting took to social media as a growing number of Labour backbenchers called for the ban on ‘life-saving’ puberty blockers to be lifted.
He wrote: ‘We don’t yet know the risks of stopping pubertal hormones at this critical life stage.
Health Secretary Wes Streeting
‘That is the basis upon which I am making decisions. I am treading cautiously because the safety of children must come first. Some of the public statements being made are highly irresponsible.
‘I know there’s lots of fear and anxiety. I am determined to improve the quality of, and access to, care for trans people. The decisions I am taking will always be based on evidence, rather than politics or political pressure.’
It emerged on Friday that Mr Streeting wants to make permanent the emergency ban on private prescriptions of puberty blockers for gender-questioning children which was brought in by the Conservatives in May.
The NHS had already ended routine use of the drugs after the landmark Cass review questioned the evidence behind gender medicine.
Good Law Project director Mr Maugham, notorious for clubbing a fox to death with a baseball bat while wearing a kimono, is challenging the ban in the High Court.
He wrote online: ‘My feelings about Wes Streeting are unprintable. These measures will kill trans children.’ [ Dusty - no evidence of this outrageous claim has been brought forward - see further below]. Since then at least four Labour MPs have tweeted in support of trans health care and against the ban.
Well done, Mr Streeting, sticking to your guns.
The full article is here:
And it appears he is backed up by the Culture Secretary, Lisa Nandy (!!!):
https://x.com/OkayBiology/status/1812792396955967737
Maya Forstater of Sex Matters writes about this in The Mail Online:
It takes courage for the Health Secretary to stand up to death threats from hysterical activists but he's right to keep the ban on puberty blockers (16 July)
In the dying days of the last Parliament, the then health secretary Victoria Atkins introduced emergency legislation that banned the use of puberty blockers for adolescents who believe they are transgender or ‘born in the wrong body’.
Her move provoked a furious response from trans activists but, as the temporary law was due to expire on September 3, they lived in hope that her Labour successor Wes Streeting would let the measure quietly do so.
Instead, it emerged on Friday that Streeting plans to make the ban permanent. He pledged always to ‘put the safety of children first’ and said the Department of Health was following advice set out in the Cass Review, an independent report on gender identity services published this year, which found there was ‘insufficient evidence to show puberty blockers were safe for under-18s’.
The response on social media was immediate and hysterical. The spotlight-loving barrister Jolyon Maugham, director of a campaign called the Good Law Project, published a feverish list of questions and, somewhat presumptuously, demands: 16 on Sunday, and then another nine yesterday.
Maugham’s first question set the tone: ‘Have you investigated the explosion of deaths amongst those on the NHS waiting list since NHS England introduced a softer version of the ban?'
Without providing any sources for this incendiary claim, he said: ‘I have now seen further evidence that, since December 2020, there has been a huge increase in deaths of young trans people on the NHS waiting list — and that NHS management has sought to suppress that evidence.’
To accuse NHS managers of trying to cover up suicides is outrageous. To do so on the basis of unspecified ‘further evidence’ is utterly irresponsible. He went on to ask: ‘When (and the evidence I have cited strongly suggests it is a “when” rather than an “if”) one or more young trans people take their own lives in consequence of your shoddy attempt to ignore professional advice but appease billionaires and the press, will you resign?’
He also addressed ‘every trans family’, urging them: ‘Now that Wes Streeting has made his position clear I think it is time, if you have this choice, to leave the United Kingdom.’[ Dusty - I suggest you leave the United Kingdom, Mr Maugham. Have you thought of Iran?].
That’s a direct message to parents and children who are very distressed — because they’ve been whipped up into despair and fed the dogma that puberty blockers are somehow lifesavers — that seeking treatment abroad is the only way to prevent a wave of suicides. It’s a horrific, callous lie.
It is impossible for the secretary of state to begin to address such aggressive, biased and polemical questions. All they achieve is an increase in online hatred.
Maugham’s hysterical tweets attracted hundreds of responses. ‘Wes Streeting is happy to see trans kids die,’ ran one. ‘Wes Streeting is basically saying he’s OK with children dying, using his Christian faith as an excuse,’ said another. While a third went even further: ‘Wes Streeting holds us in absolute contempt. Labour would rather a dead trans kid than a happy one.’
And then there are the outright calls for violence, more striking still in the light of events across the Atlantic: ‘Wes Streeting doesn’t deserve a moment’s peace as long as he lives’, ‘Keir Starmer’s trans genocide has begun. He should never feel safe showing his face in public again’, and ‘People who seek to kill us should always be dealt with appropriately’.
Others simply post stand-alone phrases such as ‘public execution’ and ‘homicide of Wes Streeting’.
One high-profile response came from Susie Green, the former chief executive of Mermaids, the transgender organisation that is currently the subject of a Charity Commission investigation. She accused Streeting of implementing a ‘murderous ban’ and ended her tweet with the words: ‘Blood. On. His. Hands.’
Susie Green
Like many of the influential figures stoking this hysteria, Green has a transgender child. She actively encouraged her child, who is biologically male, to take puberty blockers before they travelled together to Thailand for ‘gender reassignment surgery’.
She has since spoken publicly about how proud she is of her actions, and how she would support other parents in doing the same.
Maya Forstater
The feminist author Victoria Smith pointed out how deranged this all is. Until recently, she said, anyone who advocated giving experimental drugs to children expressing anxiety about their sexuality would be pilloried as a monster. Now, the Health Secretary who bans those drugs — and who happens to be gay himself — is the hate figure.
Streeting has done exactly the right thing. The Cass Review was produced by a hugely experienced paediatrician, Hilary Cass, who emphasised that we simply don’t know enough about the long-term impact of puberty blockers to take the risk of administering them to adolescents.
These drugs were developed and tested for use with children under the age of eight who suffer very early puberty.
The review was compiled with great diligence and care. It took four years to listen to the concerns of families and children and to assess all the published medical studies.
Its conclusion is that there is no good evidence that puberty blockers help children’s mental health, let alone that they are effective in reducing the risk of suicide. On the contrary, there is growing evidence of long-term adverse effects.
And though trans campaigners claim puberty blockers merely give children ‘time to think’ by ‘pausing’ their sexual development, the reality is that most children on this medication go on to be prescribed cross-sex hormones — testosterone for girls, oestrogen for boys.
This can have catastrophic long-term effects on health, including fertility problems.
Testosterone is such a powerful hormone that, in young women, it can produce all the outward signs of maleness, such as facial changes. That is true, whether or not the patient has previously taken puberty blockers — but the two drugs in combination do increase the probability of permanent sterility.
In other words, for girls, blockers have no advantages for mental health and increase the danger of physical health problems in later life. Of course the Government is right to ban them.
The people leading the attack on Streeting, including prominent lawyers, journalists and TV personalities, have a moral obligation to turn down the temperature. Not least Maugham himself.
As we have seen, the spiralling escalation in the war of words over trans politics now means that online calls for violence, even death threats, have become normalised.
The poisonous onslaught of abuse that Streeting has been subjected to has been shocking in its ferocity. It represents a baptism of fire for a man of 41 in his first Cabinet job and he must prove he can take the intense heat.
I know how shocking and upsetting it is to be at the centre of a social media storm, with people accusing you of causing the death of children. It takes courage to stand up to the viciousness of the gender ideology activists.
This Government will need to act with courage to face down these extremists, the institutions in the grip of a nonsensical ideology, and the parents who believe these drugs are the best course of action for some children.
Excellent explanation by Andy Lewis on the site Reality’s Last Stand as to exactly why a clinical trial of puberty blockers for children is not a possibility.
What Would an Ethical Clinical Trial Into Puberty Blockers Look Like?
Before any clinical trials for puberty blockers proceed post-Cass Review, there are essential clinical questions that must be addressed.
JUL 15, 2024
In light of the Cass Review, the new use of puberty blockers for children is now pretty much restricted to those enrolled in clinical trials in the UK. The Cass Review underscored the lack of consensus and the significant gaps in knowledge surrounding the use of puberty blockers, prompting a more cautious and scientifically robust approach to their application, if they were ever to be used in the future. There are currently no trials, just plans to design and start them.
Before any clinical trials for puberty blockers proceed post-Cass Review, there are essential clinical questions that must be addressed. These questions are critical to ensuring that any trial is ethical and can help inform future clinical decisions. These are the questions that must be answered before any ethical trial can take place.
1. Identifying Persistent Trans Identities
Which children will maintain their trans identities into adulthood? This is fundamental as only those likely to persist should be considered for radical treatments due to the profound and potentially destructive consequences of these medical interventions. High confidence in predicting persistence is crucial to avoid imposing unnecessary treatments on children who might naturally desist.
2. Alternative Interventions for Adolescent Distress
What other interventions can alleviate the distress leading to trans ideation? We know most children presenting at gender clinics present also with complex psychological needs and conditions, including autism, trauma, and distress over their emerging sexuality. Trans identities may be a coping mechanism for these conditions. Understanding which psychological treatments are beneficial and for whom they work is essential. Current conversion therapy bans threaten this research, potentially stifling clinical interventions that could relieve distress without resorting to life-altering medications.
3. Impact of Halting Natural Puberty
What are the long-term effects of stopping natural puberty on brain and body development? Preliminary evidence suggests potential losses in maturity and developmental issues. Detailed studies are necessary to understand these impacts fully.
4. Clinical Purpose of Puberty Blockers
What is the clinical purpose of using puberty blockers in this cohort? The Cass Review highlighted a lack of consensus. Whether intended as “time to think,” to reduce psychiatric distress, or for cosmetic reasons, each potential usage has significant problems. Evidence suggests children don’t use the time to reconsider options, and the “cosmetic window” is very narrow.
5. Safety and Effectiveness of Adult Cross-Sex Hormones
Is the subsequent use of adult cross-sex hormones safe and effective? Puberty blockers are not standalone treatments but part of a pathway. Comprehensive evaluations of the overall clinical benefits and risks are necessary.
6. Long-Term Regret Rates
What are the long-term regret rates? While this may correlate with question one, even persistent trans identities can experience regret due to factors like loss of sexual function.
7. Methodological Quality of Trials
Any trial must have the methodological quality and size to address serious clinical questions. If trials cannot resolve treatment effects from confounders, and be generalizable (for example), the risks to participants are unjustifiable. Low-quality trials with serious methodological issues must be avoided.
8. Comprehensive Understanding of Past Usage and Outcomes
Before any new trials start, we must ensure that any lessons can be drawn from historical use. This might involve much better follow up of adults who took puberty blockers as children. So far, attempts to collect this data from clinics has been met with resistance. Hillary Cass found most centres refused to help her form the linkage between child records and adult records so that outcomes could be recorded against treatments.
Ethical Considerations
For a clinical trial of puberty blockers to be ethical, it must ensure:
Autonomy: How can children consent to trials when so much is unknown? Potential harm to future sexual well-being and enjoyment, which they cannot fully grasp, complicates consent.
Non-Maleficence: Clinicians have noted that the puberty blocker/cross-sex hormone pathway can lead to permanent loss of sexual function, infertility, developmental issues, and even cancer. Do these harms outweigh the benefits?
Beneficence: Treatments must provide significant benefits. Do puberty blockers dramatically improve outcomes, justifying their use over waiting until adulthood for cross-sex hormones?
Justice: Is this an appropriate use of medical resources? Are we diverting attention from more fundamental needs like better mental healthcare for all children?
For these reasons, I cannot envisage any trial (at least in the next few decades) being a just and ethical experiment to impose on distressed children. The huge difficulties here for me highlight the true nature of the use of puberty blockers. Puberty blockers are not being used for meaningful clinical purposes but are seen by some as ideological treatments. They symbolize a sacrament–a ritualistic baptismal entry into the world of “trans” identities.
Given the significant ethical and clinical concerns, we must remain vigilant. We must challenge proposals for such trials and ensure that vested interests do not compromise the well-being of distressed children. It is imperative to demand thorough answers to these critical questions before considering ethical approval for puberty blocker trials.
Barrister, Sarah Phillimore drives home all these points and discusses the Good Law Project case and other recent cases in her latest Newsletter.
Medical experimentation on children
I was told that by publishing this I risk action in defamation. I consider that everything I publish here is either true and I can prove it, or my honest opinion and I can defend it.
JUL 15, 2024
I have thought long and hard and am unable to identify any comparable situation to the medical scandal we are now watching unfold regarding the medical ‘transition’ of children - where adults demand the right to conduct medical experiments on children, otherwise children will kill themselves. Pages 12 and 13 of the Cass Review sets out with horrible clarity where we are now:
“There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour…. This is an area of remarkably weak evidence, and results of the studies are exaggerated or misrepresented by people on all sides of the debate to support their viewpoint. The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender related distress”
The challenge to the Tavistock by Keira Bell in 2020 highlighted the shocking lack of evidence to support irreversible medical interventions to ‘trans’ a cohort of children, and was a loud wake up call to the Government and the medical profession. This led directly to the commissioning of the Cass Review, an independent review over 4 years of the available evidence in support of the medical transition of children – via puberty blockers and then cross sex hormones, in an attempt to allow a child to ‘pass’ as the opposite sex. The Cass Review has had significant ramifications, even the USA is beginning to see the light. Opinion | Why Is the U.S. Pretending to Know Gender-Affirming Care Works? - The New York Times (nytimes.com)
The NHS saw which way the wind was blowing and shortly before the final Cass report in April 2024, had already taken action to restrict access to puberty blockers for children. On 30th May 2024, the then Secretary of State for Health and Social Care Victoria Aktins went further still, making an emergency order from 3 June 2024 to 3 September 2024 under section 62(3) of the Medicines Act 1968 to restrict provision of puberty blockers by private prescription. By making an emergency order, Atkins did not have to consult any organisations likely to be substantially affected by the order.
This decision was met with fury by those adults who promote medical experimentation on children. The Good Law Project leapt into action to raise money to help the advocacy group ‘Transactual’ make legal challenge by way of judicial review, to declare this decision unlawful. Help challenge the ban on puberty blockers (goodlawproject.org)..
The crowdfunder, unsurprisingly, offers hyperbolic descriptions of the further restrictions on puberty blockers as ‘terrifying’ and repeats Maugham’s earlier bizarre and unevidenced assertions that ‘16 people lost their lives’ as a result of the earlier restrictions to the use of NHS services for transition. Not only did Maugham’s own claimed evidence fail to support this figure, publicly asserting one cause of suicide is rightly decried by every responsible organisation. Media_Guidelines_FINAL.pdf (samaritans.org)
July 12th saw the first day of legal argument in this challenge by way of judicial review, the same day that Wes Streeting declared he would consider making the temporary ban on puberty blockers permanent. Maugham responded via ‘X’ with his predictable irresponsibility, that this measure ‘will kill trans children’.
The legal submissions were helpfully reported by Tribunal Tweets, via live tweeting and on their substack. (12) Group seeks Judicial Review of Ban on Private Puberty Blocker Prescriptions (substack.com) I learned from this that the KC putting the GLP/Transactual argument relied on ‘the risk of suicide’ as a reason to declare the emergency order unlawful, going so far to say that this risk had materialised. It is not clear at all what kind of evidence is being put before the court to support this as a credible argument. It appears to me to be a wholly manipulative and coercive assertion with no evidence in support. It has been fact checked and debunked by many – here is just one example. Claims of Suicide Surge For Gender-Confused Kids Is Challenged | The New York Sun (nysun.com)
As many have already commented on social media, there is no evidence prior to the surge in referrals to the Tavistock from 2014, of ‘trans children’ dying in droves because they did not have access to puberty blockers. ‘Trans children’ are a wholly modern phenomenon and there is serious concern that a cohort of very vulnerable children have been the victims of social contagion and adult ideological pressures.
Further arguments put to the court were that the Secretary of State did not have sufficient information about the negative impact on ‘trans children’ of banning puberty blockers. This submission is all the more alarming when you consider that one of the reasons for a lack of information about this was that Jolyon Maugham and the Good Law Project explicitly discouraged it.
NHS England had earlier in 2024 contacted providers of mental health support to children to invite those on a national waiting list for gender services for a face to face appointment. Children were sent directly a ‘Gender Experience Summary Form’ asking them about the treatment they were receiving and its source. The Good Law Project considered this an ‘exercise in bringing very significant pressure to bear on trans youth and their families to cease private treatment, backed up with a threat of a safeguarding referral to social services if they do not’. It took ‘urgent advice’ from a specialist KC and set up yet another crowdfunder to attempt to challenge this attempt at data gathering. Maugham urged children and clinicians to ignore the requests. We’re taking urgent legal advice on mental health guidance for trans youth (goodlawproject.org) The crowdfunder raised £20,427.90, which was then allocated to the current case.
Transactual’s KC also referred to the ‘world wide consensus’ about the efficacy of puberty blockers, relying on organisations such as WPATH- apparently ignorant or uncaring about the recent scandals to engulf this organisation. As Jesse Singal noted in the Economist on 27th June 2024 Research into trans medicine has been manipulated (economist.com), court documents recently released in a US Case about youth gender medicine, showed that WPATH interfered with the production of systematic reviews it had commissioned from the Johns Hopkins University Evidence – Based Practice Centre in 2018. Evidence which did not support medical transition of children was suppressed.
What we are seeing here is a head on collision, noted by Dr Cass, between the ‘social justice model’ of health care - where a patient requests certain care and reframes caution on the part of clinicians as ‘gatekeeping’ - and the evidence based model. But the situation is far, far worse than simply a clash of ideological perspectives. It is one thing to support a ‘social justice’ model of health care out of a misguided but genuine belief that what you are doing is the best thing for children. It is quite another to support such a model when it is underpinned by corrupt organisations, profiteering private companies such as Gender GP and by adults – such as Maugham, who are implicated in the medical transition of their own children and thus are utterly incapable of admitting to anyone, least of all themselves, the harm they have done.
It is very alarming to see Maugham now berating politicians on social media and even claiming to have the key to a ‘new moral universe’ regarding issues of childhood transition Jolyon Declares Himself 'Holder of Key to Moral Universe' in Trans Meltdown – Guido Fawkes (order-order.com) I can only hope that the court acts to shut down these continued attempts by gender identity ideologues to expose children to medical and social experiments which have no evidence base.
There are some encouraging signs. I represented a mother in a case decided shortly after the Cass Review who objected to her then 16 year old trans identifying daughter taking hormones. The court had made injunctions to stop any access to puberty blockers or hormones while the child was under 16, but having reached that age, the court declared that a decision about medical transition was one for the child to make in consultation with clinicians. However, is interesting to note what the court said at para 51 of its judgment about the mother’s resistance to her daughter obtaining puberty blockers. O v P Final Approved Judgment.pdf (judiciary.uk)
‘The mother has made some mistakes (for example, posting things online and expressing herself in trenchant terms), but the lack of confidence she feels in the treatment of teenagers suffering from gender related distress or dysphoria has force and is shared by many others. If she had not objected to medical treatment there is every likelihood that Q would have approached a private resource offshore and been prescribed puberty blockers. The long term effects of such treatment remain a matter for further research, but it is possible that in future Q will have reason to be grateful he did not ever take them.’
This case raised serious concern about the activities of Gender GP and asked the father to agree that he would not attempt to seek any treatment there. Such concern was repeated in another case decided a few days earlier, which noted that Gender GP had given a teenage girl an initial dose of testosterone so high that it could have killed her. J, Re (Transgender: Puberty Blocker and Hormone Replacement Therapy) [2024] EWHC 922 (Fam) (01 May 2024) (bailii.org)
Adults can go to hell in whatever hand cart they want. The only acceptable form of health care for children is evidence based. They cannot possibly understand or consent to giving up their fertility and adult sexual function in pursuit of an adult lie about ‘gender identity’.
Let’s hope Wes Streeting continues to do the right thing. Otherwise, this will remain a medical scandal of continuing and epic proportions and will blight the lives of thousands of children.
I would only add that I feel that adults can go to hell in a hand cart as long as that is not funded by the National Health Service!
Mr Menno and EDI Jester both address this issue. Mr Menno is a bit more optimistic than the Jester - all thoughts, as ever, gratefully received.
https://edijester.substack.com/p/wes-streeting-and-child-experimentation
The New Government
JL on the Glinner Update discusses the new cabinet. Shockingly all the ministers apart from one that she has concerns about given their previous track records are…WOMEN!! Beggars belief!!
https://grahamlinehan.substack.com/p/a-week-in-the-war-on-women-monday-1a3
EDI Jester suggests what needs to be done ( if we had a magic wand):
https://edijester.substack.com/p/where-next-for-me
Gender Ideology in Ireland
Interesting discussion on gender ideology at a recent free speech conference in Ireland between Laoise de Brún of The Countess, Graham Linehan and Stella O’Malley.
Cass in New Zealand
Katrina Biggs reads an excellent letter to the New Zealand Minister of Health from Simon Tegg of Genspect NZ
Assassination Attempt
Yes, I know I read and listen to a lot about the gender madness but I am aware of the assassination attempt on former President Trump! Excellent piece by Andrew Doyle on his substack about the misuse of words such as fascist or Nazi - us Terfs get honourable mentions, of course 😎
Donald Trump is not Adolf Hitler
Reckless comparisons with fascism degrade our political discourse.
JUL 16, 2024
We’ve seen the assassination of Donald Trump before. In 2017, New York City’s Public Theater staged an open-air production of Julius Caesar in Central Park in which the titular role was portrayed as Trump. The theatrical spectacle of the sitting president being murdered in broad daylight stirred outrage in conservative circles, and was even seen as an example of direct incitement to violence.
This kind of depiction of Trump as a dangerous tyrant whose very existence represents a “threat to democracy” has become commonplace. Since the attempted assassination at Saturday evening’s rally in Butler, Pennsylvania, numerous montages have circulated online showing Democrats and their cheerleaders in the commentariat calling Trump a “fascist” or making comparisons with Adolf Hitler or Benito Mussolini.
The full piece is here:
https://andrewdoyle.substack.com/p/donald-trump-is-not-adolf-hitler
Endpiece By Liz
#BeMorePorcupine
I’m prepared to wait and see with Wes Streeting and hope that he stays strong, but it’s nonsense to say that there isn’t enough evidence of the harms of puberty blockers. They’ve been known for years because of their use in precocious puberty and that’s what makes their widespread use even more unforgivable. What concerns me is that he may instigate trials which will gradually be widened to the point that there’s a ban in name only. That way he ‘quietens’ both sides. As for Lisa Nandy, the woman who thinks that males should be able to choose which prison they go into……
Thanks Dusty, my loins are girded. #BeMorePorcupine. 💪🏻
It is insane isn't it, how did we get to this point where preventing a fundamental part of human development was considered acceptable in the medical profession?