Gendered "Intelligence" at the Court of Appeal

Why the Keira Bell Case Shows that Gender Should Not Be Medicalised

Gendered Intelligence insists “transgender children” are “real” and should be believed when they tell grown-ups they are transgender. The lobby group argues that when adults contradict the child and attempt to instil a bodily reality (whether one is a girl or boy) this “leaves no room for [the child’s] agency.” Teaching children and young people what is or is not possible for them according to biological sex is “disciplinary” and “normative.” Freedom for children and young people lies in “dismantling the culturally ascribed power of the biological.” Since puberty blockers pause puberty, it is “useful for young people to have access to them.” “It is important that children and young people … can experiment, change their mind, try out new styles, express themselves.” People who are concerned about puberty blockers and children’s “irreversible decisions” are hetero-normative and transphobic. “Many people change their bodies in irreversible ways”, for example, “tattoos and pregnancy.” Young people can decide for themselves whether they want to take the medical pathway so the “inside” and the “outside” match. Gendered Intelligence says the reason why some adults are exercised about the decisions children and adolescents make about their own bodies is because “there is an undercurrent in our societal thinking that trans is wrong.”

For lobby groups like Gendered Intelligence, Keira Bell is something of a thorn in their flesh. Bell, a detransitioned young woman in her early twenties says not only that she was incapable of consenting to puberty blockers, but that she was let down by the very adults who listened to her when she self-identified as male. She alleges that the specialised Gender Identity Development Services (GIDS) in the UK (managed by the Tavistock and Portman NHS Foundation Trust and mandated by the National Health Service) allowed her, aged 16, to pursue the unrealisable fantasy that she was a boy and could actually change sex. GIDS did not address her deep psychological and emotional issues and referred her for puberty blockers after only three one-hour-long appointments. One year later Bell was prescribed testosterone; three years after, aged twenty, she had a double mastectomy. She has subsequently decided to stop taking testosterone and now accepts that she is female. 

Bell has successfully brought a legal case against GIDS’ practice of referring children for puberty blockers, arguing that children, because of their emotional and developmental immaturity, are incapable of truly giving informed consent. A Judicial Review was held at London’s High Court in the autumn of 2020 which, in December 2020, concurred with Bell. It concluded that due to the experimental nature of puberty blockers and the evidence that they are a crucial steppingstone to cross-sex hormones and eventually surgical interventions and almost inevitable sterility, children 16 and under have a reduced capacity to consent since they cannot weigh up the long-term consequences. It ruled that GIDS can no longer administer puberty blockers to young people without application to the court.

Despite the High Court ruling, GIDS has an undimmed conviction that in advancing a medical pathway it is promoting an ethical and accountable stance toward “the transgender child.” GIDS, as well as the hospitals which facilitate the hormone treatment (University College London Hospital NHS Foundation Trust and Leeds Teaching Hospital NHS Trust), have been granted permission to appeal the decision at the Court of Appeal on June 23 and 24, 2021. Other organisations have been given leave to intervene, including the Endocrine Society and Gendered Intelligence. Their intervention has been funded by The Good Law Project a not-for-profit campaign organisation that declares its ethical credentials as using “the law to protect the interests of the public, challenging abuses of power, exploitation, inequality, and injustice.” The Good Law Project says that these NGOs will “speak for the voices that were not directly heard in the original Court judgment, in particular, the voice of the child and the voice of prescribing doctors with expertise in the medical evidence and standard of care for transgender health.” 

Let us examine the Good Law Project’s claim that there are two sets of currently suppressed voices that need amplifying. The first is that of the allegedly empirically existing “transgender child”, the one who truly knows that she or he is transgender but whose views are cruelly silenced by a heteronormative transphobic culture. A scholarly examination of the history of the alleged ahistorical “transgender child” demonstrates this figure is not a naturally occurring type of child who has been confined to the shadows since the beginning of time till GIDS and Gendered Intelligence brought her/ him/them/zir into the light. The “transgender child” is a newly emergent and discursively produced figure, shaped, and reshaped before our very eyes by postmodern theory, trans activist politics, and given flesh by Gendered Intelligence and GIDS. 

GIDS is doggedly committed to “thinking postmodern” about psychotherapy, and thus to a policy of affirming a child’s self-declared gender identity. It simultaneously proclaims that it practises evidence-based medicine. However, these are two antithetical propositions, and an example of GIDS’ dangerous, muddled thinking. It is impossible to practice evidence-based medicine, not only because of the lack of evidence for the efficacy of blocking puberty in reducing psychological distress but also because there is no scientific test for “transgenderism.” Unlike all other branches of medicine, the clinical diagnosis is not made by the clinician but by the patient who self-diagnoses that he or she is “transgender.” 

GIDS is blind to the evidence staring it in the face. It consistently uses the term “sex assigned at birth”, a concept coined by the arch postmodern theorist Judith Butler who has also greatly influenced the ethos of Gendered Intelligence. However, sex is not “assigned”, it is a biological fact. GIDS’ faith in an inherent pre-discursive “gender identity” prevents it from recognising the social construction of gender i.e., the specific experiences and social pressures faced by the girls who now make up its client base which is rising exponentially every year. The girls who arrive at its door are living through an increasingly sexualised culture that is hidebound by pink and blue binary gender stereotypes. In such a culture a lesbian girl, for example, might find it more psychologically relieving to identify as a “trans boy” than to come to terms with being same-sex attracted. GIDS operates from within the same lobby group culture that has influenced the young people referred to it and thus helps to construct the “transgender child.” The child’s allegedly “authentic voice” is refracted through the “gender identity” ideology that saturates social media, and which is reproduced ad nauseum by Stonewall, Gendered Intelligence, postmodern philosophy, and quasi-science. 

Secondly, the Good Law Project insists it is amplifying the unheard voices at the High Court of prescribing doctors with expertise in medical evidence and standards of care for children’s transgender health. The proposition that doctors at GIDS all speak with one voice about puberty blockers and the postmodern affirmation model is risible. Clinicians have consistently reported they have been silenced about their views that it is medical negligence to put children on to a medical pathway when the overwhelming majority suffers from familial and psychological difficulties and trauma, including sexual abuse. The affirmation model prohibits a therapeutic approach to children’s psychological difficulties and trauma as the possible cause for their identification as the other sex. Staff allege they were discouraged by GIDS Director Dr Polly Carmichael from consulting the Trust's safeguarding lead Sonia Appleby or from referring cases to social services. In a terrible irony, Appleby herself is currently attempting to bring a legal case against the Tavistock for its treatment of her when she raised the GIDS staff concerns that “the health or safety of children were being, had been or was likely to be endangered.” The internal unrest has been so grave that clinicians have attempted to whistle-blow by using print and broadcast media to alert the general public that alongside the exponential rise of children, in particular girls, seeking to “transition,” children with complex histories were being referred for puberty blockers after a few sessions and without proper investigation of their cases.

Stephanie Davies-Arai, Director of Transgender Trend, an organisation of concerned parents, professionals and academics who are critical of postmodern gender theory, was given leave to intervene in the Judicial Review. She stresses that GIDS operates “within a core illogicality” namely a belief that biological sex is irrelevant to being a boy or being a girl, while providing a service that is predicated on the existence of, and ability to define, a ‘boy body’ and a ‘girl body’.” In allegedly affording young people freedom from the restrictions of gender norms, the terrible irony is that the GIDS exposes girls (and boys) to the same sexist stereotypes that have caused them to seek help in the first place. She points out that Keira Bell was “unable to fit into the feminine stereotype” and the affirmation model confirmed her in her feeling that the fault lay with her: “Affirmation of her wrongness, affirmation that her failure to live up to those stereotypes means she is not a girl, affirmation that her insecurities are well-founded.” Davies-Arai argues that “GIDS is not competent to safeguard the bodily autonomy and integrity of adolescents who arrive at the clinic fully conditioned in gender theory and eager for the medical interventions they have been told they need.” Far from being a last resort (as GIDS constantly claims), puberty blockers “are the only treatment for children with complex histories and mental health conditions.” She continues: “This is the result of a service that operates on the basis of ideology in place of clinical standards.” 

Kind liberal people concerned about the oppression of “the transgender child” are gravely mistaken in thinking trans activism is a grass-roots movement. In the UK, trans activism is highly orchestrated by Stonewall, an LGBT lobby group and now business enterprise. Stonewall has almost single-handedly shaped the publicly accepted postmodern “truth” of inherent “gender identity” and tied it to progressivism. Stonewall was previously an LGB organisation but added the T in 2016 after it received a grant of £100,000 from the Arcus Foundation for integrating “trans” into all aspects of its work. The LGBT acronym has helped construct “transgenderism” as identical to sexual orientation, existent in “nature” outside of social and political context. Not only has Stonewall invented the idea that “trans people” have existed forever, like lesbian, gay, and bisexual people, but also that their interests are homogenous and can be defended by the same set of ethical concerns. Stonewall teaches that gender identity is “a person’s innate sense of their own gender, whether male, female or something else which may or may not correspond to the sex assigned at birth.” It is has become an extremely lucrative business enterprise funded by more than 850 UK employers who have signed up to its LGBT Diversity Championship Scheme and of which the National Health Service is one.

The medicalisation of children is driven on a global scale by a multi-trillion dollar industry which, in requiring “gender identity” for profit, shapes it. During the same period that GIDS has witnessed the exponential rise in children’s demand for the service, the relationship between “social justice for transgender children” and the medical-industrial complex has intensified. In contrast to recently-retired senior GIDS clinician Bernadette Wren’s naïve proposition, medical technologies don’t just facilitate children’s identity projects, they incite them. Researcher Jennifer Bilek writes, “In less than a decade, the ‘transgender’ ‘human rights’ ‘movement’ has morphed [for children and young people] from ‘born in the wrong body’ to ‘gender identity disorder’ to ‘gender dysphoria’ to ‘gender incongruence’ to ‘gender identity’ to ‘gender expression’ complete with its own line of make-upfashion and body scars.” She points out: “The LGB civil rights movement has been subsumed by elites who have added the T to normalise the overriding of our sexed reality as humans, staging a political coup of mammoth proportion.” The medical-industrial complex “interfaces with LGBT NGOs and are driving the normalisation of a biology-denying ideology.”

Many religious qualities now attend “the transgender child”: The High Priestess of Postmodernism Judith Butler, Gendered Intelligence and Stonewall provide the creed; GIDS provides the catechism; Big Pharma and endocrinologists facilitate the rites of passage; children are supplicants whose true “soul” can be realised by renouncing their biologically sexed bodies—“suffer little children to come unto me”; Apostates such as concerned parents, carers, GPs, teachers, psychologists (including clinicians from within GIDS) endocrinologists, social workers, and lawyers are vilified. The latest apostates are those who belong to the growing number of detransitioners who, like Bell, regret making such a life-changing decision but who are treated by trans-activist groups and their supporters with denial, vilification, ignorance and, at best, silence. In academia, scholars who are deeply concerned about ethical implications for children and young people of the construction of “the transgender child” are slurred by postmodern scholars as haters, bigots, transphobes and transmisogynists. The use of such language in the academy is resonant with the language of extremist trans activist gutter politics. According to some trans activists, gender critical feminists who bang on about the “transgendering” of children should just fuck off and die

Bell will defend the High Court’s ruling at the Court of Appeal. I hope the judges exercise as much good sense as the judges at the High Court. A first step would be to look at the issues through the lens of the child with “gender dysphoria” rather than “the transgender child.” If GIDS’ appeal and Gendered Intelligence’s intervention are successful, children’s rights to protection from physical and psychological harm will be further eroded, not only in the UK but internationally since the judgment will also impact other countries that look to the UK for legal guidance. The Good Law Project is not protecting children’s rights by allegedly challenging the abuses of power and injustice to which children have been subjected by the High Court ruling. By funding Gendered Intelligence to support GIDS, the Good Law Project is struggling to claw back the now diminishing power of the ideologues who, until the High Court ruling, have been given almost free rein in the UK to pull the wool over everyone’s eyes about the social and political meaning of children who identify as transgender.

I conclude with the words of GIDS’ psychologists who, as a result of the GIDS turning a deaf ear to their concerns, wrote two years ago to The Guardian, the UK’s allegedly most liberal broadsheet, to alert the general public to the seriousness of what is happening to vulnerable children, not only under the National Health Service watch but actually mobilised by it. The dissident psychologists said of GIDS’ affirmative practices: “We have truly wandered through the looking glass with our eyes closed and opened them only to see the emperor’s new clothes.” Their letter was never published.