Encouraging children to 'socially transition' gender risks long-term harm, say NHS experts

Henry Bodkin
There is now a two-year wait at the NHS's only child gender service - © Jeffrey Blackler / Alamy Stock Photo

Parents are risking psychologically damaging their children by allowing them to “socially transition” their gender without medical or psychiatric advice, NHS experts have warned.

Primary school-aged children are increasingly being encouraged to formally switch, in defiance of the recommended “watchful waiting” approach, the Gender Identity Development Service (GIDS) leaders said.

In some cases, children as young as six are attending school where nobody knows their original sex.

In the UK, children who display symptoms of gender dysphoria are not given hormone blockers until the onset of puberty, and cross-sex hormones may only be prescribed after they turn 16.

The GIDS psychologists, who practise at London’s Tavistock Clinic, said that younger children who believe they may have been born with the wrong body should be permitted to explore behavioural aspects of the opposite gender, such as dress or types of play.

However, they warned that many such children end up preferring to remain the biological gender they were born, and that to formally socially transition before puberty risks pre-determining the outcome.

They acknowledged that well-meaning parents, faced with deeply unhappy children, can sometimes feel they have no other option.

The situation is made worse because the waiting list to see a specialist at the Tavistock and Portland Trust, the NHS’s only child gender service, is now two years’ long.

Dr Bernadette Wren, head of clinical psychology at the trust, said: “Social transitioning has become a really big topic. 

“We have never recommended complete social transitioning but it has become a really popular thing and many advocacy groups really promote it.

“We take the long view because our concern has been that what might work to lower anxiety in a younger child may become the thing that is problematic when they get older.

“It can become harder for children as they move into adolescence, they are moving into puberty and the young person suddenly faces a wall of puberty.

“We think that is setting up problems for later.”

The Channel 4 documentary Kids on the Edge brought image to the fore Credit: Jude Edginton

GIDS received 2,590 referrals in the year 2018-19, almost a four-fold increase in four years.

Earlier this year Penny Mordaunt, the equalities minister, ordered a review to establish why there has been a surge in the number of girls seeking help.

Almost three-quarters of children seeking help with their gender are now female-born.

Around 45 per cent of the children referred to the service decide to undergo physical interventions, according to GIDS.

Dr Wren said that rather than a full social transition, “we would rather have a kind of grappling with the fact that this young person is in a slightly anomalous position but life can still be good and full of hope and there may be some solutions further down the line but it's a complicated place to be and there is no magic solution.

"For some families the social transition can work as a kind of 'it's all going to be fine' and actually the system is way more complicated than that."

The experts said various “advocacy groups” encourage parents to opt for total social transition.

Mermaids, seen as the most prominent and controversial advocacy group supporting gender-diverse children, said: For some young people social transition can be very helpful.

"However it is important to keep things open.

“Across all contexts, including schools and local communities, we need to support young people experiencing distress around their gender identity.

“We need to support exploration, which may include a social transition for some young people.

“It is also important to keep curiosity about gender identity alive and be open about any young person’s situation, including the reality of their physical bodies.”