by Julia D. Robertson, journalist and award-winning author, and William J. Malone, M.D., endocrinologist and NYU alumnus
*This article has been updated to include December 1 court case results below
On October 7, 2020, Keira Bell went to court in London to fight against a system that pathologizes and medicalizes youth nonconformity. At 16 years old, after just three appointments, doctors began the process of transitioning Bell, medically, to ‘change’ her sex. Tomorrow morning, the judgement on her case comes in.
Bell is a former patient of Tavistock’s Gender Identity Development Service for under 18s, where she was given puberty blockers at age 16, and prescribed testosterone at age 17. She was later sent to the adult Gender Identity Clinic in London, and by the age of 20, surgeons had performed a double mastectomy on her.
Bell raised £50,491 (over $67k) to bring this case to court. She isn’t looking for compensation. She’s looking to change policies that currently work against kids like her.
Young people do not reach full cognitive brain development till around the age of 25 — a fact that the medical field collectively decided to either forget, or ignore, when it came to medicalizing and performing surgeries on kids like Bell. In the US, toddlers, as young as 1, are labeled “transgender,” children, as young as 8, are medicalized, and double mastectomies are performed on kids as young as 13.
The prefrontal cortex — the section of the brain that relates to personality, expression, decision making and the ability to grasp long-term consequences — is still forming at the age Bell was when she began hormone treatments and had a double mastectomy.
The functionality of the prefrontal cortex is vital as it relates to the development of reasoning, emotional regulation, social abilities, and abstract thinking. It’s why car rental companies often won’t rent to young people under the age of 25. It’s why there’s a precedence of not performing hysterectomies on women under the age of 30.
The ability to interpret reality, to feel guilt and remorse, is also linked to the functionality of the prefrontal cortex. In adults, reduced function in the frontal lobes have been observed in those diagnosed with mental disorders, as well as in connection with suicide, criminal and sociopathic behavior.
Interruptions to brain development can be detrimental, yet research on the long-term effects on brain development have been limited, where young people medicalized for ‘gender dysphoria’ are concerned. A small study was published in Psychoneuroendocrinology, looking at executive function in a sample of youth — half of which were labeled “transgender youth,” and medicalized with blockers — but in general, efforts to look at this critically have been sidestepped.
Statistically, the majority grow out of ‘gender dysphoria,’ if allowed to grow up, without interference — About 75% would grow up to be lesbian, gay, or bisexual, and about 85% would grow up to be lesbian, gay, bisexual, or straight.
Along with Bell, the mother of an autistic child, known to the public only as Mrs. A, is also a claimant in this case. Her 16 year-old child is on the waiting list for ‘treatment’ at Tavistock. Autistic kids can be highly sensitive to their environments, so if they don’t fit into the neat little box of stereotypes expected of their sex, they might easily become convinced they are the opposite sex.
Medical malpractice has been committed on a global scale, because no one will challenge the foundational lie, that this is a biological condition.
This shift from a psychological condition to a biological one happened when activists and patients got involved with WPATH and APA, changing definitions from Gender Identity Disorder to Gender Dysphoria. This is the elephant in the room. In the case of very young children, parents are now often dictating the terms of their child’s treatment. In the case of teens and young people, they, as the patients, are often dictating terms.
Sometimes the push comes from medical professionals, who are certain this is a cure-all. But often times parents and young people are calling the shots. And it’s not just a matter of wanting compassionate treatment, it’s a matter of actual medical and surgical treatment. Doctors are now extensions of the patient’s psychic distress. They’re enabling and reinforcing distress, in stark contrast to doctors who worked in this field a decade ago.
“What is being called ‘gender identity’ is likely an individual’s perception of how their own sex-related and environmentally influenced personality compares to same and opposite sexed people… and it’s wrongly being conflated with biological sex. This conflation stems from a cultural failure to understand the broad distribution of personalities and preferences within sexes…”
In Bell’s case, she was allowed to call the shots, and now realizes she couldn’t have possibly understood the decisions she was making at such a young age.
On her Crowd Justice fundraising page, Bell writes, “I had peripheral doubts on and off throughout transitioning but pushed through these after reading online comments by other trans people that doubt is normal and by being affirmed as a boy by the clinical team that worked with me. I now reject the harmful concept of gender identity (in terms of your brain and/or soul having a gender) and the idea that someone can be born in the wrong body.”
Over a year ago, Bell stopped the process of medical transition. Now, at age 23, she explains, “In my tormented state of mind I was not able to identify how incredibly destructive transition was… However I have now been left with the life-long consequences of medical treatment for gender/sex dysphoria (including a deep voice, facial hair and no breasts).”
There were also underlying issues with identity, sexuality, and trauma, that went unaddressed at the time. Bell’s decision to transition was additionally fueled by the internet. Now, as an adult, she has a number of medical concerns, including the possibility that she won’t be able to have children.
“I hated my female body, periods, make-up, dresses and anything feminine. I thought that I must be male. It was never challenged by the people who were treating me. It was encouraged.”
— Keira Bell
Dr. Debbie Hayton, a well-regarded trans journalist and high school science teacher, writes, “More than 2,700 children, some as young as 10, were referred to the clinic last year — a twentyfold rise over the past decade… Many, like Bell, are quickly put onto puberty blockers that can cause dangerous side effects.” Currently, the most alarming rise is seen among girls, as demonstrated in the graph below.
Bell writes, “I decided to transition after dealing with an abundance of mental and body issues. I did not realise it at the time, but this is (unfortunately) extremely common, particularly for young, pubescent girls in this society and it is a common denominator between most female transitioners and detransitioners.”
On Bell’s fundraising page, she’s made it clear that the case isn’t about compensation. She writes, “There is no pay-out with this type of case. This case is challenging the policy of the NHS that prevents clinicians from helping children suffering from gender dysphoria be at ease in their sex. That policy is set out in the Memorandum of Understanding on Conversion Therapy.”
The Memorandum of Understanding on Conversion Therapy was originally written to protect kids from gay conversion therapy. It was updated in 2017 to include “gender identity,” ironically leaving the door wide open for a ‘progressive’ new version of gay conversion therapy.
Since most of these kids, statistically, would otherwise grow up to be LGB (if allowed to grow up), we’re currently dealing with a massive human rights violation of LGB youth and young people in general.
“I have now come to realise that gender identity is in fact a reference to gender roles and stereotypes. Therefore it is regressive to have the idea that gender (role/stereotype) non-conforming (GNC) people are really the opposite sex or are different from their biological reality… feeling disconnected or experiencing hatred for your body is unfortunately not uncommon for young girls. It has resulted in many young, vulnerable people risking their health and damaging their bodies because they have been affirmed in their belief that they have been born in the wrong body.”
— Keira Bell
If the court rules in Bell’s favor, young people will have a better chance of growing up before life-altering decisions are made. This case doesn’t just represent Bell, it represents thousands of young people who’ve come forward with similar stories, despite a powerful campaign to silence them.
*Please check back for an update on tomorrow’s (12/1) court ruling
Update: It’s been announced by attendees, of today’s December 1st Judicial Review, that the claimants have “won” the case.
The document below details the overall conclusion of the court:
A child under 16 may only consent to the use of medication intended to suppress puberty where he or she is competent to understand the nature of the treatment. That includes an understanding of the immediate and long-term consequences… It is highly unlikely that a child aged 13 or under would be competent to give consent… It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences…
In respect of young persons aged 16 and over… Given the long-term consequences… and given that the treatment is as yet innovative and experimental, we recognize that clinicians may well regard these as cases where the authorization of the court should be sought prior to commencing the clinical treatment.
See the Judgement in full here.