Gender dysphoria

In 2016, the Obama-Biden administration concluded that “the quality and strength of evidence” for medicalized gender transition was “low” and insufficient “to determine whether gender reassignment surgery improves health outcomes for Medicare beneficiaries with gender dysphoria.” Six years on, such skepticism has evaporated. In June, the Biden-Harris administration issued an executive order directing the departments of health and education to “promote expanded access to gender-affirming care.” What changed? Not the evidence, only the politics. At a special Pride Month ceremony for LGBT activists at the White House, the president promised to use the “full force of the federal government” in implementing their policy agenda, from education to healthcare.

Sajid Javid is right to worry about the way the NHS has treated children who identify as transgender. The Health Secretary is reported to be preparing an urgent inquiry into the issue, and planning an overhaul of how the health service treats young people with gender dysphoria. He is the Secretary of State for Health and Social Care, so it is his job to be concerned. But for too long ministers have shied away from what future generations may consider to be a scandal of epic proportions. In England, children presenting with gender dysphoria are referred to a single NHS provider – the Gender Identity Development Service (GIDS) operated by the Tavistock and Portman NHS trust. Dr Hilary Cass is currently undertaking a review of GIDS.