Transgender Media Coverage: Real-World Consequences
I think it’s fair to say that until the Keira Bell case (Bell v Tavistock), most people had never heard of puberty blockers. Now, they have become part of casual conversation; a highly politicised talking point seemingly apt for dinner parties, watercooler moments and the school gates.
Puberty blockers. Surgeries. Regret. Detransition. These words have become commonplace.
Gonadotrophin-releasing hormone (GnRH) antagonists, known as puberty blockers, cause the body to stop producing sex hormones. They are sometimes prescribed within a gender service to delay or prevent puberty, to “buy time”, so that gender questioning individuals can consider their position.
Whether puberty blockers should be an option, or not, to young people is a point of contention. Some sections of the media would have us believe that thousands of naïve children are being put on blockers seemingly against their will, by overzealous prescription-wielding niche specialists.
A BBC investigation found that 267 people under the age of 15 started using blockers between 2012 and 2018. Two hundred and sixty-seven. Over six years. It is not to say that this number is insignificant, but is it proportionate to the tone of the recent coverage? What are the effects on unconscious attitudes to transgender identity?
LGBTQ+ hate crime is disproportionately on the rise in the UK. The Transphobic Hate Crime Report (2020) found that in the past 12 months 4 out of 5 respondents had experienced a form of transphobic hate crime. 1 in 4 had experienced physical transphobic assault or threat of physical assault. Nearly 1 in 5 experienced sexual assault or the threat of sexual assault.
Anti-blocker and detransition campaigners can be sensible, educated, intelligent and even well-meaning. However, some may fail to see that broad-brush negativity can fuel transphobia and stigmatise one of the most marginalised groups in society. There are real-world consequences to distorted public debates.
It is estimated that approximately 0.6% population may identify as transgender but the number of trans and non-binary people accessing services at Gender Identity Clinics in the UK is much smaller than this. It is typical to wait two to three years for a first appointment in a gender clinic in the UK. This comes nowhere close to the 18-week referral to treatment standard set out by the NHS.
Gender diverse people are disproportionately disadvantaged in the access to gender affirming care, despite evidence indicating that transgender identity-recognition develops analogously to that of cisgender children. One study highlighted that 75% of transgender male and female adult participants could tangibly trace their gender dysphoria to age 7 or younger (Zaliznyak et al., 2020).
Reisner et al. (2016) found rates of depression and anxiety in people with gender dysphoria to be as high as 52% and 38% respectively. These figures compare to 19.7% of the cisgender population suffering from depression (Mental Health Foundation, 2019).
The Stonewall Trans Britain Report (2018) notes that 48% of trans people have attempted suicide, while 89% have considered suicide, and 72% have self-harmed at least once (Bachmann and Gooch, 2018). A recent study from Harvard Medical School (Turban et al., 2020) of 20,619 transgender adults found that 90% of those who wanted, but were unable to access, puberty blockers experienced suicidal ideation. For those who were able to access puberty blockers, the prevalence reduced significantly to 75%.
Transgender (and non-binary) identity is not a mental illness, lifestyle choice or social contagion. Its existence is not something to be “debated” any more than we can debate the existence of gravity. The case of Keira Bell is an undeniably sad one, about which media coverage must play an important role. Yet, we have an ethical responsibility to dispense with the moral panics and provide balanced unbiased reportage so that this complex issue can be better understood.
Dr Amber Keenan is a clinical psychologist and gender specialist. If you are interested in training, consultation or supervision for your business, school or organisation, please get in touch: firstname.lastname@example.org but please note that Amber does not carry out individual gender assessments (for diagnostic, hormone or surgical purposes) in her private practice due to a conflict with her NHS gender identity clinic role.
See here for details of an upcoming workshop: Understanding Gender Dysphoria: An Introductory Workshop for Therapists Tickets, Multiple Dates | Eventbrite