Why we endorsed Lesbians United’s paper on puberty blockers
Lesbians United have published their review of over 300 sources of evidence regarding the use and adverse effects of drugs which are used to suppress puberty in adolescents who are experiencing distress around the development of their sexed bodies.
As they point out in this review, evidence based on studies of children and adolescents is in short supply and of generally poor quality. However, there is a wealth of evidence available from studies which have examined the use of these medications in treating adults for various health conditions. Many adverse side effects have been reported in connection with these drugs, including increased risk of osteoporosis, potential for lowered IQ, dementia, depression and suicidality, fertility problems, diabetes and chronic pain.
We were invited to consider this review of the available evidence, and we were glad to endorse it. The use of puberty suppressing medication has recently been prominent in the news in the UK, with the announcement that the Gender Identity Development Service (GIDS) at the Tavistock Centre is to close, following concerns raised by Dr Hilary Cass’s independent review.
Scotland has a very similar clinic for young people, based at the Sandyford, and we join calls for the Scottish Government to heed the implications of the Cass Review, as well as this new paper from Lesbians United. There have been recent calls from Joanna Cherry, MP, and Robin Harper and from David Bell, previously a psychiatrist at the Tavistock, for the clinic at the Sandyford to be closed.
As a group working to advocate for lesbian wellbeing, we are very aware and very concerned about the prevalence of young people being seen at gender clinics who may go on to be lesbian or gay. Dr David Bell has previously likened the practice of gender-affirming treatments to, ‘a form of conversion therapy for young people who are gay or lesbian.’ As Lesbians United state, girls and particularly lesbians are over-represented in treatment for ‘gender dysphoria’. There are already many accounts of detransitioning young people who are lesbian or gay, and accounts of gender identity clinics offering treatments based on young people’s failure to feel comfortable with the kind of sexist, rigid gender roles that our mothers were teaching us to reject in the 1970s.
We suggest that there needs to be a research focus on developing a holistic understanding of the needs of young people who are struggling with issues around their developing sexed bodies, and a more critical focus on the prevailing culture in which they feel such discomfort and distress. For young lesbians in particular, we believe that there are huge risks in overlooking the role of factors such as lack of visible role models, lack of acceptance of same sex attraction, unwanted male attention, use of dated, heteronormative standards to define normal development, the influence of pornography, and a deluge of information on gender identities along with pressure from peers and others to fit in with these.
Lesbians United’s review of puberty suppressing medications, along with Dr Cass’s review, make it abundantly clear that current treatment practices for these distressed young people are not acceptable. The work of providing an appropriate response will lie not just with researchers and clinicians, but will require a concerted effort from many different groups to challenge and change a culture in which so many young people can imagine no better future than that offered by medical treatments which can have devastating, life-changing side effects.