April 19, 2024 - 7:00am

So it turns out that Scottish children are no more suitable for medical experimentation than English ones. Yesterday NHS Scotland responded to the Cass Review by pausing the prescription of puberty blockers for gender-confused children and — in a move that goes further than its English counterpart — halting cross-sex hormones for under-18s.

This is a tremendous relief and, to some of us, a surprise. As Dr Hilary Cass noted, evidence-based care for vulnerable children has been disrupted by those who prefer “a social justice model”. Being in favour of the sterilisation of autistic and gay children — or “protecting trans kids”, as it’s been known — has long been a way to advertise one’s right-side-of-history credentials. It has also, in the eyes of certain Scottish politicians, been a way to indicate that one’s own country is young, progressive, and forward-looking, rather than mired in stuffy old principles such as “child safeguarding”.

It would have been a tragedy if, yet again, adults were permitted to sacrifice the health and future wellbeing of children for the sake of their own egos. Even so, the announcement on the Sandyford Gender Service website leaves a lot to be desired. There’s no shame, no apology, seemingly no awareness that if you are indeed lacking “evidence of safety and long-term impact” for the therapies you have already been prescribing, you are complicit in doing harm. The language is oh-so-neutral.

Apparently, none of this means practitioners are not “committed to providing the best possible clinical care”. It’s just pure coincidence that even someone like me, with no medical qualifications, suspected that there was a problem years ago. There are only so many videos of homophobic mothers describing the “fixing” of their children that a person can tolerate (let’s be honest: it should only take one).

There is progress here, certainly. Thanks to this belated return to ethical standards, some children who would have been harmed will be able to grow and thrive. Right now, however, many of them will not want to. The thought of being “forced” to go through the “wrong” puberty must be terrifying them. If the adults around you have spent most of your life affirming your own sense of wrongness, then how could the Sandyford decision seem anything other than barbaric? You’ve been told — by organisations visiting your school, by books in your school library, by teachers, parents and doctors — that the way you feel and behave is incompatible with the sex you have been “assigned”. Why, then, should anyone be barring your only escape?

The problem is not just that evidence-based medicine was abandoned in favour of cultural trends. Any return to basic standards has to go hand-in-hand with a serious critique of the culture. On the same day the Sandyford decision was announced, it was reported that “LGBT champions” are visiting primary schools in Scotland to teach children as young as four about gender identity. That is, to teach them that if they are gender non-conforming they may in fact be the opposite sex — there is no real “championing” of LGB in this entire enterprise.

It is not possible to reform “gender medicine” without addressing the incoherence, bigotry and cruelty of this ideology. Gender-variant children have always existed, usually growing up to be lesbian or gay. The “trans child” was constructed to validate trans-identified adult men and appease homophobic parents, before being championed by individuals more interested in appearing cutting-edge than engaging in the poorly-rewarded, unglamorous work of putting children first.

It is too late for those who were complicit to say they didn’t know. Now we must create an environment in which children bullied into fearing their own physical development can start to feel safe again. It’s time for the bullies to get out of the classroom and off the bookshelves. Back off and let these children grow.

Victoria Smith is a writer and creator of the Glosswitch newsletter.