Clegg is propping up Miliband's EU policy

Both pro-EU, both queasy about a referendum. Who will jump first?

In increments the Liberal Democrat position on an EU referendum is shifting towards full-blown commitment. Nick Clegg has already conceded the point that the big question is "when, not if" the British public is invited to choose how European it wants to be. Today, in the first of what are promised to be monthly press conferences, he clarified the point that a referendum on any future EU treaty would necessarily have to be an in/out vote.

This is an important distinction because, under the 2011 European Union Act (aka the “Sovereignty Act”) a referendum on any substantial new treaty is automatic. Well, actually it is semi-automatic. Ministers can still declare a treaty insubstantial in terms of powers being shared in Brussels and block the plebiscite. Largely for that reason, the Sovereignty Act never satisfied eurosceptic Tory back benchers, although their satisfaction was, of course, David Cameron’s only motive for passing the law in the first place.

Now the Sovereignty Act is serving an entirely different purpose. It is the temporary get out clause for Nick Clegg and Ed Miliband. The Labour leader quietly acquiesced to the measure last year, meaning he too has signed up to a referendum in the event of a major treaty revision. All that remains is for Miliband to clarify, as Clegg has done, that this would effectively be an in/out poll and the two parties’ positions will be indistinguishable.

MPs in both parties think that position is unsustainable. Very senior Lib Dems have told me they recognise the implausibility of going into a general election campaign in 2015 without a referendum pledge in their manifesto when they had one in 2010. In other words, the wheel is being turned slowly but the direction is clear enough. By polling day, Clegg will have stripped away the caveats and signed up to national vote on EU membership. There are plenty on the Labour side, including a good number of shadow cabinet ministers, who think Miliband will ultimately have to make the same calculation.

The Tories are confident that their commitment to a referendum appeals beyond the ranks of militant eurosceptics. It is, they say, a point of principle – consulting the people and accepting their judgement. The fact that the Tories would split down the middle when it came to actually deciding how to vote in this great democratic consultation is a worry for after the election. Before polling day the only point that matters to Cameron is that he can insist that his party trusts the people and that labour doesn’t. As I wrote a few weeks ago there is mounting anxiety in the Labour ranks that such an attack has deadly resonance.

Miliband has good reasons for not promising an EU vote. Referendums are a dreadful policy tool. There are plenty of important decisions affecting national sovereignty, trade and international diplomacy that aren’t put to a vast national show of hands. Besides, why would an incoming Labour government want to spend its first year in office organising a campaign that only exists because Cameron (who by this stage would be the ex-leader of the Conservative party) felt bullied into something by his backbenchers, Ukip and their press cheerleaders?

Labour’s position is not as ridiculous as many Tories insist. Those who are obsessed with Europe naturally overestimate how much it matters to everyone else and how relevant it will be to their voting intentions. There is always the possibility that Tories banging on about Brussels stokes the sense of grievance among people who will always feel betrayed by Cameron, while signalling to moderate voters that the Conservatives are uninterested in their concerns. Cameron tends to treat his party's euroscepticism like an itchy rash. He gives into the temptation to scratch it hard, which feels good for a while but only makes it angrier, nastier-looking and harder to ignore in the long term.

So, in theory at least, Labour could hold a line against a referendum insisting that the nation’s priorities are elsewhere. Let Cameron and Co. swivel their eyes in imitation of Ukip, Miliband might say, while those of a more moderate disposition talk about jobs, growth, the cost of living etc. Except Miliband isn’t yet talking about those things in a way that captures the public imagination. Labour seem marooned between their old position of resisting austerity and their election pitch, which will be some variant of fiscal discipline with a conscience.

This Friday, parliament will vote on a Tory backbench motion affirming Cameron’s earlier pledge of a referendum some time in the next parliament. It cannot be legally binding on a successor parliament so its value is entirely symbolic. Labour MPs will for the most part stay away. Nick Clegg today confirmed that, as far as this particular legislative ruse is concerned, the Lib Dem position is again identical to Labour’s. The junior coalition party would not, he said, "waste any time helping the Conservatives indulge in their own internal feuds on the floor of the House of Commons on Friday."

But all the while Clegg is manoeuvring into a position where he accepts the inevitability of a European referendum. When he does so he will also position the Lib Dems as unequivocal and united campaigners for an "in" vote, drawing a clear contrast with the Tories. This poses a new hazard for Miliband, who is as instinctive a pro-European as you will find in parliament these days. If Clegg jumps first and declares himself the pro-referendum, pro-EU candidate, where does that leave the Labour leader? His allies say he will make a decision about Labour’s European policy based on principle alone; that he will not have his agenda dictated by media pressure or tactical Tory games. But by the time he has made up his mind, he could find that the clear positions – for and against; in and out – are taken. Then Labour once again will be left looking like the party that plays catch-up and whose defining approach to tricky issues is a preference not to talk about them.

Nick Clegg and Ed Miliband attend a ceremony at Buckingham Palace to mark the Duke of Edinburgh's 90th birthday on June 30, 2011 in London. Photograph: Getty Images.

Rafael Behr is political columnist at the Guardian and former political editor of the New Statesman

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How society is failing transgender children

In the wake of the cancellation of a public debate on this subject, one of the speakers shares her view on where society's approach to gender nonconformity is going wrong.

In August this year, several UK councils issued guidance to schools on accommodating female pupils who wear binders. A binder is a constricting undergarment for the upper body: what it binds are the breasts, pressing them down to a flatness that the wearer feels is appropriate to their self-perception as masculine or gender-neutral. According to Cornwall Council, the binder is “very important to [the wearer’s] psychological wellbeing.” But binders have unwelcome physical side-effects too, including “breathing difficulties, skeletal problems and fainting.” Lancashire Council’s advice urges teachers to “monitor [wearers] carefully during physical activities and in hot weather. It may be necessary to subtly offer more breaks.”

When the NSPCC invited me to participate in a discussion on the subject “is society letting down transgender children?” (part of its Dare to Debate series), those guidelines were one of the first things I thought of. They’re written in accordance with the overriding principle of gender identity politics, which is that affirmation is all. Any bodily harms incurred count for little compared to the trauma believed to be inflicted by a “mismatch” between appearance and identity. It’s a doctrine that insists we’ve moved beyond the tyranny of physical sex and social pressure, and into a realm of pure selfhood where all must be able to live in accordance with their own inherent being.

And yet, look again at that list of side effects: breathing difficulties, skeletal problems, fainting, inability to participate fully in exercise. The female adolescents wearing binders have reproduced all the problems of tight-lacing corsets, this time in the service of restrictive anti-femininity rather than restrictive femininity. So is issuing guidance to reduce the harms of binder-wearing in schools an act of care for transgender children, or an abdication of it? Is the role of adults in authority – whether parental, educational or medical – to validate everything that comes under the rubric of transition, regardless of long-term consequences, or could another approach be better?

The number of children who identify as trans is small, but rapidly increasing: referrals to the Tavistock and Portman NHS Trust’s gender identity development service have doubled year-on-year. Putting gender-nonconforming youths on a medical track opens the possibility that they will be prescribed puberty blockers, delaying the physical changes of adolescence that individuals may find distressing. Later, treatment can include cross-sex hormones and surgery to create the desired sexual characteristics.

For many, this can alleviate profound anguish about the self, but not without costs. The long-term effects of hormone therapies aren’t known, and won’t be until the current generation of trans children have lived well into adulthood. There’s a risk that increased medicalisation could be imposing permanent physical changes on children who, left to their own devices, would discover they are quite happy living with their natal sex – about 80 per cent of children diagnosed with gender dysphoria desist before adulthood, but the normalisation of medical transition could commit many to irrevocable treatments they would otherwise avoid.

Remarkably, as I found out when I worked on a long feature on the subject, there isn’t any agreement on what gender identity is or how it relates to the physical body. Which means that transitioning children are receiving an untested treatment for an undefined condition. Medicine often involves a surprising degree of idiosyncrasy and guesswork, but this uncertainty both about what is being treated and the effects of the treatment should be a cause for caution. While many who transition find it wholly positive, not everyone does: doubt and detransition happen, and these stories tell us that the quickest path to reassignment is not always the best treatment for someone presenting with dysphoria.

Sometimes, a diagnosis of gender dysphoria might mask a different underlying cause to a child’s distress. Psychiatrist Susan Bradley reports that children with cross-sex identification are often (not always) either responding defensively to a violent background or engaging in the obsessive behaviours associated with autistic spectrum disorders. A policy of “watchful waiting” – listening to the child, supporting them and giving them freedom to experiment and develop – is vital if we are to give children the kind of help they really need. But in an environment where anything short of total and immediate reinforcement is deemed abusive, “watchful waiting” is not an option.

One more problem: if gender dysphoria is conceived as the problem, and gender reassignment as the solution, then transition represents the summation of a process which should in theory resolve everything. In practice, newly-transitioned young people (especially those crossing the threshold from child and adolescent mental health services to adult provision) can find themselves stranded, no longer in receipt of the support they had during transition. We simply aren’t getting the treatment of transgender children right if we’re only treating their gender.

The consequences extend well beyond children who identify as trans, of course. Schools are suffused with sexual harassment and sexual violence, yet girls are expected to accept a child they previously knew as a boy as female like them, or be called bigots. The naturalisation of sex-stereotypes in parental narratives of transition surely has a limiting influence on other children’s conception of sex-appropriate behaviour. For some gender-nonconforming children, the cultural celebration of transition leads to anxiety about whether they themselves should be trans, even if they’re happy in their bodies. Certainly, many gay and lesbian adults have looked back on their own childhoods and remarked nervously that their behaviour then would qualify them as trans now.

If we’re not able to address these issues, then we’re manifestly failing children. But addressing them is incredibly difficult: practitioners who privately mention their doubts about current approaches to gender noncomformity are afraid to ask questions publicly, anticipating personal attacks and the loss of their jobs.

They’re not wrong to do so. After announcing the Dare to Debate event, the NSPCC was put under sustained pressure, I was persistently abused, and following the withdrawal of the other panelist, the charity cancelled the event. Previous installments in the series have looked at child sexualisation, foetal alcohol syndrome, and asked whether the investigation of child sexual abuse has tipped into “hysteria”, but apparently it would be just too daring to talk about gender. Doctrine so bitterly defended that it must even be protected from good-faith debate is a kind of restrictive garment for the intellect. Wearing it can ease our mental pangs. But the damage it does besides is very real.

Sarah Ditum is a journalist who writes regularly for the Guardian, New Statesman and others. Her website is here.