David Cameron shakes hands with Alex Salmond outside at St Andrews House in Edinburgh on October 15, 2012. Photograph: Getty Images.
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The SNP is praying for a Tory poll surge

The party needs the Tories to move ahead of Labour to encourage Scots to back independence. 

What will it take to persuade a majority of Scots to vote for independence? The SNP believes it has found the answer in the form of another Conservative-led government. In the last fortnight, two polls have shown that up to 55 per cent of voters support independence when confronted with the prospect of David Cameron returning to Downing Street. 

To mark Ed Miliband's speech in Edinburgh today, the SNP is devoting itself to talking down Labour's election chances. It notes that just 9 per cent of Scots believe Miliband looks like a prime minister, that 50 per cent believe he has been a weak leader and that the Tories have a 15 point lead over Labour on the economy. Added to this, it highlights that Cameron's former director of strategy Andrew Cooper, a recently appointed adviser to the No campaign, has tweeted that "No opposition party has ever gone on to win the next election from the poll position Labour is in now." 

It is not hard to see why the SNP is determined to promote the idea that Miliband is destined . As Labour leader, he has adopted precisely the kind of centre-left policies championed by the nationalists. He has pledged to scrap the bedroom tax (which, like the Poll Tax, has become a symbol of Conservative callousness in Scotland), to reverse the privatisation of the NHS, to invest more in early-years education and childcare, to spread the use of the living wage, to rebalance the economy and to increase infrastructure spending. He has condemned the invasion of Iraq, prevented a rush to war in Syria and pledged to pursue a foreign policy based on "values, not alliances". And he has denounced the rise in income inequality (which, as Salmond rightly laments, has made the UK one of "the most unequal societies in the developed world"),  and has made its reversal his defining mission. If the UK elects a Labour government next May, it won't need Scotland to serve as a "progressive beacon". Rather, it will become a more progressive country through its own means. 

Awkwardly for Salmond, then, Labour's slight but stubborn opinion poll lead endures (at an average of five points). None of the findings cited by the SNP are persuasive evidence that this will change. Scots may take a dim view of Miliband but since the country, as Salmond complains, has little influence over the outcome of general elections (accounting for just 59 of Westminster's 650 MPs), why should this be relevant? That Labour's lead has remained even as Miliband's ratings have worsened suggests they may not be an obstacle to victory. The Tories may also lead Labour on the economy (as they did in 1997) but they continue to trail on the crucial issue of living standards. As for Cooper's observation, I have explained before why history is likely to prove a poor guide to the outcome of this election. 

To persuade Scottish voters that the Tories are most likely to be back in government after May 2015, the SNP needs the unambiguous evidence provided by a Conservatiove poll lead. Thus, we are presented with the grim sight of a "progressive" party cheering on a reactionary one. 

As it happens, the belief that a Tory poll surge would persuade Scots to back independence is almost certainly wrong. The question on the ballot paper will not be "Should Scotland be an independent country to free itself from Tory rule?" (the leading question used by pollsters) it will simply be "Should Scotland be an independent country?" Voters will consider far greater issues than the likely outcome of the 2015 election. And, when they do, every poll continues to suggest that they answer "No". 

In the meantime, as Salmond prays for a Tory poll surge now and a Tory victory later (to increase the possibility of a second referendum), this debased and opportunistic alliance deserves more attention than it has so far received.  

George Eaton is 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.