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8 February 2024updated 09 Feb 2024 8:58pm

Kemi Badenoch sticks to the facts

Evidence suggesting young gay people are most at risk from gender-affirming treatment goes back decades.

By Hannah Barnes

Select Committee hearings are often written off as dry affairs, where both politicians and onlookers can be caught stifling a yawn. Not so Kemi Badenoch’s appearance before the Women and Equalities Committee last December.

In a highly charged, combative atmosphere, the Business and Trade Secretary – who also has ministerial responsibility for women and equalities – highlighted a worrying lack of knowledge by parliamentary colleagues (on all sides), who did not seem to be on top of their brief. As is often the case when issues of gender and identity are discussed, particularly when they relate to children, there was plenty of heat.

At one point Labour’s Kate Osborne, with whom Badenoch clashed the most forcefully, seemed to suggest that it might be the case that “there is no such thing as biological sex”. Discussing material being used in sex and relationship education in schools, Badenoch suggested that some children were being taught this “nonsense”.

“Who says it is nonsense?” Osborne replied. Proceedings got especially fiery when both MPs accused the other of lying.

It was Badenoch, though, who was attempting to shed light. Light based on evidence and facts, not ideology or emotion. And yesterday, she went a step further, writing to the committee’s chair, Conservative MP Caroline Nokes, with a stream of studies that back up her words. Some may find those words uncomfortable, but they are supported by both research studies and clinical experience.

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The most controversial is the argument that those most likely at risk from a ban on so-called conversion therapy which includes gender identity as well as sexuality, are young people who will grow up to be gay. This is sometimes referred to, rather unfortunately, as “transing away the gay”.

“Both prospective and retrospective studies have found a link between gender non-conformity in childhood and someone later coming out as gay,” Badenoch wrote on Wednesday (7 February). “A young person and their family may notice that they are gender non-conforming earlier than they are aware of their developing sexual orientation. If gender non-conformity is misinterpreted as evidence of being transgender and a child is medically affirmed the child may not have had a chance to identify, come to terms with or explore a same-sex orientation.”

The Business Secretary is right. This is a narrative I heard time and time again from clinicians who worked at the once-flagship NHS children’s gender clinic at the Tavistock and Portman Trust while writing my book on the Gender Identity Development Service (GIDS). Almost everyone – even those who believed GIDS to be offering good care – raised it as an issue: that so many of the young people they were seeing were same-sex attracted. In some cases, those staff felt that GIDS was performing “conversion therapy for gay kids”. Indeed, Badenoch references this in her letter.

Anecdote is not enough though, and Badenoch highlights the rafts of studies that show that the most likely outcome for gender non-conforming young people, including those who are highly distressed around their gender, is to be gay or lesbian as an adult.

These studies are not of high quality – they’re observational, have few participants (a high proportion of whom drop out), and they measure different things. This is symptomatic of this field. But the overall message was the same: take a group of children distressed around their gender, a small number would retain that distress and transition as adults; the great majority would not, and many of those would be gay. That is, until puberty blockers started being used in early puberty.

This is not a secret. It has been discussed in clinical circles for years, including – as Kemi Badenoch points out – by the team that pioneered the medical transitioning of children and young people. “The Dutch founders of medical gender transition for adolescents wrote in 1999 that (the language is their own): ‘Not all children with GID (Gender Identity Disorder) turn out to be transsexuals after puberty… Prospective studies of GID boys show that this phenomenon is more strongly related to later homosexuality than to later transsexualism. These findings are in accordance with retrospective studies that have shown that male and female homosexuals recall more cross-gendered behaviour in childhood than male and female heterosexuals.’” Badenoch quotes from a further study in 2012, also by the Dutch: “Follow-up studies have demonstrated that only a small proportion of gender dysphoric children become transsexual at a later age, that a much larger proportion have a homosexual sexual orientation without any gender dysphoria.”

One thing the equalities minister omits is the rather startling feature of the pioneering Dutch study from 2010/11, which began the worldwide medical transitioning of children: only one out of the 70 children who started treatment with puberty blockers saw themselves as heterosexual. Limited data from GIDS, cited by Badenoch, paints a similar picture.

Some in the trans community say that the findings of these older studies should be ignored: that the young people in them were not truly gender dysphoric, but just gender non-conforming, and they wouldn’t meet the more stringent criteria for a diagnosis that we have now. Perhaps. But that would mean also throwing out the Dutch studies that pioneered medical treatment for young people today. All the participants of those studies were diagnosed under the old criteria too.

What was so striking about the committee hearing back in December was the lack of basic knowledge around gender-questioning young people, and the medical care provided to them on the NHS, by so many members. Caroline Nokes and others were seemingly unaware that referrals to NHS England’s only children gender clinic based at the Tavistock Trust in London has increased dramatically over the last decade and a half; that there had been a shift in demographics of those being referred from predominantly pre-pubescent boys, to adolescent girls; nor that young people with autism were overly represented.

As someone who has covered this area of healthcare for five years, this is astonishing. These are basic, well-reported, uncontested facts. Referral figures have been published annually. They are included in the official NHS-commissioned Cass Review of youth gender identity services. There are dozens of academic papers that detail these facts. As Badenoch pointed out to Colburn in the committee hearing on 13 December, “I am happy to write more formally with details, but it is not new information. This is why we started looking at the cause of the increase in children referred to clinics. It is related to the entire Tavistock scandal and why we had to close that clinic. It is not something new or controversial.”

Badenoch’s letter contains the relevant numbers on referrals: in 2021/22 there were over 5,000 referrals to GIDS; a decade earlier in 2011/12 there were just under 250 referrals in 2011/12.

“In 2020 referrals stood at 2,500 per annum, meaning that the rise to 5,000 in the most recent year represents a doubling in a single year. As I said in my evidence session, this trend represents an explosion in numbers of referrals.” Having described referrals as an “explosion” during the December evidence session, Badenoch was admonished by Nokes: “You have not provided the data to back that up.” She should not have had to. In her influential role, Nokes absolutely should have known it. So, too, that young people with autism are over-represented in referrals to gender clinics, something that Badenoch also provided data on, excluding GIDS’s own observation that, “Around 35 per cent of referred young people present with moderate to severe autistic traits.”

These are difficult matters to discuss, but discussed they must be. The potential good health and happiness of thousands of young people are at stake. As Badenoch said back in December, “We need to be able to have disagreement without turning it into, ‘I feel unsafe’ or ‘This is triggering people.’ That is not our job as legislators. People out there might say things on Twitter and whatever, but as legislators, we should be the grown-ups in the room.”

[See also: Who runs Labour?]

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