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A collection of articles by Dr. Susan Matthews THE CURIOUS WORLD OF GENDER MEDICINE The Curious World of Gender Medicine “When I use a word,’ Humpty Dumpty who don't fit sex stereotypes: all the odd kids like I said in rather a scornful tone, ‘it was - all the ones who are the outsiders, the ones means just what I choose it to mean who get le� out, the ones who get bullied, the — neither more nor less.’ slightly vulnerable kids, the ones with mental health issues that…You know I really feel like I get those ’The ques�on is,’ said Alice, ‘whether kids.’ Like Stephanie, I wanted to find out why kids you can make words mean so many were being sent off for medical interven�ons and different things.’ why our culture had bought into this answer to distress. ’The ques�on is,’ said Humpty Dumpty, ‘which is to be master — Through the Looking Glass with that’s all.” Mermaids ― Lewis Carroll, Through the Looking Glass My first three pieces for Transgender Trend took me through the looking glass into the mythic world of The Care Quality Commission found that staff at GIDS Mermaids. (the NHS gender service for children and adolescents) were trained on incident repor�ng. But the GIDS had When ITV announced that Anna Friel was starring as an odd understanding of what cons�tutes an a lightly fic�onalised version of the Susie and Jackie ‘incident’. An audit of pa�ent records in March 2020 Green story, we knew we had to provide an examined the way that ‘capacity, competency and alterna�ve view. BBC online presented the show as consent’ was recorded. Established procedures were public service broadcas�ng in a glowing review by not followed in eight out of the eleven records Rebecca Thomas. The accompanying s�ll shows Max reviewed: hoping to cross the glass wall to the underwater world where he can become a mermaid: The absence of a structured assessment had not been recorded as an incident for any of these records, despite the absence of a formal record of assessment poten�ally leading to a risk of medicines being administered unlawfully. Administering medicines unlawfully sounds serious. But this was not ‘recorded as an incident for any of these records.’ The wrong name on an envelope, however, triggered the proper procedures: a member of staff described an incident involving the young person’s preferred name being wri�en on a le�er but their given name, which they did not like to use, was wri�en on the envelope. The service sent the young person a formal apology for this. Hard, really, to find a clearer image of the fantasy sold to parents and children by Mermaids. Paris Lees There’s a topsy turvy logic at work here: feelings are hoped the show would ‘be a game-changer." As it a lot more important than facts, language than happened, the game-changer, arguably, was a series powerful body altering medicines. of ar�cles by Andrew Gilligan in the Sunday Times that were illustrated by images from the show. When I met Stephanie in 2016, I was impressed by Transgender Trend decided to release a blog to the way she sought out facts and evidence. I was follow each episode. In the first, we argued that ‘the also struck by her concern for the kids and young show significantly and dangerously misrepresents adults caught up in this movement. In her 2021 current thinking on the care of gender confused interview with Benjamin Boyce, Stephanie said: children and young people.’ The s�nging last line ‘I see myself as an advocacy group for all children was the work of Shelley Charlesworth. 2 THE CURIOUS WORLD OF GENDER MEDICINE Butterfly: A Mermaids Tale Post published:October 14, 2018 Image from the trailer for Bu�erfly showing Mermaids product placement Bu�erfly, an ITV drama starring Anna The show not only follows the Mermaids script but Friel, follows a family as they try to appears complete with product placement, branding and Mermaids supporters in small ac�ng roles. Over understand their troubled gender the credits we see Max’s room, painted an non-conforming 11-year-old. underwater blue, li�ered with Li�le Mermaid toys and a mermaid pendant. Visi�ng the SeaLife The ‘inspira�on for the show very much came from aquarium, Max has a vision of a mermaid, an real-life’, Pink News reports: ‘Susie Green, head of a�rac�ve woman with breasts and fishtail costume, the charity Mermaids, worked closely with the swimming towards him. Mermaids of course belong producers of the show and Bu�erfly mirrors the true to the pre-sexual world of children’s literature: we story of Susie and her child Jackie.’ In a glowing don’t and can’t know what happens below the waist. review on the BBC website by Rebecca Thomas, Bu�erfly is presented as public service broadcas�ng But in the real world, Max faces strict gender in the spirit of Lord Reith: this is drama to ‘entertain, policing: the credits show nail varnish being educate and inform’. The ITV mini series ‘will surely removed and lips�ck wiped off. Turning up to collect have a beneficial effect.’ Max and sister Lily for a day out, the dad praises Max’s new haircut and calls him a “handsome young In an ar�cle in the Guardian the writer of Bu�erfly, chap”. To heal the split in the family, Max tells his Tony Marchant, is clear about the intended dad that when he grows up he wants to be a audience: footballer, adding in a shaky voice that his dad ‘knows’ what he really wants to be. The viewer “The primary-colour storytelling pale�e is, knows that what Max wants to be is a woman, a however, inten�onal. Marchant envisages a career choice on a par with Max’s other two op�ons, family audience, who presumably will watch on catchup since moments of Bu�erfly are too footballer or astronaut. shocking to air before 9pm. “First, it would be kids going through this, with or without the In this drama, femininity is expressed in gender support of their parents. It’s a posi�ve, affirming stereotypes. Max doesn’t want chips because he is message. Then I’d hope it would be parents who ‘watching his weight’ (here a sign of femininity that aren’t coping with it. A�er that, maybe just kids with any sort of difference, and their parents. would be worrying even in a slim 11-year-old girl). Some sense of: this is what we need to do, this Back home, Max reveals his innate femininity when is OK.”” 3 THE CURIOUS WORLD OF GENDER MEDICINE he tells his mother that his father’s new girlfriend is ‘“I really wanted to be a girl”, he said. “Thank “a bit Kardashian”. While Vicky and her daughter God the world of now wasn’t then, because I’d be discuss Max’s girlyness, we see him dancing alone in on hormones and I’d be a woman. A�er I was 15 I never wanted to be a woman again.” his bedroom, wearing a strappy pink top. Max doesn’t feel he has a choice, but nor do his The take home message for the viewer is that parents, especially when Max starts self-harming, femininity in a boy points to a transgender iden�ty. slashing his wrists at the moment that his mum is There certainly are kids who diverge from the about to set off on a date. Self-harm, the script gendered norms associated with their sex and do so suggests, is a response to Max’s gender issues. But despite the culture of the family in which they are we know – Samaritans is clear on this – that there ‘is raised. Some boys, for instance, display a more no simple explana�on for why someone chooses to extreme form of femininity than would be the norm die by suicide and it is rarely due to one par�cular for girls. In fact we know from robust research that factor.’ gender atypical boys are far more likely than the norm to turn out to be gay (though most will be We also know that the best way to help someone heterosexual). The least likely outcome in adulthood with suicidal thoughts is to listen without imposing a is a transgender iden�ty. meaning on their ac�ons. But this scene contributes to the idea that transgender children are peculiarly At school, Max is called “gay boy” and a girl s�cks vulnerable to suicide even though weknow out her tongue at him. In a flashback, we see Max that ‘Suicide among young children is vanishingly dancing to music in a fluffy pink sweater and being rare’. Max is 11: to get a sense of how rare suicide in hit by Stephen – a moment of violence which leads this age group is, we need to realise that 10 out of to his father leaving home. Si�ng alone in the the 3.3 million kids aged 10-14 killed themselves last school playground, Max longs to join a line of girls year. But sta�s�cs don’t mean much to parents who are dancing and when he finally does so, faced by a child in distress. encouraged by his sister, we see Max relax is he expresses his feminine side. The inevitable bullying In a statement released to the Sunday Times, follows: two boys corner Max on his way home to Tavistock GIDS had this to say about the portrayal of call him ‘Dance boy’ and ‘Gay boy’.

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