(8 months, 1 week ago)
Commons ChamberThe subject of this debate has been thrust into the spotlight in recent weeks. Michael Shellenberger’s WPATH—World Professional Association for Transgender Health—files report by Mia Hughes was published on 4 March, swiftly followed last week by Dr Hilary Cass’s eponymous report. Both make it clear that gender identity and sex are completely different things, but ideological capture has blurred the lines.
In the early 1990s, I was asked a question by a relative who was volunteering for the Samaritans and speaking to a transvestite male who was struggling with his mental health. Did I, as a gay man, have any advice? I was bemused by the question, because the only advice I could muster was that I had absolutely no insight whatsoever into cross-dressing behaviours, as most transvestites were heterosexual males.
The notion that there is such a thing as an “LGBT person” is ludicrous. Homosexuality is an innate sexual orientation centred on one’s natal sex. I am not a lesbian, bisexual or trans; I am a gay male. Working with others who are same-sex attracted on shared LGB rights has always made sense to me. As I have illustrated, there was a time in the not-too-distant past when heterosexual cross-dressers were confused with what it meant to be a gay male. There is little evidence of any T in the LGB. As they were then, what we now call gender identity and sex remain completely unconnected concepts, and they must not be confused.
I started working in the NHS when I was 19 years old. Since then, I have had a responsibility for child safeguarding that continues to this day. In 2019, I assumed that my professional knowledge and academic experience would have been of value to my then political party, the SNP, as it attempted to grapple with gender recognition reform legislation, but I was wrong. I was an SNP candidate and the chair of Fife Pride when I met my then friend Shirley-Anne Somerville for a coffee to discuss my safeguarding concerns about gender recognition reform. In addition to her Cabinet Secretary role in the Scottish Government, she was also covering the equalities brief. This was someone I had known for years—someone who knew my family.
I covered all the bases, emphasising exemplar cases such as that of local sex offender Lennon Dolatowski, also known as Katie, who had been accused of sex offences in Ms Somerville’s constituency and convicted of sexually assaulting a 10-year-old in the Kirkcaldy and Cowdenbeath constituency, which I was contesting. Despite assuring me throughout the conversation that she fully understood the concerns I raised, Ms Somerville concluded by telling me in no uncertain terms that the policy approach was Nicola’s priority, so I would have to keep my views to myself. In other words, I was being told to be silent on safeguarding. I told her that I would not be able to do that—I could not be silent on the matter of safeguarding children.
Soon after that meeting, the attacks from the gender-radical wings of the SNP, the Greens, Labour and the Lib Dems began. Since 2019, and indeed before that, people who have had concerns about LGB rights and the safeguarding of children and young people have been systematically silenced, and not just by the SNP. As recognised by the Minister for Women and Equalities, and again today in the Chamber by the Secretary of State for Health, there has been a deep-rooted capture within our institutions, with senior leaders ignoring the actual law and ideologically captured groups such as Stonewall misrepresenting it.
I commend the hon. Gentleman for bringing forward this issue, which we touched on in the statement earlier today. Does he agree that we have a duty to protect children of all backgrounds from the lobbying groups that abuse the system to promote a harmful ideology? For example, multinational companies such as Starbucks have supported charities such as Mermaids. It is time that those types of charities, which advocate for those as young as 14, rethink their charitable endeavours. Charities should instead help to protect our children, who must be left alone. Let kids be kids.
I thank the hon. Gentleman for that intervention. I made this point earlier today during in the statement, but the tentacles and influence of Stonewall need to be rooted out of every institution across these islands. It has been my long-held view that the agenda that Stonewall has pushed has seen queer theory-based policies insinuate their way into every public body—
I will go back a step. Stonewall has pushed queer theory-based policies into every public body, including in policing, education, and health, and even on to the Floor of the House of Commons, where straight women tell gay men to get back in their closet. The decision by Stonewall to add the T and incorporate cross-dressing heterosexual males under the wide banner of “trans”, or the more recently added “Q+”, was directly responsible for the elevation of concern among LGB people, women and transsexuals.
The damage done by Stonewall has been immeasurable. LGB people, women and transsexuals have all been subjected to vitriolic attacks from queer-theory activists who hide their vicious and vindictive mob behaviour behind hashtags such as BeKind. I could give a roll call of those who have stood up to that mob, or been dragged through the media and the courts for vexatious purposes, but I would be on my feet all week.
I also want to put on the record that the Labour party leadership needs to come out of hiding on this issue. The shadow Health Secretary’s recent Damascene moment of realisation does not mask the continued silence from the Leader of the Opposition, nor quell the ideological contingent of the parliamentary Labour party. That is not good enough in a general election year. People across these islands need to know that this nightmare is coming to an end before they cast their vote. I am encouraged by the emergence of sex equality and equity networks—known as SEENs—across the public sector, which challenge this harmful ideological capture. Silence will not cut it.
This indoctrination is causing very real and lasting damage, but the impact on those of us who spoke up has been nothing in comparison to the evil of medical malpractice visited on many vulnerable young people. Many of them were just lesbian, gay or bisexual, or young people dealing with trauma, mental health issues or neurodivergence, or in the care system. As Sex Matters, now a recognised human rights charity, has highlighted:
“A false global consensus around a ‘gender affirming’ approach has emerged because of ideological actors putting their individual belief-systems ahead of the protection of distressed young people, many of whom are lesbian, gay and bisexual.”
The WPATH files shone a light on the lack of evidence to support so-called gender-affirming care, and the ideological bias of documents masquerading as clinical standards. Tragically for children in the UK, WPATH’s standards of care have been extremely influential in shaping NHS protocols since 2011. Young people and many others have been badly failed.
The Cass review must be the final nail in the coffin for a “gender-affirming” model of care for gender-distressed children. Dr Cass builds on the concerns set out in the WPATH files report, which lifted the lid on the culture inside the World Professional Association of Transgender Healthcare. The Cass report also criticises WPATH guidelines as lacking in evidence and developmental rigour, and emphasises the vital need for fully informed consent, especially for young people with mental health conditions or other diagnosable co-morbidities.
I would ask the Minister to consider, and discuss with colleagues in the Department of Health and Social Care, an urgent package of investment in child and adolescent mental health services as a starting point. That WPATH’s unscientific standards of care guidelines have repeatedly been lauded by Governments as international best practice is another issue of deep concern, and I ask the Minister if he will commit to looking into the reasons why that was allowed to happen.
Dr Cass dismisses any notion that puberty blockers or hormones have any part in standard treatment for under-18s. The report explicitly states that the medical pathway will not be right for most young people with gender distress:
“the focus on the use of puberty blockers for managing gender-related distress has overshadowed the possibility that other evidence-based treatments may be more effective… clinicians have told us they are unable to determine with any certainty which children and young people will go on to have an enduring trans identity.”
Dr Cass decisively refutes the idea that suicide prevention is a reason for medicalising gender distress in youth:
“It has been suggested that hormone treatment reduces the elevated risk of death by suicide in this population, but the evidence found did not support this conclusion.”
Gender distress has been treated within the NHS in a way that is different from other sorts of distress, to the detriment of vulnerable children.
The Cass review definitively shows that young people with gender distress have been badly let down by those who claim to be protecting them. It substantiates what so many, including Hannah Barnes and Helen Joyce, have argued: that gender-affirming care is not underpinned by a credible or developed evidence base. It leads to sub-optimal outcomes and the diagnostic overshadowing of complex underlying health and social issues. Dr Cass emphasises that there has been undue ideological influence on healthcare decision making, specifically noting a suppression of evidence and a rush to medicalise vulnerable young people.
This has been facilitated close to home in Kirkcaldy and Cowdenbeath, too. Carolyn Brown, a retired depute principal educational psychologist for Fife Council, said in The Sunday Post this weekend:
“The same harmful ideologies identified in the Cass report have been happening across Scotland for years now as senior officials in health, education and social work failed to listen to concerned voices and adopted the ‘Three Wise Monkeys’ attitude while vulnerable children were harmed…
Many children going through puberty do question their gender, their identity and their bodies. That’s just part of growing up. The danger comes when officials affirm those questionings and tell a child they can change their gender. This is ethically and morally irresponsible as well as psychologically harmful and more likely to compound the mental health issues the child already has and reinforce the child’s self-perception that he/she really is trans.”
According to queer theory extremists, these children were born in the wrong body.
Once again, I commend the bravery and strength of those who have de-transitioned and have had the courage to tell their stories—Keira Bell, Ritchie Herron and Sinead Watson and those yet to find their voice. It is a double scandal that we do not know how many other young people have been affected, and whose lives have been irreversibly altered, by medical malpractice. These young people were exceptionalised and subjected to life-altering treatments without due regard for safeguarding, and they were denied the necessary follow up expected in every other sphere of clinical practice.
The cohort of Gender Identity Development Service patients was disproportionately made up of girls. Prior to the publication of the Cass review, Tavistock whistleblower Dr David Bell spoke of young LGB people, especially lesbians, having their sexuality “transed away,” yet it is women’s voices that have been sidelined the most, and none more so than the voice of lesbians.
It will not have escaped the few people left in the Chamber that I am not, and never can be, a lesbian, so I turned to lesbian activists in Scotland to give me their perspective on the impact that Stonewall’s queer theory practices have had on their life. These are their words:
“It has become very difficult to exclude men from lesbian spaces, especially if those spaces, events, or groups are advertised publicly. Males are demanding access to lesbians for dating, and to shame, bully or threaten lesbians who refuse. This has had the effect of driving lesbian culture underground, which means it is very difficult for young or isolated lesbians to make connections…
Young lesbians tell us that they are under a great deal of pressure to accept men in their spaces and as romantic partners. Some of the lesbians in the group have been pressured to identify as trans because of their same-sex attraction… The campaigns around Gender ideology legislation has emboldened homophobes, who make lesbians feel that there is something shameful or bigoted about our sexual orientation. Lesbians who assert their sexual boundaries are described as being obsessed with genitals or as having a ‘fetish’ or ‘kink’.”
This is undeniable and unacceptable homophobia.
In Scotland, the Sandyford clinic is continuing with these discredited hormone treatments, and to date the Scottish Government have persisted with the claim that this amounts to “international best practice”. That is a claim we now know to be manifestly false and worthless.
As highlighted by the LGB Alliance, Dr Cass found that 89% of girls and 81% of boys referred to GIDS were ultimately not trans but were homosexual or bisexual. That indicates an alarming pattern of misdiagnosis and inappropriate, unnecessary and irreversible medical and surgical interventions, and confirms what many have feared: that the NHS GIDS’ adoption of gender affirmation as a model of care has led to their, whether inadvertently or not, practising medical and surgical gay conversion therapy. It is incoherent to put sexual orientation and gender identity under the same conversion therapy umbrella. Parliament should not legislate in this area until sound clinical evidence on the best model of care has been properly developed and validated.
In a letter to First Minister Humza Yousaf raising my concerns about so-called “trans-inclusive conversion therapy”, which we now know is gay conversion therapy, I made the following point:
“Legislating to compel belief in gender ideology runs counter to provisions in the Equality Act 2010 put beyond doubt by the Maya Forstater v CGD Europe and Others ruling. Forcing an ideology or belief on others...would transform the Crown Office and Procurator Fiscals Service into a pseudo-theocratic enforcement agency and would thus preclude any notion of receiving a fair trial. ”
The Scottish Government, under Nicola Sturgeon and Humza Yousaf, have abandoned any pretence they are upholding their public sector equality duty, putting women, children and LGB people at risk. They have been warned repeatedly, but they called such concerns invalid and went ahead anyway. This place must not do the same.
Both First Minister Humza Yousaf and Ms Somerville have defended the introduction of non-statutory schools guidance, enabling non-expert teachers to affirm and enable the so-called “social transitioning” of minors in the absence of parental involvement or consent, but in a landmark legal opinion, human rights barrister Karon Monaghan concludes that schools and councils using such an approach are very likely to be in breach of equality and human rights legislation, and at risk of being sued by excluded parents. As the hon. and learned Member for Edinburgh South West (Joanna Cherry) noted recently, both the Equality Act 2010 and Human Rights Act 1998 are reserved matters, so the same risk of litigation should hold true in Scotland. There is little personal or professional protection for an activist teacher, given that this guidance is non-statutory, so the personal repercussions could be significant if they are pursued directly by excluded parents.
All of those warnings were stated long before the Cass report was published, but the virulent opposition to reason fostered and facilitated by Stonewall’s ideological capture across our public sphere has kept too many silent about the unfolding tragedy. Last week, I wrote to the Clerk of the House setting out in detail the legal and political incongruence and substantiated risk of harm from ropey ideologically-driven legislation. Therefore, I am seeking confirmation from the Minister that any such legislation will be excluded from the upcoming Criminal Justice Bill—I am referring to new clause 37—given the weight of evidence that Dr Cass has published about the dangers of embedding such practice in statute.
When I read the Cass Report and contrast its findings with the meticulous follow-up so carefully developed and provided to the children and young people I cared for during their cancer journey, it makes me furious and ashamed that clinicians could ever behave in such a cavalier manner. The LGB and other vulnerable young people who went to GIDS were subjected to life-altering treatments, only to be cast aside without follow-up. That must never be allowed to happen again—it is unethical and unprofessional, and the damage inflicted is, frustratingly, unknown. The evidence contained in the Cass report and the WPATH files is incontrovertible: in more than 80% of cases, gender-affirming “care” is gay conversion therapy.
Ending the routine prescribing of hormone supressing treatments is very much to be welcomed, but I wish to press the Minister further on the steps the Government will take to ensure that clinicians operating in private clinical practice and online pharmacies adhere to the NHS clinical guidelines issued by NHS England. This is a matter for the Department of Health and Social Care, the Ministry of Justice and the equality hub to work on in concert.
What further steps will the Government take to ensure that private clinics and online pharmacies are not able to circumvent these clinical guidelines? What sanctions and enforcement measures will be put in place? Will the Minister make it clear that never again will services for children and young people be exceptionalised in the way that they have been, and that Dr Cass’s recommendations will be implemented in full so that healthcare, clinical practice and equalities will be based on evidence, the best interests of every child and young person, and clinical expertise?
In closing, I agree with Dr Cass that LGB and gender non-conforming young people “deserve very much better”. Members of this House no longer have any excuse to look the other way or to hide.
I thank the hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey) for securing this important debate. He has raised a number of very serious issues. As he will understand, we are still considering a lot of them, so I may not be able to go into too much detail at this moment, but I will be more than happy to write to him and update him on progress in each area.
I completely agree with him on the need for us always to think about the safeguarding of children and young people, regardless of whether they are LGBT. We need to ensure we uphold our obligations in that regard. We welcome much in the Cass report—it is a comprehensive report. As the Secretary of State for Health and Social Care said to the House earlier, we will be considering and responding to a lot of points made in the report in due course. Much of what the hon. Gentleman is saying is that we need evidence-based decisions, which will clearly be incredibly important.
As I have mentioned at the Dispatch Box a number of times, this debate sometimes gets toxic, which does not help anybody. There are strong views on all sides of the debate, but for me it is really important that we base the debate on evidence and ensure we are careful in the way that we articulate our arguments. There are people out there, particularly young people, who will listen to some of those words and feel very affected and pressurised, in whatever direction that may be.
That is why the Government and I are committed to improving the outcomes of young people, especially recognising that LGBT young people can face very specific challenges, which may include bullying at school, an increased risk of mental health issues, which the hon. Gentleman alluded to, difficult family environments or, occasionally, even homelessness as a result of their sexuality. I assure the hon. Gentleman that the other equality hub Ministers and I regularly engage with our counterparts across Government Departments on these important issues.
To help achieve the goal of improving outcomes for LGBT people, we have ensured that spending for children and young people’s mental health services has increased. The hon. Gentleman was right to raise that important point. We have increased spending from £841 million in 2019-20 to just over £1 billion, but I will ensure that I write to my colleagues in the Department of Health and Social Care to raise the points that the hon. Gentleman has made this evening.
The Minister has raised the issue of mental healthcare for young people, including child and adolescent mental health services, which is extremely important to me. I wish to reflect on the statement that was made this afternoon by the Secretary of State for Health and Social Care and some of the comments that came from the Opposition decrying the long waiting lists for good services. I would just like to make this point: in this area, there is an attrition rate of upwards of 80% of young people. Most of those were on a waiting list for a long time, during which they worked out that they were just lesbian, gay or bisexual, so they did not go through with the surgical medical treatments. Does he not agree that those long waiting lists may have saved some young people from the harm that has been inflicted on others, and that the focus now needs to be on CAMHS funding to make sure that young people get the mental health support they need before they make these irreversible and irrevocable decisions?
That is exactly why the Cass report is so important. It is very carefully considered, and the Government now need to take the time to consider our response. None the less, the hon. Gentleman is right: when young people are deciding to come out or are wondering whether they are lesbian or gay, they should have the support that they need to help them to do that. We recognise that some may not have the sort of family support that I was fortunate enough to enjoy. I am blessed with an amazing family who were very supportive of me, but I do recognise that that is not the case for many others. The hon. Gentleman has made some important points and, as I committed to a moment ago, I will ensure that I write to my colleagues in the Department for Health and Social Care with the questions that he raises.
It is important to point out that we work in partnership with the Department for Education as well, because we need to ensure that there is plenty of work going on in the anti-bullying arena. The hon. Gentleman alluded to some of the pressures that the people he has spoken to have felt. That is why we have allocated a further £3 million of funding, divided between five anti-bullying organisations, to tackle bullying in school. That is on top of the £4 million that has already been spent in this area since 2016, and this includes projects that specifically target anti-LGBT hate-related bullying.
In October 2022, we launched a victim support service for anyone affected by, or at risk of, conversion practices, regardless of sexual orientation, sex or transgender identity, and the helpline is there to provide support and information to anyone over the age of 13. As I have said on many occasions, conversion practices are not a one-way street. Conversion practices—changing somebody from what they believe they are to something else—are, in my view, abhorrent and clearly wrong. As I say, it can go either way, and it is really important that we acknowledge that.
I have also done a lot of work on homelessness. I have seen so many instances of young people who find themselves in these challenging areas ending up homeless. That could be because of that lack of family support that I mentioned or because of mental health issues. That is why last year I and the Minister responsible for homelessness convened a roundtable for local authorities and charitable organisations to ensure that we provide tailored support for LGBT people, which is something that we take incredibly seriously.
The hon. Member also mentioned the issues in Scotland. It would not be responsible for me to answer on the Scottish Government’s behalf, and I do not want to do that. But in terms of what we are doing here, we want to ensure that children are prepared for life in modern Britain, and they need to understand the world in which they are growing up. That is why the statutory guidance states that all pupils should receive teaching on LGBT content during their school years, including in secondary schools.
I thank the Minister for giving way; he is a good sport, as always. Just for clarity on the issues in Scotland, the fundamental question is about the implementation and observation of responsibilities in the Equality Act 2010 and upholding the Human Rights Act, which are both reserved matters. In particular, the public sector equality duty has been an issue across a whole range of public bodies, not least the Scottish Government, who seem to have their own, perhaps Stonewall, view of how that should be interpreted. It is incumbent on all of us to refocus on the fundamental principles contained within that duty.
The hon. Member is absolutely right to raise the issues in regard to the Equality Act. This can get quite complex and I would be terrified of saying the wrong words at the Dispatch Box, but if he allows me, I will write to him with a few more details on those important points.
I was talking about the processes in the statutory guidance. Our colleagues in the Department for Education are reviewing the statutory guidance and we expect that to go out to public consultation later this year. The review has been informed by an independent expert panel, which brought together inputs from health, curriculum and safeguarding. We hope that that will be a good piece of work that provides updates on the guidance.
As for guidance relating to gender-questioning students, the hon. Member will be aware that the Department for Education published comprehensive draft guidance for teachers on how best to support pupils questioning their gender in schools. Parents, teachers and school leaders were encouraged to respond to that 12-week consultation, which closed on 12 March. A range of views will be considered, and I look forward to the publication of the consultation response as we continue to work in this sensitive area. It is important that we get that absolutely right and that parents are involved; that is incredibly important.
I feel like I have not given the hon. Member a million answers at this stage, but I hope he will understand that we have just had the Cass report, and it is important that we take the time to consider it. We are going through the review of the guidance that I mentioned. It is important that those proper processes take place. On the other issues that he has raised, I will write to my colleagues in the Department for Health and Social Care, and I will update him when I have had a response.
In the meantime, I thank the hon. Member for raising this important area of work. My view is that we all want to help people to live their lives as they wish, without prejudice or pressure, and there is a responsibility on all of us in this House to do that in a way that is humane and compassionate. I am grateful for the opportunity to outline what we are doing as a Government to support that.
Question put and agreed to.