What does the Keira Bell case tell us?

“I look back with a lot of sadness. There was nothing wrong with my body”. Nothing wrong with my body. These are the words of Keira Bell in an interview with Raquel Rosario Sánchez. I am not crowing over her victory today, the fact that she won her case against the Tavistock Clinic and Portman Trust.

This is a win that has come at such tremendous cost to Bell. One can only wish her well and hope that this gives us pause to think about the complexities around gender identity. As ever, the esteemed men of Twitter are telling us what is permissible. I do not need or seek their approval.

A pause is what we need. Puberty blockers are given often with the understanding that by delaying puberty, a young person can work out where they are going and who they are. This is the therapeutic thinking behind their use in GIDs. They have other applications too though. When early puberty happens, as it can with thyroid problems, genetic disorders, the effects of radiotherapy or even just naturally, this is a medication that reduces hormone levels for a few years . Early puberty is more common in girls than boys.

Now though, puberty blockers for young people with gender identity issues are becoming increasingly contentious. While some advocates see them as potentially lifesaving (preventing suicide), others perceive them as the gateway drug to cross sex hormones and surgery as they were for Bell.

Already, I am very uneasy here. Suicidal ideation bandied about as proof of these drugs's necessity has to be backed up by evidence. Evidence that in this case was sorely lacking in all kinds of ways. What percentage of those on blockers end up on cross sex hormones? The defendant i.e. The Tavistock Clinic did not know.

The ruling given today then is really about how much somebody under 16 can understand the long term effect of taking this medication. What are they consenting to?

This is an extremely difficult question as the long-term effects of cross sex hormones are in themselves disputed territory. Puberty blockers are seen as reversible by some medics, but others have concerns about bone density and brain development.

None of this is easy. For professionals dealing with deeply upset adolescents who hate what they are and are frightened of what they might become it’s even harder.

Puberty is an extremely difficult time for girls, and I am talking about girls now, because the concern of feminists such as myself has been prompted by the huge uptick in the number of girls wanting to transition.

This concern over basic safeguarding means that someone like me is tarred with the label TERF/ Transphobe / Evil bigot because really I can see that for a lot of folk, it’s easier to throw these increasingly meaningless labels around than to think about what is actually going on. It’s certainly hard to think about what has been done to someone like Bell, sometimes by well-meaning liberals.

One of the most shocking things to me about this case was that Bell was given puberty blockers after only three sessions of being seen.

Anyone who has worked with adolescents or anyone who has any experience of counselling has to be alarmed. Three sessions are not enough time to diagnose the cause of someone’s deep unhappiness and send them off with a prescription.

Maybe some of this is to do with the huge waiting lists for treatment. In which case, more money needs to be poured into mental health services for young people, something I have always argued for.

Again, we must ask what is causing this misery for girls and why suicide rates are rising. Why are female bodies such an uncomfortable place to be?

That question needs to be thrown back to society and not always located in the psyche of the individual. This is why I find parts of trans activist discourse so totally conservative. There is no analysis of how gender operates, of how bodies and definitions do not exist in isolation, how the notion of a true self may itself be false.

So much thinking that underpins the trans ideology of selfhood, is that selfhood is sovereign rather than social. It has much more in common with right wing thinking than it does with left wing thinking. That so much of the left has rushed to embrace it is a sign of the times.

Meanwhile, young people are meant to untangle these enormous questions, while lobby groups and drug companies make all sorts of claims that go without question.

“Winning” amongst such pain and confusion is hardly possible. We can move towards more understanding.

The thing that I keep coming back to though is the relationship between biology and the way women are treated. I too would love a drug that could disconnect me from that. Who wouldn’t?

If sex is irrelevant we cannot collectively connect our oppression to it or resist it. The reconstruction of gender as a collective enterprise is indeed radical. But that’s not where we are.

So let’s pause, just pause.

This debate must be had between adults not played out on the bodies of children. Does this even need spelling out?

Unfortunately, it does.