Episode 5 - A gender clinic insider speaks out

Pysi sinun katsominen, että joten on suurin katsominen. - Sitten on. - Sitten on suurin. Sitten on suurin katsominen. Sitten on suurin katsominen, että joten on suurin katsominen. Tommi on suurin katsominen. Tomson, se on hienoa. Tommon on suurin katsominen. Tommon suurin katsominen. 20-years ago, or even 10-years ago, many children would have had that thought. And in a sense, it might not have mattered too much. It would have passed. Of course, it matters, but I don't mean it would have had determining consequences. But now, of course, because of the change culture, there's a tendency for that to be immediately enforced. So, to put it very briefly, these children internalize a homophobia, but as they hate themselves for being gay or lesbian. And a way out of that is transition. So, in that sense, transition becomes a kind of conversion therapy for gay children. So, I understand everything you've said so far. But what about the what if the not gay? What about if they are genuinely at that age, trans? What about if they genuinely know within their core that they are in the wrong body identified by society? Well, I think that's an inappropriate way of thinking. There's no such thing as a child being born in the wrong body. There's no evidence for that kind of way of thinking about things. And it's certainly very unhelpful. I don't understand. Truly the whole basis. And I'm approaching this podcast, not understanding a lot. I'm trying to learn from it. That's why I'm doing it. But truly the whole point of people, when they say they want to transition, they are saying from them for themselves, that they are being identified by society, by everybody else, as something that is not them, that they are in the wrong, they are being identified as the wrong sex. They are a woman. They might have a penis. They might be identified by society as male. But they know they're a woman. They know they're a girl, a young age. You see, but they don't know that. Well, how can you tell them what they know? No, no, let me explain. It's a great misunderstanding and confusion between gender dysphoria and being transgender. Gender dysphoria describes a deep disturbance in the child's relationship with their sexual body. For example, and this is common, a girl may hate her sexual body. Absolutely hate it, wants to be out of it. So there's two aspects of this as both thinking she is or wanting to be a boy, but also the hatred which is much more the driving force of the sexual body that you're in. So that's gender dysphoria. Then there are many roots to gender dysphoria and I was trying to describe some of them before. For example, internalized homophobia is one of them. Other complex problems, for instance children, feeling rather lost in the world and don't know who they are. And because of the influence, particularly a peer group, sometimes families, sometimes social media, they misunderstand this problem as being in the wrong body. And that becomes an explainer to them. And then there are various other things that I mentioned such as the historic sexual abuse and the family and so on. And this takes us right back to the beginning, you see. So the child may say, "I am in the wrong body. I want to change gender." But I understand that as gender dysphoria, and I need time to understand what underlies that. The child's statement that they are in the wrong body and they need to change may change over time. So example, there's quite a bit of clinical evidence and studies showing that children who are in the wrong body who present with gender dysphoria and are intent on going on a medical pathway, change their minds if supportively helped in a service that isn't kind of a funneling service towards medical transition and assessment service for medical transition. And David, Dr. Bell, is there always a causation? Is there always a reason why a human being will have gender dysphoria or from birth could someone have a detest for their own body? I think there's always a reason for it. I don't think there's any evidence that a child is born in the wrong body. A child from very early on may show preferences for gender activities, which are not of their own gender, but that can evolve over time. So for instance, Stella Mallee did a very good documentary talking, I think her program was called It's Time to Talk, but what she was interested in was, for example, in herself that when she was a teenager, she hated being a girl. She did all boy things. You're nothing to do with girls. Now she's, however old she is, I'd say she's in her forties and she's married with children and visibly comfortable in her body. But if she had that kind of feeling, now instead of 25 years ago, whatever, she would be being referred to the Tavis.clinic and there would be an over acceptance of the idea that she was in the wrong body. When you say doing all boy things, does such a thing exist or is that not a creation of society? No, of course it's a creation of society. Any definition that we have of gender activities is very largely a cultural construction. Not completely cultural because the one's body does affect it, but it's largely a cultural construction. Whereas it seems to me that the trans-ideologs treat it and what I would call an essentialist way rather than a constructionist way. That is, that they think there is some real almost bodily essence that is gender. I don't think that's true. Therefore they think the only way that it can be changed is by changing your body. Now I'd like to finish the other question because I haven't quite finished and it's quite important. That is, if you've got a population of children who are all suffering from gender dysphoria, let's say all those children are 12. Let's say that in that group of children, there's group A and group B. Now group A are the ones who in a few years' time, they will desist from their belief that they're in the wrong body and won't want medical transition. And I believe there's a lot of evidence to say that is by far the majority group. Then there's another group who will call group B who will not desist but persist and when they're 18, when they're 19, when they're 20, when they're 21, they're saying the same thing. Now the thing is we have no absolutely no knowledge, no research, no evidence for any particular child rather than in group A or group B. So we're at risk of taking the things at the manifest or surface level and acting too quickly on what is being said and therefore in danger of doing irreversible damage to a child who might have desisted. Then that's very, very important. But why is that happening? Well that's another big question which of course we don't know. All psychiatric and psychological disorders. Outcomes if you like, of complex interactions between the developing identity, the developing self and the culture in which you find yourself. No psychological disorder is separated from the culture. And that's very important because although we may have certain core problems, they're manifested in different ways depending on the culture. So if this is in Freud's time, hysteria amongst a certain group was a relatively frequent disorder. 20 years after Freud's death it disappeared. Another good example would be false memory syndrome. This became a very important diagnosis in the 90s, ideologically driven, that many people were told in a terrible way by therapists that they'd been abused as children when they hadn't or there was no evidence for that. And that again died away. So there's something happening in our culture which we don't necessarily understand. Where psychological disorders, psychological problems, core conflicts about the self, about sexuality and identity are being funneled if you like through a change in culture into manifesting themselves as gender dysphoria and trans. And why that is is probably complex. And I don't think we understand it. And I would say when you get an increase in referrals from 80 to 2,700 over a period of about eight or nine years, and that's continuing to increase. You have to ask yourself, you have to pause and say what's going on? What is happening at the level of the individual families and the culture that they're in that this is happening? And the reason that it's happening is because maybe it's just no more accepting culture, Dr. Bell. Well that's what that has been been said, but I don't think that's the case. The trouble is that there's been an invasion by trans-ideological movements who've been managed to get the attention of the professions, of politicians and so on. And been able to invade schools in a way which I'm happy to say has now been stopped. It's a majority word. Well you're describing these organizations as invading. Yes, I am. But they're entitled to try to, with the freedom of speech that we treasure in this country, they're entitled to make representations wherever they go. Aren't they? They're not. I don't agree with you. Have you read the children's guidelines as they were before the government change them? No. No. You see, the government changed them in a very, very important way. That is the schools were being told that the right way to treat children who say I'm of the wrong gender is to immediately affirm it, to celebrate it, and never, never to question. And if you questioned you're being transphobic. And this has been, of course, terrible damage because people, even clinicians, become frightened of questioning something for fear of being called transphobic. So the neutrality which is necessary for dealing with these matters is invaded by an ideological movement. Surely any decent professional clinician will ask those questions and will be neutral. Surely they will. They'll not be frightened of asking the right question. Will they? I'm afraid they are. Why? Because of lobbying? Yes. You see, I've got this information from various places, but of course that the Tavis dog I spoke to clinicians who were concerned that the summer of the children they were seeing had internalized homophobia and they felt there was a homophobia in the service unacknowledged. They don't mean a conscious homophobia, but something less conscious. And when they raised this, they were taken off the cases and they were told they were making a fuss and they were silenced. And they tried to raise elsewhere within the trust and they weren't listened to. And what they was in the service at that time was that the way to deal with these things was to affirm them. So if the child says this, rather than taking the clinically neutral attitude, which should be, yes, you say that. And of course I accept you say that, but I need to get to know you, understand you, understand where this has come from, what it means to you and all that. There was a fear in the clinicians that I spoke to that if they tried to do that, they were called transphobic. But to come back to what you're saying, because you put a very important question to me, aren't people free to? The child guidelines have now been changed in a way that Stonewall certainly do not agree with. And that Stonewall trying to still influence schools through their Stonewall Champions movement, you know, where they get schools to sign up. The way those guidelines were changed was, I can't quote you directly, but more or less, it says that it isn't the job of a school to immediately affirm or disaffirm a child if they say they're of the opposite gender. And it warns schools to be wary of gender stereotyping. The guidelines say something which I agree with, which is that we should celebrate gender fluidity. That's fluidity of gender identification. That girls should be free to express themselves in what culturally we think of as more masculine ways and boys more feminine ways. And that we should help people with. That's the way they want to It doesn't that include calling themselves a boy if they're born a girl. No, I don't think it's helpful to ever call a child a trans child. I think we should say it's a child with problems who's expressing themselves in a particular way that he's understanding and may become a trans person and may not. But once you call them a trans child, you're doing what we call foreclosure rather than exploring. And of course, your judicial review has supported this perspective. Ry� mewn maen nhw ydych yn y wyenodddwch sy buywaw wrgy layout a sefodd i fy bonid yn tiethigio ddiwedd Phan chocolate ar yna dro hyn injected ac pateorio dal y Cloyd y cefydатeth y modest i действio y lawwl am agol nadau rு. 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Mae ni mewn usage conti Week Strategy 😉 o wyговethau mith gydaselu acwhataisau nhw'n oes ac Ysdשוב…. hyw mae monna yma hyn hyn nhw'n i whestana. A siol nem y Pan Ysgynnyr Chleip yn rhoi bethwyeld os, mae oemdeeth o G helphadef yn hynny yn p Pressiaeth i Thur동ol yn dodir a rowdyg yn eiогachau hearbar a iyawiww i th ouri maen nhwEN ein preidio arlyfniad. preidau gall Prestorwallio \ a boi if they want to do less masculine things in our society then they should be free to do so. Why should they not be free to identify if they're able to do all of those activities in our society? Why is there any harm in them calling themselves what they want to? If they want to call themselves a girl, why care? Well, you see, what I was saying, what the new guidelines say is that given that we want to support gender fluidity in children, if children are non-conforming, we must be very wary of treating them as if they're not of their natal sex. Because the do so is to indulge in gender stereotyping. And this is why the LBG Alliance, of course, left the LG PDQ movement because they felt there wasn't sufficient support for children who may be gay or lesbian and then expressing this perhaps as thinking they're of the opposite sex. And it was leading to a kind of conversion treatment for homosexuality being put on a medical pathway. So I wouldn't necessarily, if a child says they are a boy, if I was looking after that child, of course, wouldn't say you're not a boy if it's a girl, I wouldn't say that. And accept what they're saying. And that's okay. But what you mustn't do is subject that child to irreversible medical and surgical treatment, whose consequences we don't know. We now know there's a very large growing number of detransitioners and I've met them who were absolutely sure when they were children that they were of the opposite sex. The ones that I've met have been largely women and all of them are gay or lesbian women, all of them are gender non-conforming. But they now realise that they were expressing their difficulties with their sexual body through calling themselves to the other sex. That was supported culturally and socially and also by the clinic that they attended. And they now feel that that was a terrible mistake as one young woman put it to us. I look in the mirror, I do not see a male body, I see a mutilated female body. That's another important thing that you cannot change your natal sex. You can change your gender, but you cannot change your natal sex. That's a biological fact. When we're talking about puberty blocking drugs, three high court judges determined that children under 16 with gender dysphoria are unlikely to be able to give informed consent to undergo that treatment. They actually said it was de-infectory as sharp. We were sitting with Lord Justice Lewis and Mrs. Justice Leven said it is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers. It's doubtful they said that a child aged 14 or 15 could understand in a way the long-term risks and consequences of the administration of puberty blockers. So helping understand then the politics within the Tavastok gender identity clinic. What was the split in terms of, because all of the people are qualified in some way, what was the split of people who wanted to do it against those people who didn't? Well, I don't know. You see, I can't give you numbers, but what I can say, because it takes me back to my 2018 report, because my report said exactly what the judges said, that clinicians that I talked to felt one, that there was insufficient attention given to the complexities of consent and two, they didn't think the children really understood what they were consenting to. And they felt that this was a major problem. Now, what the judges said, and it's also what I'd, what I'd come to learn, is these children, some of the clinicians acquired them as some of the most difficult and complex children that they've seen, and these were experienced clinicians. So the child, it's not as if the child is sitting there saying, I want, or this would be good for me. The children are usually in a much more desperate state. They hate their body. You know, a boy might say, I can't talk about my penis. Don't even mention that word in front of me. I want to be rid of it. I can't stand it. I hate this body. I want to be out of it. Now, a child in that state, are they in a state to make a reason judgment about the irreversible consequences of the pathway they're about to be put on? Which I mean, eventually having parts of their body removed, we going on opposite sex hormones, which have permanent effects, causing all sorts of effects that can't be chafers. The girl's voice can't be changed back. Girls will have to eventually have a hysterectomy because the dangers of vagina, that trippy, were learning more and more about the consequences of these irreversible actions. So, what I'm saying is, as one clinician said to me, I spoke to the child about the possible or even likely consequences of being an orgasmic. And the child who was, you know, 12 said, "Ugh, I don't want to talk about that. I don't like sex. I'm not interested in that." Or to another child, you won't be able to have a baby. "Oh, I'm not interested in babies. That's a woman thing. I hate it." So, these children are in a quite a difficult, highly conflicted, disturbed state. The judges decided correctly that they're not in the position to calmly weigh up the pros and cons of the consequences of starting on a medical pathway. Further, even if they were able to weigh it up, which I agree is something that wouldn't be able to do, there isn't the evidence base for them to make any reason decision on. How much does sexual maturity within the body affect someone's vision who, up to that point, has disliked their body? When they understand the anatomy of the body and the role, you know, a penicent of a giant of plays in sex, how important is that in a determinant for whether someone likes their body or not? If they haven't up to that point. You see, things are on a kind of continuum. I'm trying to struggle with the way of representing this. But I'll tell you what I mean. So, it's not uncommon for girls, for example, to manage their bodies reasonably okay until puberty. And it's not uncommon. It's not universal by any means, but it's not uncommon for a girl once she start to see her breasts grow and the other changes in her body to hate it, to feel that she's being taken over by something that she can't control. In some situations, which I'd be more familiar with, the, talking about adults, but they've remembered it from their childhood. Their child had a great conflict with their mother, a girl child, a girl. So, hate some mother, not uncommon, at least to go through a period of hating their mother. But then when she sees herself becoming a woman, gets confused and thinks she's becoming her mother. Fairies' story is, of course, full of that kind of narrative. So, the girl feels she's becoming her mother and she doesn't, she doesn't want to show her breasts, she's not proud of them. She's not proud of the other changes. She hates them. Now, you know, that shades into normal development. But amongst those groups, there'll be ones who have various complicated reasons. It's much, much more intense. And given that we're now in a culture in which the possibility of thinking of yourself literally as being in the wrong body or the gateway is open to a medical treatment. That's likely to accelerate and amplify and increase the number of children who feel like that. That's what I meant at the beginning that psychology is an independent of culture. So one of the ways you can also think of it is when there's a treatment available for something, there's always an increase in the diagnosis of it. Now you may say that's because people are coming forward for treatment, but some people and I'm one of them think that the very availability of certain forms of treatment leads to an increase in the incidence. I think that was so for hysteria. But what I mean is that the complex reasons why the numbers go up and the intensity of the demand increases, and that's to do with the culture which is set and the availability of services. I don't think there should be a national gender identity service. I think that happened because of the invasion of the trans ideologies into public policy in an unquestioned manner. Why I say that is because these children have multiple problems. And if they get funneled towards a national gender service, all the problems get rebadged as a gender problem, the referral confirms it as a gender problem. And then there's the double problem of acting on it as if it's only a gender problem, possibly subjecting the child to irreversible medical consequences. And also the other problems don't get addressed. I think they should be seen in the context of an ordinary child and adolescent mental health service, a CAM service, but they would need a lot of extra funding to manage it. What's your view on Stonewall? Well, I'm an old 68er, so I was very much part of the world in which gay and lesbian people were coming out, and we celebrated that. And when Stonewall came into being, I can't remember when, but certainly for me it was a great organisation and a great movement, because it was showing us all the ways that gay and lesbian people were continued to be discriminated against. And they've won tremendous battles, not just Stonewall, because society has changed, but if you think of the freedom that gay and lesbian couples have now, which they didn't have before. But for reasons that I don't understand, the interest in gay and lesbian issues seems to have gone away, and they've been completely, though, very less like a trans organisation. And I don't think this is a matter of freedom, that's a terrible misunderstanding, because there's a wish you see too. Those of us who are concerned about this in children, there's a tendency to say we're transphobic using the same kind of language of homophobic. Now, I think I've probably said enough to you to make you realise that that's not the case for me. But I think through their capacity, through their Stonewall Champions programme, that people unthinkably sign up to this ideology without realising its implications. That is, its implications that damage been done to children, and which I'm pleased to say the judicial review, at least partially, put an end to, but Stonewall and other organisations were very, very active in promoting the kind of damaging foreclosure that I was talking about, and the damage to ordinary gender fluidity, confusing it with a rather characteristic binary view of gender identity. They also have fermented a view which is just wrong. You cannot change biological sex. Biological sex is a material fact, and the women I talked to had gone through, you know, surgery that had mastectomy and so on, they felt very, very let down, being told that they could change their biological sex. They know that they can't. They can change their gender identity. But there's a very strange thing in all this, is that if we accept, at least in an urban culture, we accept much more gender fluidity than there was before, I think that men who are rather feminine, people aren't really that interested anymore, and people are less interested in who someone goes to bed with. I think culture has changed and that's a good thing. But it's very odd, isn't it, that kind of fluidity can go with an acceptance of the biological body. And what's happened is a peculiar, I would call, regression in thinking, whereby the fluidity has become rather caricaturistic and binary, and the body is viewed as if it's fluid, that the body can just be changed. And people talk about this as if it's some kind of cosmetic surgery, like some mile-plastic surgery. This is major surgery with potential very serious consequences in terms of surgery going wrong, and I've seen cases of those, tragic cases of those. And it means becoming a lifelong medical patient with all sorts of ongoing possible medical problems they're going to need further treatment, I gave the example of vaginal atrophy. So it's treated superficially, and that's very, very damaging. And the trouble with the gender service is that by putting the, when the puberty block has started, they were regarded as an interregnant, a time to stop and think. And the majority of children came off them and pursued normal development. That completely changed, and it completely changed because of the change in the culture that I've been mentioning. And now it's 98%, so if you put the children on puberty blockers, and the judge has said this, your de facto putting them on a pathway, which will lead to the opposite sex hormones. And do you think Stonewall, as an organisation, because that's who we are looking at in this podcast? Do you think their powerful lobbying is changing the behaviour of a significant number of clinicians? Definitely. Because you see clinics are signed up as Stonewall champions. To be Stonewall champions, they have to sign up for the kind of agendas which I've been saying are doing such damage. So you sign up as a Stonewall champion that implies affirmation towards children with gender dysphoria, affirming them as the opposite gender, that is damaging. They're still trying to influence schools completely against the government, new government guidelines. To give an affirmative agenda, a kind of immediate celebration of a child who says, "And why this is, I don't know, why they've been so captured by this powerful ideological movement. I don't know why that is." I think the person who put this very clearly is the James Kirkup from the spectator pointing out that in all his 25 years, I think, as a political correspondent, he's never known any movement that so quickly attracted and got the support of professions, government and policy makers, that the only thing that compares, as he put it, with the speed, is the complete lack of investigation or understanding. There's one thing being a Stonewall champion, but are you actually saying that medical professionals, trained in fact, on discovery, are altering how they do things because of a lobby group? Well, you can't put it quite as direct clear as that. The lobby group is itself part of a cultural movement and change, but medical history is full of getting things wrong and trying to correct them. You think of LeBotomy, for example. Many doctors thought it was the right thing to do. We now know, of course, terrible damage, and it was the wrong thing to do. Or, in our more recent time, false memory syndrome. That was the whole movement that lots of people with psychological disorder in adulthood were really sexually abused in childhood. When there was very little evidence for that, that caused a lot of damage, telling people that they've been sexually abused. So that it is one of the curiosities about psychology and psychiatry, that we don't function completely separate from the cultural world in which we locate ourselves. And that means that demands of us, that we have to be cautious and scrutinised and be aware of the consequences of big cultural movements that cause a sudden change in the way we think about things. And I don't think there's been that true caution. I think what has happened is that people have thought it's a liberal. I think one of the things that happens, you see, is that I, of course, am totally against any discrimination against transgender people. And I'm aware that they are discriminated against, and I'm aware that they suffer. And I'm, of course, completely against that. But what happens is, the sense that we want to completely against that gets confused with having to affirm trans children, children as trans, and that's very damaging. And I think that's what's happened. People think that this is to do with not discriminating against gay and lesbian, against trans people, whereas I think it's a completely separate matter. And I think the attempt to write it into the same history as homophobia and discrimination against gay and lesbian people is quite willful. And I think it causes considerable confusion. Stonewall are now so unbedded in our society and in many of these organizations organizations to Dr. Bell, that these organizations themselves attempt to climb up a leg table created by Stonewall and judged by Stonewall. The BBC is among them, the police is there, the government's there. And so in order to climb up this leg table, you need to adhere to Stonewall's policies. That's right. Which the freedom of thought and the independence of those organizations with that? Well, of course I agree with you and that's, you know, I'm not sufficiently knowledgeable, for example, about the police. I have some knowledge of it. But what I have more immediate knowledge of is of course my own world. And that's the world of psychoanalysis, psychiatry, psychology and the Tavistok. And the Tavistok, we've always seen ourselves, as I said, engaging with a certain degree of complexity and ambiguity, not foreclosing things, not jumping to conclusions, accepting the unconscious or less conscious forces acting on an individual or acting in a family. And yet the organization has been captured by Trans-Ideology and the Jitz service, which exists to some extent in a rather semi-detached relation to the Tavistok, has become huge in the organization. And that is, can't be unconnected with the penetration of the ideological movement. But it's true. The Tavistok, to some extent, got captured. I would say that we in the adult department and the Portman Clinic did not. And I suppose I became a central person in that. And that's why there was such attempts to silence me, to remove books from the library, to stop me from speaking anywhere. And to threaten me with disciplinary action. So your books were removed from the library, were they? No, a book was removed from the library, a very good book, which I wrote the forward to, called "Inventing the Transgender Child and Adolescent." It was removed from the library by the management, because it was a very good book. It's not obviously got the same view as "Current on Jitz." But when you say, you know, we agree with free thinking. It's very characteristic of this debate that people are not allowed to feed them of thought. People are no platformed. And this was a good example of no platforming. That the book was removed from the library on the spurious claim that it raises legal issues. Well, the Tavistok challenged the book before it's published, raising certain legal concerns, and they lost, and the book was published. So they then removed it from the library. Eventually, it was put back after I and a lot of people complained. It was put back in the library. But there's been not a single lecture given at the Tavistok that gives the other point of view, say a more psychoanetic point of view, or a more nuanced view about problems of transgender and gender dysphoria in children. There's been very, very little possibility of putting an alternative view within the trust. So the trust has been captured, management has been captured. But there's still protests within the trust. Most of it very quiet, but I decided not to be quiet about it. And have you had any significant levels of backlash because you're not quiet about it? And what type of response do you think you'll get? Well, within the trust, as I said, the trust tried to silence me, issued instructions I wasn't allowed to give lectures or write things about gender. And eventually, to discipline and reaction against me for my activities, in the end, it didn't happen. But they threatened with discipline and reaction. They set up a disciplinary tribunal. But it was also in the period just before I was retiring from the trust. And there were various complications about that, which I won't go into. But in the end, they decided it had timed out. But I needed legal advice for the last two or three years in order to continue to be able to speak at meetings, to write things, and be sure that I was, so to speak, safely, legally for many action by the trust. And when you're saying the trust, do you mean the trust that was in charge of Tavistock? Is that what you mean? The NHS, each organisation is a trust. Every hospital is a trust. Or part of a trust, I should say. But the Tavistock is one of the few that's a freestanding trust. So, you know, there actually can't an an easy-to-be mental health trust. That's that big organisation. But the Tavistock is technically the Tavistock and Portman NHS Foundation Trust. So, I say, the trust, that's what I mean. And finally, David, we are where we are. What do you think needs to happen going forward, especially in the context of what this investigation is all about, what this podcast is all about. It is how, still more, what an incredibly effective lobbying it is, whether it's right or wrong, it's incredibly effective. I don't think you can dispute that. So, what needs to happen now in your view? Well, in terms of Tavistock, I find it surprising. And I suppose I should be on being shocked, but I am shocked that the judicial review could have said what it said, industrial mind, you two things. One was a focal thing, which the judicial review was about, was about capacity consent. But in the course of that review, they raised very, very serious questions about the service. They pointed out to the lack of data, the lack of follow-up, the lack of proper investigation. All that is mentioned. And although the Tavistock of appealing against the judgment, they cannot really appeal against those findings. They can appeal on issues of consent. Secondly, the CQC echoed a lot of those concerns and included in its concerns that clinicians were frightened to speak up. So, I find it extraordinary, and I don't know if you know, but on the BBC website currently, there was a 2015 document, which the BBC has found, and that document was a consultation to the service, which said it was not managing, and it should immediately cap referrals. No action was taken. So, I find it extraordinary that the NHS England, stroke government, can hear all this about a dysfunctional service and allow it to continue. So, I think the service should be closed down. I think children with these problems should be looked after by local CAM services, but I'd like to remind you that CAM service have been systematically cut over the whole years of Tory government, and they cannot manage. They cannot manage the fact that they've been cut and the increase in numbered children with serious mental health problems. So, just to say they could look after this will make things even worse. So, they have to be proper funding available for CAM service in general and perhaps a special fund to help with this service. But then the children would be looked after in their local areas in a way that's appropriate, and the other needs that they have be autism. We know that up to about 30% of the girls are autistic, or depression, or family problems can all be dealt with in an integrated way. As more of the more general problem, that's going to be much slower. And I think that's going to involve trying to show the various stakeholders, which would include of course government, how they'd be misled. And that is going to take a lot of work. It's possible that it's going to have a lot of resistance as well. Yeah, but my sense is that people are beginning to listen. I don't think things were as they were in 2018, but as you know newspapers wouldn't publish anything on this. I think things are changing, and I think people are beginning to see. So, I'm guardedly hopeful that the pendulum will swing a bit, and people will begin to see that this has slipped through for purely ideological reasons, not scientific reasons, and has not been interrogated as it needs to be. This is my final point to you. Are you really saying that the police, the government, institutions like the BBC have been captured? Yes, of course. And I think it's naive to think any organisation, bit police, the medical profession, government, BBC is above the influence of the cultural and social networks within which it functions. And it's possible for, it's the BBC here and the police here, it's symptomatic. They're not outside the culture. Doctor David Bell, I've really enjoyed talking to you today. And thank you very much for doing so. Thank you. [Music] At Stoonwall we're working towards a world in which all lesbian, gay, by, trans, unqueer people can live freely as themselves. LGBTQ+ inclusion makes the world a safer place for everyone, and it is deeply disappointing that in 2021 this can still be thought of as controversial. Our work from equity and healthcare to advocating for LGBTQ+ people in law improves the lives of all LGBTQ+ people. And we will continue until every LGBTQ+ person is free to be themselves wherever they are. Since we talk to David Bell, there's been another development on what's been happening at the Tabestock. This is Heart was reported by the BBC's News 9 program, who broke the story about safeguarding concerns at JEDS, Emily Mitless. A woman who raised concerns about the safety of children at an NHS gender clinic has been awarded £20,000 in unemployment tribunal case. Sonia Appelby is children's safeguarding lead for the Tabestock and Portman NHS Foundation Trust, which runs the Gender Identity Development Service. JEDS, it's the only NHS gender service for children in England. Ms Appelby's job involved protecting children at risk from maltreatment. A number of JEDS staff brought their concerns about the safety of some of the young people being seen to her, including that some were being actively encouraged to be transgender without effective scrutiny of their circumstances. Well, our Newsnote producer, Hannah Barnes, has been working with Health Correspondent Deb Cohen. They broke the original news that formed part of Sonia Appelby's case that JEDS staff had reported being advised not to seek help from Ms Appelby and Hannah joins us now. Just talk us through the ruling, first of all, Hannah, what did that say? Well, the Central London Employment Tribunal ruled that Mrs Appelby had been vilified for raising concerns, blowing the whistle effectively, about safeguarding issues at the Gender Identity Development Service, known as JEDS. The panel said that she had been treated in a judgemental and punitive way by her line manager at the trust, and that some senior JEDS staff saw her as having an agenda after she relayed the concerns of JEDS clinicians to others in the Tabestock. The Tribunal pointed out that Mrs Appelby had hitherto an unblemished, blameless, professional career. It's important to point out that the Tribunal explicitly were not making any judgment on the rights and wrongs of the treatments offered by JEDS itself, but rather the rights and wrongs of how Mrs Appelby had been treated. So what then were the concerns that the JEDS staff took to Sonia Appelby? Well, the panel heard that Mrs Appelby herself had had concerns about record keeping at JEDS going back to 2016, but those staff concerns included that some children might be gay, rather than transgender, but that this wasn't being properly explored. That staff were discouraged from raising safeguarding concerns. That staff who did raise safeguarding concerns were then accused of being transphobic, and that family difficulties in trauma that some of these children had experienced also weren't adequately being taken to account when they were assessed. Now, these are very similar to the concerns that News Night Broadcast last year, which were contained in transcripts between JEDS staff and the Trust Medical Director, who is Mrs Appelby's lie manager. And those transcripts also contained a claim that staff had been instructed not to seek Mrs Appelby's help. The Tribunal heard two weeks' worth of evidence. They read nearly 2,000 pages of documents, and they agreed that there had been that explicit instruction to staff because Mrs Appelby was seen as being in some way hostile towards JEDS. The Tabestock Trust say that it is considering the judgment carefully. The Tabestock Enforcement Trust, which runs JEDS, declined requests to be interviewed as part of this podcast. Here's what they said in a statement. The Tabestock Enforcement denies that any steps were taken against David Bell for being unalleged whistleblower. The Trust supports staff raising concerns and has strengthened its mechanisms for doing so in recent years. It is important that all staff can raise concerns without fear of detriment and have them properly addressed. The recent employment tribunal decision shows there is always learning in these kind of difficult situations, and we are looking carefully at what this means for us and what we should take from it going forward, including how we best support our staff and protect our patients. We have in the past taken a series of appropriate actions to seek our staff. Dr Bell was asked not to speak as a trust employee on gender identity issues, as his views did not represent those who were providing the service on behalf of the trust, and the trust was made aware that several patients and other employees find some of the views expressed by Dr Bell to be offensive. So David, since we spoke with Dr Bell, there has been an update in this case, has there? Yes, since that interview with Dr David Bell was recorded, the Court of Appeal has now overturned the decision of the high court that under 16s are unlikely to be able to give consent to puberty blocker medication. And the Court of Appeal ruled that doctors can judge if under 16s can give informed consent to puberty blocker use rather than having to go to a court. The appeal was brought by the Tabestock Trust, and it was brought over the original high court case, which itself was brought by Carabell. Carre says that the clinic should have challenged her more over her transitioning, and she says she was disappointed by this latest decision and she's going to seek permission to appeal to the Supreme Court. In its judgment, the Court of Appeal referenced the landmark 1980s, Gillick ruling on the competency of children to make decisions about contraception, and they said that nothing about the natural or implications of treatment with puberty blockers allows for a real distinction to be made between puberty blockers and contraception. In the original ruling, the high court described puberty blockers as experimental, which is disputed. The Court of Appeal decided that it would have been better for the high court to avoid controversial factual findings. There was also criticism of the high court's finding that the vast majority of patients taking puberty blockers go on to cross-sex hormones, under on a pathway to much greater medical interventions. The judgment stated that for the high court to have reached that position, it would also have to evaluate evidence as to how patients were chosen for puberty blockers, the progression of the treatment, and multiple issues affecting progression between treatment pathways, including the consent processes for subsequent treatment stages. The judgment stated that in practice, the high court's guidance placed patients, parents and clinicians in a very difficult position, and would have the effect of denying treatment in many circumstances for want of resources to make such an application coupled with the inevitable delay through court involvement. The Court of Appeal judgment also cleared up a misconception that it's the Tavastock that provides puberty blockers to children. The Tavastock referred to other NHS trusts and it's those trusts clinicians who consider the prescription of puberty blockers. Coming up in the next episode, we find out what influenced Sturmwoller's hard on public policy across the UK and find out how the word "mother" has been removed from some government documents.