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'Sterilising children' to treat gender dysphoria is not an acceptable long-term policy

3 min read

Lord Lucas says research around medical treatments for gender dysphoria in children is weak and more needs to be done to understand the "far-reaching and long-lasting consequences."


I welcome wholeheartedly the Government’s LGBT Action Plan and look forward to the day when we do not label and hobble each other with gender stereotypes. Biological sex is mostly binary, though there are distributions around the two modes and some people who are in between. Behavioural gender is not binary. Gender cannot be counted or clearly defined. We can distinguish male typical expression and female typical expression, but there is an immense amount of crossover and interpenetration.

Over the centuries, labelling people as men and women has led, particularly for women, to serious, crippling oppression, to limitation of their lives and to there being a whole list of things that women are not supposed to do because they are women. There is no good reason for it, and many of us have spent a chunk of our lives fighting against it and trying to make it possible for more women to be engineers, more men to be primary teachers and so on. The use of gender as a binary concept has done nothing but hinder us as individuals and as a society. Why should any of us try to make people behave in ways that they choose not to when we are quite happy to let other people behave in exactly those ways merely because we assign them to a different gender?

However, radical change such as those proposed in the LGBT Action Plan will generate predictable problems. The obvious ones are to do with women-only spaces, women’s sport, and the medicalisation of gender dysphoria. To cover the first two would make this a much longer article, so I shall say only that attempts to close down debate are disgraceful. Where hard-fought-for rights are affected, those who presently enjoy them should be heard with respect.

The medical treatment of gender dysphoria in children has far-reaching and long-lasting consequences. A child who embarks on puberty blockers (as far as we can tell from the limited research available) enjoys immediate benefits to their psyche, and is almost certain to move on to cross-sex hormones, and thus become sterile without (because their gonads never get the chance to develop) the option of freezing their gametes. Similar children (again, the research is weak) who do not get puberty blockers have a worse time of it psychologically, but preserve their fertility, and only 25% of them eventually choose cross-sex hormones or surgery.

We owe it to the children concerned, and to the doctors who help them and their families, to immediately commit to a comprehensive programme of research. We need a much better understanding of the condition, and of the benefits and consequences of each alternative treatment.

Sterilising children who, left to develop to adulthood naturally, would not choose sterility, is not acceptable as a long-term policy, even if it is the best we can do now.

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