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August 29, 2024 - 12:45pm
Last month, the council of the British Medical Association voted in favor of a motion to ‘publicly critique the Cass Review‘. Hilary Cass’s four-year investigation into provision of care for gender-questioning children was apparently not up to scratch. The right thing to do, according to BMA activists, was to pause the implementation of its recommendations while a ‘task and finish group’ cobbled together some more politically acceptable ones.
Anyone could see what was really being argued by BMA chair Philip Banfield and others: that even the most tentative calls for caution were not acceptable in the field of pediatric gender medicine. Hence the council’s desire to continue prescribing puberty blockers until there was ‘solid evidence’ that all the evidence against them was flawed. Perhaps the hope was that, one day, everyone would forget there had ever been alternative pathways at all. Lifelong medicalization, with a loss of fertility and sexual function, would be the best life had to offer, and no more questions would ever be asked again.
Thankfully, not all BMA members are in agreement with the council’s approach. This week it has been reported that many have handed in their membership in protest. An open letter opposing the official BMA stance has attracted hundreds of signatures, two-thirds of them from BMA members and many from former or current presidents of medical royal colleges. This provides some reassurance, not least for anyone who fears their own doctor may be more interested in scoring political points, as well as avoiding embarrassment, than in doing no harm. Thus far, however, the BMA council remains unrepentant.
It is concerning that doctors in such positions of power think this way. More than that, though, it is concerning that they so clearly believe this is a debate they now ‘own’. Unlike them, or indeed Cass, I don’t have a medical background. If I did, I’d like to think I’d have signed that open letter, too. I’d like to think I’d be aware of the limits of my own knowledge. As it is, the fundamentally shaky concept of ‘gender medicine’ — the only ‘life-saving’ medicine that treats something which cannot even be called an illness — has created a situation in which a medical-activist elite vastly overestimates the reach and value of its own expertise.
What are we talking about when we discuss ‘pediatric gender medicine’? Drugs? Surgeries? Psychological therapies? It is all of these things, but much, much more, right down to the nature of being human — and the impossibility of transcending the human condition. In a recent interview with LADbible, UK gender surgeon James Bellringer dismissed J.K. Rowling’s position on trans issues as ‘ill-informed’, claiming he wished the author would ‘stick out of what I do and not comment on stuff she doesn’t know much about’.
I don’t doubt that Bellringer knows more than most of us about the mechanics of creating a neovagina. But when it comes to understanding human embodiment socially, relationally and politically, in terms of both its possibilities and its limitations? ‘I did some stuff to one person’s body and I think it made them happier’ simply doesn’t cut it.
If anything, the Cass Review does not go far enough — and cannot go far enough — because the current situation forces us to treat vast, age-old questions regarding what it means to be, what it means to have a body, as something those with a medical degree can solve. Yet what it means to move from one life stage to another — physically, emotionally, developmentally — is not taught on any degree course. It is not learned in a lab, or thrashed out in a seminar room. It can only be lived through.
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