Other countries should learn from a transgender verdict in England

WHAT SHOULD you do if a 12-year-old girl says: “I am a boy”? If the answer were simple or obvious, the question would not be so explosively controversial. A good place to start, if you are a parent, is to affirm that you love the child. It should go without saying, too, that no child should be bound by gender stereotypes. Boys can wear dresses; girls can play with cars, or become plumbers. The question gets much harder, however, when children say they hate their body and want a different one. Gender dysphoria (a feeling of alienation from one’s natal sex) is real, and the proportion of children and adolescents diagnosed with it in rich countries is rising for reasons that are poorly understood (see ). One school of thought, which has spread rapidly, is that you should agree with youngsters who identify as transgender, and offer them medical interventions, if they ask for them, to help their bodies match what they regard as their true selves.England’s high court last week highlighted some of the problems that can flow from such thinking. The case concerned Keira Bell, who says she was rushed into life-changing medical treatment when she was 16, which she now regrets. The process began with drugs that delay puberty. These are typically described as reversible and a way to “buy time”. But at the Tavistock clinic, where Ms Bell was treated, most patients who took puberty blockers went on also to take cross-sex hormones (oestrogen for males who want to grow breasts; testosterone for females who want to develop male sexual characteristics). Many then proceeded to surgery.