Anne Health Founder, Susie Green, Urges Wes Streeting to Lift Puberty Blocker Ban in Open Letter
As an organisation supporting trans+ people of all ages, we present the contents of the Open Letter below, written by our Director and Co-Founder Susie Green, to Wes Streeting, Secretary of State for Health and Social Care.
We are witnessing the utter devastation being experienced by trans and non-binary young people and their families due to the temporary ban of puberty blockers. This damaging ban has been supported by both the new Labour Secretary of State, and NHS England. We urge Wes Streeting and other MPs to listen to those affected and to immediately cease any plans to make the puberty blocker ban permanent.
We will always stand by trans youth and their families and will continue to advocate for accessible gender-affirming healthcare for all ages. #ProtectTransKids
Dear Wes Streeting,
I am writing to you in response to the current (extended) ban on puberty blockers for under 18s and the devastating effect it is having on families and young people.
As someone who has supported thousands of families with trans children over two decades, including my daughter, I would like you to understand the potentially fatal impact of your actions if you were to make the temporary puberty blocker ban permanent.
My Story
Nearly 20 years ago, I was faced with a personal dilemma. My daughter was suffering as a male puberty began. For her, this was torture. Yet the NHS at this time refused to offer blocking medication before 16 years of age. I found out about research in the Netherlands, on introducing puberty blockers after the onset of puberty and asked them whether my daughter would qualify for their service. They agreed that she would be eligible for blockers, based upon her history and her gender dysphoria diagnosis, but that because she was a UK citizen she could not be treated by them.
I fought for over two years, from when my daughter was 10, to get the NHS to follow international best practice guidelines, which followed the Amsterdam team protocol. I fought so hard. I was lied to, spoken down to, and told that I did not know what was best for my child.
My daughter was refused medical intervention. At that time, private healthcare providers for young trans people did not exist. So, in desperation, I found a way to order the medication online. My alternative was to watch my child suffer unimaginable pain. She was already targeted due to her gender identity and was physically and verbally assaulted many times.
She never wavered from who she was, but she did not want to live if she lost her female voice and her body changed to be masculine rather than feminine.
When puberty began, as I struggled to convince the NHS of how life-threatening this was, she took several overdoses and started self-harming. If you speak to families of trans kids today, they will echo this story, and their desperation to protect their children is the same as mine was back then. For her, the saviour came in the form of an American endocrinologist, Norman Spack. Through the contacts made through the charity Mermaids, which I was then a trustee of, I was introduced to Norman, and he agreed to see her. He initiated puberty blockers within three months based on her puberty already being underway. I was lucky. I had a house I could re-mortgage to pay for this treatment.
I do not doubt that if I had not acted, my daughter would be dead.
Trans youth healthcare today
Two decades on from my daughter's experiences within the NHS, progress had been made, and care was being offered to trans youth in the UK. However, in December 2020, following the first judgment in the Bell vs Tavistock legal case, NHS England (NHSE) caused untold pain and suffering by promptly closing down access to medical intervention for trans youth. They continued to block access to treatment, despite an appeal overturning the original ruling. Since then, waiting lists for gender care for trans youth have increased to over 4 years - effectively making gender care on the NHS inaccessible to gender-questioning and trans youth in the UK.
Following this, the Cass Review was commissioned by a Conservative Government intent on provoking ‘culture wars’ and wooing the extreme right-wing vote. The Cass Report is a political document. It has been vilified internationally and within the UK. The trans+ community, as a whole, rejects it. And it will, sometimes fatally, damage generations of trans young people. And not just in the UK.
“I desperately wanted Labour to get in because I believed they would look after my child and immediately overturn this cruel ban. They did not. When Wes Streeting announced in court he intended to make it permanent, I had a complete panic attack and could not breathe. This lasted hours. I could not believe my child would be expected to resume puberty, which would immediately out her as being transgender. She is now almost 6 years into a total transition from male to female. It is impossible for her to live if she will turn into a man so late into her transition and after we had so much hope that this nightmare was over. To this day, I remain highly anxious and afraid. I do not sleep and I have nightmares of Wes Streeting attacking me.”
By putting your weight behind the findings of the Cass Report, despite the criticism and the rejections of its methodology and very questionable outcomes, you are also helping it to be used against transgender youth around the world.
The poorly managed closure of GIDS following the interim report of the Cass Review, and the delayed opening of a replacement service has devastated trans young people still further. The new service has failed to recruit enough qualified clinicians, and has neither the capacity nor the expertise to be able to address the list of thousands of young people desperately waiting for help.
The final cruelty is that they are now waiting for a service which can not even prescribe the puberty blocking medication many so desperately seek.
Experts agree, puberty blockers save lives, and medical intervention works.
I know this not only due to my lived experience but also from the process I followed as a team member that worked on WPATH's Standards of Care for Transgender and Gender Diverse People, Version 8 (SOC-8). Guidelines that were developed by global professionals in medicine, psychology, law, social work, counselling, psychotherapy, family studies, sociology, anthropology, sexology, speech and voice therapy, and other related fields support the use of puberty blockers. SOC 8 took over 4 years to complete, with meticulous methodology and oversight..
In recent weeks an independent study by the New South Wales Government, Australia, has found that puberty blockers are safe and reversible.
WPATH and its SOC have been cited as a source of “best practice” for transgender healthcare by numerous medical bodies internationally.
While here in the UK, the British Medical Association (BMA) have challenged the Cass Report, while the General Medical Council (GMC) and The Royal College of Psychiatrists refer to WPATH in their own recommendations.
I am proud to have been part of the WPATH team. And I am deeply disturbed to see WPATH guidelines being ignored in favour of the Cass review, which has been recognised globally as deeply flawed.
The impact of the ban on puberty blockers
Government actions and the mainstream media hysteria and fear-mongering around puberty blockers has ensured that medical professionals are now fearful of supporting trans youth. As the Minister for Health and Social care, you tell families supporting trans kids that you are banning puberty blockers to protect their children and that they have been failed. They have. But not by the provision of timely effective healthcare, but by the previous government’s actions. And if you continue to refuse to listen, by making the ban permanent, you are failing them again.
Families seeking routes to medical intervention have now been effectively criminalised if they obtain medical support in the form of puberty blockers. Either that, or they watch their children suffer as the medication that treated their gender dysphoria wears off. For them, with puberty blocking medication now forcefully withdrawn, the torture resumes and concerns about self harm and suicide ideation becomes a reality.
“[My daughter] is beside herself with worry. She is back needing 24/7 support to cope in life and to sleep. Her OCD has never been so bad and I cannot access CAMHS as they are not going to help us but will instead report us to social services. I feel I cannot access any NHS healthcare for my child at all because they will find out she is transgender and report us. She has health issues that need addressing but we have decided the risk of seeking help for them is too great as it will trigger the police and social services and I can’t leave her by going to prison.”
Some parents are turning to private routes to medication, others are looking at less reputable sources. Many are huddled in private chat groups sharing desperate messages about trying to keep their children from sinking into depression, self harm, and worse.
Since the impromptu ban instigated in a fit of political and ideological vengeance by the Conservative government in their dying days, parents of trans children who have been previously prescribed or are seeking treatment with puberty blockers have been living in a world of fear.
Most are observing a sharp decline in mental health in their already gender dysphoric children, with many parents experiencing a decline in their own mental health.
“I feel isolated and used by politicians and the media. I feel our child is being misunderstood and used for someone’s gain with no thought to her care.”
As the Director of Anne Health, the only UK organisation currently supporting families to access legal routes to obtain puberty blockers, I have spoken to nearly 100 parents over the last few months. Many were utterly distraught, fearful for their children, literally sobbing as they considered how they were going to tell their kids that they had to come off medication that has had a hugely positive impact on them.
“I’m terrified of what my child is going to do. Before blockers she self harmed and wanted to die. If she has to go through puberty then I fear for my child’s life.”
Do you want to be known as the Health Secretary who oversaw the deaths of trans young people due to the blocker ban?
Who will parents blame if their child dies?
“He is more withdrawn. He has stated if he can’t get blockers he is more likely to kill himself. I can’t believe that a ban on a drug that makes a CHILD want to end their life is something this country, supposedly civilised one, thinks is an option.”
Where is the support promised to trans youth?
As the Minister for Health and Social Care you have promised to reduce NHS waiting lists, however you are erecting even more barriers, potentially increasing the waiting list for youth gender services still further. The pathway you have put in place is effectively endorsing an approach of conversion practices by stealth, with no practical medical assistance for those who desperately need it.
“I am just longing to have the NHS look after us, care for us, support us properly as we support our child in her medical transition. Instead we are blocked constantly and told what we are doing is harming our child when I know that the opposite is true.”
Whilst it is important that young people have access to affirmative and supportive counselling as and when they need it - especially in these times of ignorance, transphobia and media-generated hysteria about trans people - talking therapy does not work in isolation.
You cannot talk someone out of being trans, no matter how hard you try.
You can, however, force young people into an endless cycle of analysing their gender identity while seeking ‘causes’ as a diversion to actually treating them - this is the very thing that conversion practices do.
The ‘holistic care’ that you have promised in the new centres is seen as an attempt to talk young people out of being trans. This is conversion therapy. Yet Labour has pledged to ban conversion therapy. Those aims are clearly at odds.
“It is terrible to see how Wes Streeting has harmed my child. I feel so angry when I watch her suffer and worry about things a 14 year old should not have to worry about.”
How can you say you are doing your best for trans young people when the families themselves tell you what their children need, and you ignore their voices?
Listen to the experts. Listen to those impacted.
Why do you, Dr Cass, and those lobbying to remove trans kids access to puberty blockers know better than those affected?
The Cass review did not say that blockers were dangerous, yet a ban was introduced as if this medication was deadly. It makes no sense. It is driven by the belief that a cisgender outcome is better than a trans outcome. But forcing kids through puberty at odds with their sense of self won’t make them cis, it will just harm them.
“I have been a public servant of this country for nearly 30yrs and I’m angry, embarrassed and at a loss that we have to battle for care for our son. I’m in tears frequently because of this ban which is not something I have ever done despite being in extremely stressful jobs. I don’t want to use my GP for myself, let alone my son, as I now do not trust the NHS.”
If any other medical report for a specific health issue was met with such broad condemnation from the community it was meant to serve, would it continue to be held in such high esteem? I doubt it.
If authoritative worldwide expert organisations in the specific field of healthcare refuted and rejected its science, methodology, bias, and politics, would your government continue to stand by it? I would hope not.
No matter how much mental health support you provide, if you force trans young people through puberty that does not match their gender identity, you are causing them great harm and risking lifelong damage and deadly consequences. International bodies have stated this clearly, and the deaths in the GIDS service after the NHSE ban was introduced show in brutal clarity what happens when you remove access to care.
The cisgender bias and paternalistic approach to the care of trans people under the pretence of faux concern is heart-breaking to see. Many people I love are trans. They are ALL struggling. You have a chance to make it better.
Please, I beg you, listen to trans+ youth, listen to their families, and listen to the community it affects.
“I have moved my daughter to another country so she can continue to access the blockers and healthcare she needs. If we were in England she would be extremely distraught.”
I would welcome the opportunity to have a meeting with you, to introduce you to some of the young people and families affected by your decisions and connect you with expert members of the WPATH SOC 8 team.
Before you make any permanent decisions that will impact people's lives - including your own - I implore you to meet those who will feel the ramifications the most.
Susie Green
Director and Co-Founder of Anne Health