The Nolan team based in Belfast are a group of BBC journalists well used to asking awkward questions. Nolan looks at the influence Stonewall has in public institutions across the UK. This 18 month investigation has already had significant impact behind the scenes in major public institutions. The podcast is the story of how it all unfolded.
A team of volunteers at Fair Play For Women have transcribed the main content from each of the ten episodes spanning over 6 hours of audio content. You can listen to the full audio here or read the condensed transcript below.
Episode 5: A gender clinic insider speaks out
Dr David Bell speaks about his experience of the UK’s leading gender clinic.
A girl may hate her sexual body, absolutely hate it wants to be out of it. So there’s two aspects of this is 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 routes to gender dysphoria. For example, internalised homophobia is one of them. These children internalise a homophobia. That is, 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.
Other complex problems, for instance, children feeling well, they’re lost in the world and don’t know who they are. And because of the influence, particularly peer groups, 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 historic sexual abuse in the family and so on.
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, and that’s very, very important.
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 is expressing themselves in a particular way that needs 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.
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.
So I think the service should be closed down. I think children with these problems should be looked after by local CAMHS services.
[00:03:33.170] – Stephen Nolan
Dr David Bell was a consultant psychiatrist at the Tavistock and Portman NHS Foundation Trust in London. The Tavistock specialises in treating children with gender identity issues. He wrote a controversial report on staff whistleblowers, which was critical of the clinic’s practices.
[00:03:58.530] – David Bell
A lot of these children were gender nonconforming children, that is, they didn’t conform to the rather conventional idea of what a girl is or what a boy is. So just for convenience, if you take the situation of a girl. Think of a girl who’s non-gender conforming. Maybe dresses, behaves and wants to behave in what we think of in our culture as more masculine. May not be interested in sort of girly pursuits, may even have a great distaste for them. And such a girl may also have noticed that she feels an attraction towards other girls.
[00:04:38.310] – David Bell
So that is she’s lesbian in terms of what we call her sexual object choice. Don’t misunderstand the word choice. It’s not as if it is so much a choice, it’s who you are. But such a girl may pick up – either in herself or in the family or in the world around her – a great hostility, conscious or not so conscious about the idea of being gay. You know as a boy once put it to me, my father couldn’t stand me with my feminine gestures, and it caused terrible, terrible trouble in the family. This is someone telling me this as a man. Such children, if you go back to the example of the girl may think at least for a moment ‘I’m not a girl. I’m a boy’. Now 20 years ago, or even ten 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 wouldn’t have had determining consequences. But now, of course, because of the changed culture, there’s a tendency for that to be immediately reinforced.
[00:05:45.810] – David Bell
So to put it very briefly, these children internalise a homophobia. That is, 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.
[00:06:04.470] – Stephen Nolan
So I understand everything you’ve said so far. But what about the what if they’re 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?
[00:06:26.850] – David Bell
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.
[00:06:40.470] – Stephen Nolan
I don’t understand. Surely 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 surely the whole point of people, when they say they want to transition, they are saying 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’re 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 at a young age.
[00:07:19.770] – David Bell
You see, but they don’t know that.
[00:07:22.470] – Stephen Nolan
How can you tell them what they know?
[00:07:24.810] – David Bell
No, let me explain. There’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 is 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.
[00:08:05.790] – David Bell
Then there are many routes to gender dysphoria, and I was trying to describe some of them before. For example, internalised homophobia is one of them. Other complex problems, for instance, children feeling well, they’re lost in the world and don’t know who they are. And because of the influence, particularly peer groups, 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 historic sexual abuse in the family and so on.
[00:08:40.590] – David Bell
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. Now the child’s statement that they are in the wrong body and they need to change may change over time. For example, there’s quite a bit of clinical evidence and studies showing that children who present with gender dysphoria and are intent on going on a medical pathway changed their minds, if supportively helped in a service that isn’t kind of a funnelling service towards medical transition, an assessment service for medical transition.
[00:09:30.990] – Stephen Nolan
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 just have a detest for their own body?
[00:09:46.410] – David Bell
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 gendered activities which are not of their own gender, but that can evolve over time. So, for instance, Stella Malley did a very good documentary. I think her programme 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.
[00:10:22.830] – David Bell
She did all boy things. You want nothing to do with girls. Now she is, however old she is, as I said, she’s in her 40s and she’s married with children and reasonably 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 Tavistock Clinic. And there would be an over-acceptance of the idea that she was in the wrong body.
[00:10:48.570] – Stephen Nolan
When you say doing all boy things, does such a thing exist, or is that not a creation of society?
[00:10:55.230] – David Bell
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 everyone’s body does affect it. But it’s largely a cultural construction. Whereas it seems to me that the trans ideologues treat it in 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.
[00:11:31.470] – David Bell
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, and let’s say all those children are twelve. 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.
[00:12:05.250] – David Bell
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, whether they’re 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, and that’s very, very important.
[00:12:44.670] – Stephen Nolan
But why is that happening?
[00:12:46.710] – David Bell
Well, that’s another big question, which, of course, we don’t know. All psychiatric and psychological disorders are 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, for instance, in Freud’s time, hysteria amongst a certain group was a relatively frequent disorder. 20 years after Freud’s death, it disappeared.
[00:13:30.390] – David Bell
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’ve 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 funnelled, if you like, through a change in culture into manifesting themselves as gender dysphoria and trans.
[00:14:13.950] – David Bell
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 2700 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 we’re in that this is happening? And the reason that it’s happening is because
[00:14:43.410] – Stephen Nolan
maybe it’s just a more accepting culture Dr. Bell.
[00:14:47.430] – David Bell
Well, that has 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 have been managed to get the attention of the professions, of politicians and so on, and being able to invade schools in a way which I’m happy to say has now been stopped.
[00:15:11.850] – Stephen Nolan
That’s a pejorative word you’re describing these organisations as invading?
[00:15:15.090] – David Bell
Yes, I am.
[00:15:15.870] – Stephen Nolan
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?
[00:15:25.710] – David Bell
I don’t agree with you. Have you read the children’s guidelines as they were before the government changed them?
[00:15:32.190] – Stephen Nolan
[00:15:33.810] – David Bell
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.
[00:16:12.870] – Stephen Nolan
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?
[00:16:25.350] – David Bell
I’m afraid they are.
[00:16:29.250] – Stephen Nolan
Why? Because of lobbying?
[00:16:30.930] – David Bell
Yes. You see, I’ve got this information from various places, but of course, at the Tavistock, I spoke to clinicians who were concerned that some of the children they were seeing had internalised 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 it elsewhere within the Trust, and they weren’t listened to. And what it 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.
[00:17:33.930] – David Bell
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 there’s Stonewall trying to still influence schools through their Stonewall Champions movement, 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 were of the opposite gender.
[00:18:11.250] – David Bell
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 it.
[00:18:37.590] – Stephen Nolan
But doesn’t that include calling themselves a boy if they’re born a girl?
[00:18:42.690] – David Bell
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 is expressing themselves in a particular way that needs 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, the Judicial Review has supported this perspective. Because one of the things that they mentioned in the Judicial Review, which is also mentioned in many places, is there’s been no follow up of these children. There’s no evidential base for this medical treatment, none. The Tavistock Service, for example, wasn’t even able to get figures to the Judicial Review of what percentage of children had other problems, such as depression, autism and various other things I’ve mentioned. They weren’t able to say what percentage of the children went on to have surgery because they don’t follow them up. I think 98% of children who go on puberty blockers go onto opposite sex hormones, and then a percentage of those will go on to surgery. So by calling the child a trans child. Or if they’re a girl saying you are a boy, forecloses, when there’s a lot more to work with and understand.
[00:20:05.430] – David Bell
And I called my paper recently published ‘First Do No Harm’. And the reason for that is that given that there’s no evidential basis, given that there’s no follow up, given that we don’t know if the child is group A or group B, I think it’s totally medically not taking care of a child putting them on a medical pathway which has unknown side effects. Well, we know some of them. We know that puberty blockers affect bone growth. They probably affect brain development. They may well affect cognitive development. All these things are issues that have been raised by experts. So there’s a pressure to push through which has to be resisted.
[00:20:52.350] – Stephen Nolan
Let me talk to you about the puberty blockers in a moment. But to come back to the question I wanted to ask, which is you said to me that you totally support gender fluidity. And you define that as a boy, 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?
[00:21:26.130] – David Bell
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 nonconforming, we must be very wary of treating them as if they’re not of their natal sex. Because to do so is to indulge in gender stereotyping. And this is why the LBG alliance, of course, left the LGBTQ movement because they felt there wasn’t sufficient support for children who may be gay or lesbian. And expressing this, perhaps or thinking they were the opposite sex. And it was leading to a kind of conversion treatment for homosexuality being put on a medical pathway.
[00:22:15.690] – David Bell
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. I’d 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.
[00:22:48.030] – David Bell
The ones that I’ve met have been largely women, and all of them are lesbian women. All of them are gender nonconforming, 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.
[00:23:22.770] – David Bell
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.
[00:23:33.390] – Stephen Nolan
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 Dame Victoria Sharp who was sitting with Lord Justice Lewis and Mrs. Justice Levin said it is highly unlikely that a child age 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 and weigh the long term risks and consequences of the administration of puberty blockers.
[00:24:11.970] – Stephen Nolan
So help me understand then, the politics within the Tavistock 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?
[00:24:28.050] – David Bell
Well, I don’t know. 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 the 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’ve come to learn, is these children, some of the clinicians describe them as some of the most difficult and complex children 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. 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.
[00:25:42.570] – David Bell
I want to be out of it now. A child in that state. Are they in a state to make a reasoned judgement about the irreversible consequences of the pathway they’re about to be put on. Which will mean eventually having parts of their body removed, going on opposite sex hormones, which have permanent effects, causing all sorts of effects that can’t be changed. If the girl’s voice can’t be changed back, girls will have to eventually have a hysterectomy because of the dangers of vaginal atrophy. We’re learning more and more about the consequences of these irreversible actions.
[00:26:18.390] – David Bell
So what I’m saying is. As one clinician said to me, I spoke to the child about the possible or even likely consequence of being anorgasmic. And the child who was twelve said, ‘ew 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 they wouldn’t be able to do, there isn’t the evidence base for them to make any reasoned decision.
[00:27:17.730] – Stephen Nolan
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 a penis and a vagina 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.
[00:27:44.370] – David Bell
You see, things are on a kind of continuum. I’m trying to struggle with a 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 starts 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’ve been more familiar with talking about adults, but they’ve remembered it from their childhood.
[00:28:30.850] – David Bell
Say, a child had a great conflict with their mother. A girl child girl so hates her 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. Fairy stories are, of course, full of that kind of narrative. So the girl feels she’s becoming her mother and 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 that shades into normal development. But amongst that group, there will be ones who, for 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 isn’t 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 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.
[00:30:11.830] – David Bell
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 funnelled 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 a 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 CAMHS service that they would need a lot of extra funding to manage it.
[00:30:57.130] – Tommy
What’s your view on Stonewall?
[00:31:00.670] – David Bell
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, but because society has changed, 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 issue seems to have gone away, and they’ve been completely they are a trans organisation.
[00:31:52.330] – David Bell
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, the damage being done to children and which I’m pleased to say the Judicial Review had 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 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 surgery they’d had mastectomies 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 effeminate 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.
[00:33:47.530] – David Bell
And what’s happened is a peculiar what I would call regression in thinking, whereby the fluidity has become rather characteristic 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 mild 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 blockers started, they were regarded as an interregnum, 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. So now it’s 98%. So if you put the children on puberty blockers and the judges said this, you’re de facto putting them on a pathway which will lead to opposite sex hormones.
[00:35:11.230] – Stephen Nolan
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?
[00:35:26.170] – David Bell
Definitely. Definitely. Because you see clinics are signed up as Stonewall Champions. To be Stonewall Champions, they have to sign up to 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 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. And I think the person who put this very clearly is James Kirkup from The Spectator pointing out in all his 25 years, I think as a political correspondent, he’s never known any movement that so quickly attracted and got 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.
[00:36:46.790] – Stephen Nolan
There’s one thing being a Stonewall champion. But are you actually saying that medical professionals, trained, in fact and discovery, are altering how they do things because of a lobby group?
[00:37:01.190] – David Bell
Well, you can’t put it quite as directly 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 Lobotomy, for example, many doctors thought it was the right thing to do. We now know it caused 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.
[00:37:46.070] – David Bell
So 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 due caution. I think what has happened is that people have thought it’s a liberal, and 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.
[00:38:29.630] – David Bell
And I’m, of course, completely against that. But what happens is the sense to be one 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 this is to do with not discriminating against gay and lesbian against trans people. 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 lesbian people is quite wilful. And I think it causes considerable confusion.
[00:39:05.510] – Stephen Nolan
Stonewall are now so embedded in our society and in many of these organisations, Dr Bell, that these organisations themselves attempt to climb up a league table created by Stonewall and judged by Stonewall. The BBC is among them. The police is there, the government is there. And so in order to climb up this league table, you need to adhere to Stonewall’s policies.
[00:39:37.070] – David Bell
[00:39:37.790] – Stephen Nolan
Where’s the freedom of thought and the independence of those organisations with that?
[00:39:45.170] – David Bell
Well, of course, I agree with you. 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 Tavistock. And the Tavistock, we’ve always seen ourselves, as I said, is engaging with a certain degree of complexity, 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 organisation has been captured by trans ideology and the GIDS service, which existed to some extent in a rather semidetached relation to the Tavistock, has become huge in the organisation. And that can’t be unconnected with the penetration of the ideological movement. But it’s true the Tavistock, 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 were such attempts to silence me, to remove books from the library, to stop me from speaking anywhere, and to threaten me with disciplinary action.
[00:41:07.790] – Stephen Nolan
So your books were removed from the library, were they?
[00:41:10.730] – David Bell
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’s a very good book, it’s not obviously got the same view as current at GIDS. But when you say we agree with free thinking, it’s very characteristic of this debate that people are not allowed their freedom of thought. People are no platformed. And this is a good example of no platforming that the book was removed from the library on this spurious claim that it raises legal issues.
[00:41:47.510] – David Bell
Well, the Tavistock 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 Tavistock that gives the other point of view, say, a more psychoanalytic 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 protest within the Trust. Most of it very quiet, but I decided not to be quiet about it.
[00:42:34.310] – Stephen Nolan
And have you had any significant levels of backlash because you’re not quite about it? And what type of response do you think you’ll get?
[00:42:44.210] – David Bell
Well within the trust? As I said, the trust tried to silence me, issued instructions that I wasn’t allowed to give lectures or write things about gender, and eventually took disciplinary action against me for my activities. In the end, it didn’t happen, but the threatening discipline 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.
[00:43:15.770] – David Bell
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, safe legally from any action by the Trust.
[00:43:29.630] – Stephen Nolan
And when you’re saying the trust, do you mean the trust that was in charge of Tavistock? Is that what you mean?
[00:43:35.270] – David Bell
In 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 free standing Trust. So there might be Camden and Islington Mental Health Trust, that’s a big organisation. But the Tavistock is technically the Tavistock and Portman NHS Foundation Trust. So I say the Trust, that’s what I mean.
[00:43:57.170] – Stephen Nolan
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 Stonewall, 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. No, what needs to happen now, in your view?
[00:44:23.870] – David Bell
Well, in terms of the 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. And I’ll just remind you two things. One was the focal thing, which the judicial review was about was about capacity and consent. But in the course of that review, they raised 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 are appealing against the judgement, they cannot really appeal against those findings, they can appeal on issues of consent.
[00:45:11.630] – David Bell
Secondly, the CQC echoed a lot of those concerns and included in its concerns that conditions were fighting 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 extraordinary that the NHS England stroke government can hear all this about a dysfunctional service and allow it to continue.
[00:45:55.430] – David Bell
So I think the service should be closed down. I think children with these problems should be looked after by local CAMHS services. But I’d like to remind you that CAMHS services 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 the number children with serious mental health problems. So just to say they could look after this will make things even worse. So it has to be proper funding available for CAMHS services in general, and perhaps a special fund to help with this service.
[00:46:30.050] – David Bell
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, the 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 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’ve been misled and that is going to take a lot of work.
[00:47:08.450] – Stephen Nolan
It’s going to have a lot of resistance as well.
[00:47:11.090] – David Bell
Yeah, but my sense is that people are beginning to listen. I don’t think things were as they were in 2018. Whereas 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.
[00:47:41.870] – Stephen Nolan
This is my final point to you. Are you really saying that the police, the government institutions like the BBC have been captured?
[00:47:51.650] – David Bell
Yes, of course. And I think it’s naïve to think any organisation, the 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 BBC here and the police here, it’s symptomatic. They’re not outside the culture.
[00:48:18.110] – Stephen Nolan
Dr David Bell, I’ve really enjoyed talking to you today. Thank you very much for doing so. Thank you.
[00:48:41.710] – Stonewall Statement
At Stonewall, we’re working towards a world in which all lesbian, gay, bi, trans and queer people can live freely as themselves. LGBTQ plus 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 health care to advocating for LGBTQ plus people in law improves the lives of all LGBTQ plus people and we will continue until every LGBTQ plus person is free to be themselves wherever they are.
[00:49:13.450] – Stephen Nolan
Since we talked to David Bell, there’s been another development on what’s been happening at the Tavistock. This is how it was reported by the BBC’s Newsnight programme who broke the story about safeguarding concerns at GIDS.
[00:49:28.090] – Emily Maitliss
A woman who raised concerns about the safety of children at an NHS gender clinic, has been awarded £20,000 in an employment tribunal case. Sonya Appleby is Children’s Safeguarding lead for the Tavistock and Portman NHS Foundation Trust, which runs the Gender Identity Development Service, GIDS. It’s the only NHS Gender service for children in England. Ms. Applebee’s job involved protecting children at risk from maltreatment. A number of GIDS 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.
[00:50:06.070] – Emily Maitliss
While our Newsnight producer Hannah Barnes has been working with health correspondent Deb Cohen, they broke the original news that formed part of Sonia Applebee’s case that JID’s staff had reported being advised not to seek help from Ms. Applebee, and Hannah joins us now. Just talk us through the ruling. First of all, Hannah, what does that say?
[00:50:24.790] – Hannah Barnes
Well, the Central London Employment Tribunal ruled that Mrs. Applebee had been vilified for raising concerns, blowing the whistle effectively about safeguarding issues at the Gender Identity Development Service, known as GIDS. The panel said that she had been treated in a judgmental and punitive way by her line manager at the Trust and that some senior GIDS staff saw her as having an agenda after she relayed the concerns of GIDS clinicians to others in the Tavistock. The tribunal pointed out that Mrs. Applebee had hitherto an unblemished blameless professional career.
[00:51:02.050] – Hannah Barnes
It’s important to point out that the tribunal explicitly were not making any judgement on the rights and wrongs of the treatments offered by GIDS itself, but rather the rights and wrongs of how Mrs. Appleby had been treated.
[00:51:12.970] – Emily Maitliss
So what then were the concerns that the GIDS staff took to Sonia Applebee?
[00:51:18.310] – Hannah Barnes
Well, the panel heard that Mrs. Applebee herself had had concerns about record keeping at GIDS 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 and trauma that some of these children had experienced also weren’t adequately being taken into account when they were assessed. Now, these are very similar to the concerns that Newsnight broadcast last year, which were contained in transcripts between GIDS staff and the Trust medical director, who is Mrs Appleby’s line manager. And those transcripts also contained a claim that staff had been instructed not to seek Mrs. Appleby’s help. The tribunal heard two weeks worth of evidence. They read nearly 2000 pages of documents and they agreed that there had been that explicit instruction to staff because Mrs. Appleby was seen as being in some way hostile towards GIDS. The Tavistock Trust say that it is considering the judgement carefully.
[00:52:36.250] – Stephen Nolan
The Tavistock and Portman Trust, which runs GIDS, declined requests to be interviewed as part of this podcast. Here’s what they said in a statement.
[00:52:46.270] – Tavistock Statement
The Tavistock and Portman denies that any steps were taken against David Bell for being an alleged 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 safeguard 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.
[00:53:46.070] – Tommy
So David, since we spoke with Dr Bell, there’s been an update in this case. Has there?
[00:53:49.850] – David (Producer)
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 sixteens 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 Tavistock Trust and it was brought over the original High Court Kia, which itself was brought by Keira Bell. Keira says that the clinic should have challenged her more over her transitioning and she said she was disappointed by this latest decision and she’s going to seek permission to appeal to the Supreme Court.
[00:54:30.230] – David (Producer)
In its judgement, 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 nature 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 bloggers go on to cross sex hormones and are 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.
[00:55:29.930] – David (Producer)
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 judgement also cleared up a misconception that it’s the Tavistock that provides puberty blockers to children. The Tavistock referred children on to other NHS trusts and it’s those Trust clinicians who consider the prescription of puberty bloggers.
[00:56:04.470] – Stephen Nolan
Coming up in the next episode, we find out what influence Stonewall has had on public policy across the UK and find out how the word mother has been removed from some government documents.
Want to read more? The transcripts for all 10 episodes are available