Bigmouth Strikes Again: Carrie Marshall's blog

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Category: LGBTQ+

  • The Brexit of healthcare

    Another day, another demonstration that the Cass report into puberty blockers was a political move, not a medical one.

    As the epidemiologist and writer known as Health Nerd posted to Bluesky, “The BMJ journal Archive of Disease in Childhood has just published the epidemiological study done by York university that was commissioned as part of the Cass review into gender clinics in the UK. It contains some startling (and yet, unsurprising) revelations… this report undermines most if not all of the Cass review recommendations regarding clinical care.”

    The study found that gender dysphoria diagnoses were incredibly uncommon; that a tiny proportion of those studied were prescribed any medication; and rates of prescribing were falling, not rising.

    Elsewhere, solid criticisms of the Cass report continue to be published. This piece in the Journal of Paediatrics and Child Health describes it as the Brexit of health care and notes that “it is very unusual in the history of medicine that a time-honoured treatment, with a good safety record, even if based on non-randomised trials and experts’ opinion, is simply banned”.

    You can find a very comprehensive collection of links to Cass-related studies and commentary on Ruth Pearce’s website here.

  • Turkeys celebrate Christmas

    With depressing predictability, the leading lights of the UK anti-trans mob and their pet journalists are celebrating the inauguration of Trump and downplaying or making jokes about copying Elon Musk’s nazi salutes. In particular they’re celebrating the newly signed executive order designed to drive trans people out of society – an order that makes it very clear, once again, that they’re turkeys voting for Christmas.

    The executive order is a mess, of course, bigoted, and often horrendously unscientific. But it also contains something very important: a definition of men and women. And in the order, personhood begins not at birth, but at conception.

    It’s important to read that in context. The context is:

    “It is the policy of the United States to recognize two sexes, male and female… the following definitions shall govern all Executive interpretation of and application of Federal law and administration policy”.

    All interpretation and application of law and policy. Not just the anti-trans bits.

    That’s not an accident. It’s because the people writing Trump’s policy are also coming for abortion and contraception and women’s rights, like they’ve been promising they would for the best part of a decade now, like we’ve been trying to tell you for the same period of time.

    Chase Strangio, writing in TIME:

    It might be easy for people to dismiss the impacts of sweeping anti-transgender policies since, despite this outsized fixation we provoke in our opponents, we only represent .6% of the U.S. population. However, none of these rhetorical, political, or legal attacks on transgender people will ultimately end with us. The anti-trans rhetoric that fueled the 2024 elections was accompanied by a larger message about how men and women are supposed to act, live, and raise families.

    Strangio quotes Alexandria Ocasio-Cortez, who said of banning trans girls from sports:

    “What this also opens the door for is for women to try to perform a very specific kind of femininity for the very kind of men who are drafting this bill, and to open up questioning of who is a woman because of how we look, how we present ourselves, and yes, what we choose to do with our bodies.”

    The people celebrating the assault on trans women in the US have paved the way for an assault on all LGBTQ+ people and on cis women as well as trans women. And they’re trying to do the same in the UK.

    Update, 23/1/25

    Well, that didn’t take long: Trump’s wrecking ball has come for more of women’s protections. Trump has ordered the end of Lyndon B Johnson’s Executive Order 11246, which forbade federal contractors from discriminating on grounds of race, colour, religion, national origin, sex, sexual orientation or gender identity. It’s part of the wider destruction of diversity programmes, the biggest beneficiaries of which – for decades – have been white women.

  • A shameful fraud

    Yet another damning review of the Cass scandal has been published, this time in the New England Journal of Medicine. The publication is one of the world’s most respected peer-reviewed journals, and in a better world this article would be the final stake through the Cass review’s heart.

    The article says that Cass’s report “transgresses medical law, policy and practice… deviates from pharmaceutical regulatory standards in the United Kingdom. And if it had been published in the United States… it would have violated federal law.” The review misrepresented data to arrive at conclusions the data did not support, it did not follow established scientific methods, it did not follow international publication standards and is so clearly a stitch-up that “observers must speculate about who else participated in the manuscript’s drafting — and whether they held bias against LGBTQ+ people.”

    The review was a foregone conclusion, as Kemi Badenoch has already admitted; its job was to rubber-stamp transphobia, and anti-trans activists were deliberately placed in “the positions that mattered most in Equalities and Health.” It is as unscientific and as wicked as the anti-trans measures Donald Trump is expected to announce in the US later today, measures that will make the lives of trans and non-binary people immeasurably harder and will undoubtedly kill some and damage more for no reason other than bigotry and cruelty.

  • Panic

    The coverage of, and social media commentary on, a trans girl being stabbed in England is bringing back an old and poisonous trope: the gay panic defence.

    The gay panic defence, and its trans equivalent, asks people to agree that gay and trans people are so disgusting, so repellent, so predatory that their very existence sends straight and/or cis people into such a panic that they commit extreme violence. In this example, the line is that sure, a young woman was sexually humiliated, lured into a trap, beaten and stabbed. But she brought it on herself because she was trans.

    Even if the underlying bigotry were true, which of course it isn’t, this wasn’t a crime committed in the heat of the moment over an unwanted advance. A man received oral sex from a trans girl he wasn’t sure was trans, was embarrassed about it later, and conspired with his friends to get revenge. That’s not a panic.

    Again and again the gay/trans panic has been used to excuse violent men – and it’s usually men – who’ve committed terrible acts of violence against LGBTQ+ people. And that’s exactly what’s happening around this horrific attack.

    This matters more widely because there’s currently an issue – driven, inevitably, by the genital-obsessed weirdo brigade – over whether trans people are deceiving sexual partners if they don’t first disclose that they’re trans. New guidance from the CPS hasn’t really helped, as it suggests that in some cases the law might decide that it does.

    One of the key cases here wasn’t about trans people; Justine McNally was a teenage cisgender girl who pretended to be a teenage cisgender boy and had penetrative sex with another cisgender girl. The court found that McNally violated consent because she had lied about her sex and gone to great lengths to deceive her sexual partner even during penetrative sex. And in the minds of the genital-obsessed weirdos, all trans women do that all the time because to them, all trans women are and will always be men irrespective of hormones, surgery or anything else.

    It doesn’t matter who you are or what body parts you may or may not have or whether you’re one of the hottest women who ever walked the earth; what matters is what the hospital wrote down on the day you were born. And if you don’t disclose that to men, even if it’s just a one-night stand? Then you deserve anything bad that happens to you.

    And that’s where a lot of the horrific response to the stabbed girl is coming from. In the minds of the anti-trans mob, the girl is a predator; she obtained sex by deception, performing oral sex on a boy who she had tricked into believing she was female (because for the mob, no trans girl is or can ever be female). What he and his friends did was bad. But what she did was worse.

    This isn’t just incredibly bigoted. It’s incredibly dangerous, because when you combine it with the trans panic you give men a green light to be violent to any women who are trans.

    Which, of course, is what the bigots want.

  • Victim blaming

    The Mail, the Telegraph and the Times are all framing a horrifically violent attempted murder in the same way: they’re blaming the victim. Of course they are. She’s trans.

    [I don’t usually come back and edit posts but I’m going to fix this for clarity the day after posting it, because it was written in a hurry and got the timeline slightly wrong.]

    The attack was on a teenage girl who’d been flirting with a young man. He’d been told that she was trans, but when he asked her if that were true she said no; the girl had previously been attacked for being trans and seems to have been concerned for her safety if she’d said otherwise. They kissed, and the young man asked her to perform oral sex on him. He filmed the act without her knowledge or consent and shared it online on Snapchat.

    When the video circulated, the young man was told again that the girl was trans. He asked her again, but this time he told her that he’d stab her if she lied. So she said yes, she was trans. The young man and his friends then conspired to lure her into a trap.

    The girl was jumped in the street by the young man and several other people in a sustained attack during which she was stabbed multiple times, stamped upon, kicked and robbed. Their friends filmed the attack and shared it online; the most violent of the attackers, the one who brought a knife it to stab her, was a young woman who later posted a Snapchat story which included footage of the attack, an image of the victim on a ventilator and a number of transphobic slurs.

    The Mail describes this as being targeted “over her trans identity lie”; The Telegraph says she was stabbed “after lying about her gender”. The Times puts the last two words in quote marks but the headline is still “Transgender teenage stabbed 14 times by Snapchat gang ‘for lying’”.

    The Metropolitan Police rightly called it a “horrendous and violent assault on a young woman, motivated by the fact she is transgender”. But the response on social media and Mumsnet is to call the girl a rapist, say that the attempted murder was her own fault and demand her prosecution for not disclosing her gender history to the young man who filmed her performing oral sex without her knowledge or consent and who conspired to plan her attempted murder. His criminal behaviour doesn’t matter; she, the self-proclaimed defenders of women say, was asking for it. She had it coming. Although of course they don’t call her “she”.

    This is the world that “gender critical” journalism has created: a world where trans kids are beaten up if they tell people they’re trans and stabbed if they don’t. The UK press and the bigots they platform have blood on their hands.

  • A girl called “it”

    Platformer has obtained what it calls “the dehumanizing new guidelines moderating what people can now say about trans people on Facebook and Instagram.” Examples include “trans people aren’t real. They’re mentally ill”, “a trans woman isn’t a woman, it’s a pathetic confused man” and “a trans person isn’t a he or a she, it’s an it.”

    The report says that Meta’s chief marketing officer Alex Schultz, the firm’s highest-ranking gay employee, has suggested that for FB and Instagram users, “seeing their queer friends and family members abused on Facebook and Instagram could lead to increased support for LGBTQ rights.”

    It’s not just trans people. It’s pretty much anybody who isn’t MAGA. And it’s not really new, because marginalised people have been trying and failing to get Meta to moderate hate speech for a long time. But what’s different is that this is now policy, and the policy explicitly says that hate speech is fine when directed towards specific minorities.

  • A broken system

    Abigail Thorn, actor and writer of Philosophy Tube, posted a video two years ago about her (awful) experiences of the NHS. The short version: she demonstrated how the NHS is institutionally discriminatory towards trans people. So I imagine she was quite surprised when a very senior NHS figure approached her about being the face of a new campaign about changes in NHS trans provision.

    Thorn said no, and has written an article explaining why. Thorn is the first to say that there are some very good people working in the NHS, and in trans care specifically. But the organisation itself is broken, and treats trans people appallingly. And it’s getting worse.

    I’m writing this in my sixth month of having my basic healthcare refused by my GP, healthcare that the GP happily provides to dozens of cisgender people but which is apparently too difficult to provide to me. I’m a few months away from finally getting surgery I first asked to be referred for six years ago, a referral that was never made because the gender clinic doctor simply didn’t bother doing it, a mistake or deliberate omission that I didn’t find out about for two years. My next referral was delayed because the gender clinic made an appointment for the mandatory second opinion, never told me about the appointment, and then concluded that I had changed my mind about wanting referred because I didn’t attend. Another year gone.

    So it’s fair to say I’m sympathetic to Thorn’s argument.

    There are many problems with NHS care for trans people, and they’re about to get worse with a Cass-style stitch-up labelled as a review of adult care. That review isn’t going to recommend that the NHS does something about the infiltration of conversion therapists, or the humiliating assessments we have to go through, or the woeful lack of staff, or the waiting lists that mean many trans people will die before even having a first assessment. And it’s not going to do anything about making trans people’s access to care any easier, because as Thorn points out:

    every single person I have spoken to in the NHS- from local GPs to the National bosses- told me they are powerless. There is nobody at any level of the organisation who takes responsibility for the state the service is in and the suffering it is causing. Every single person blames the person above them, even the man at the top.

    …I agree with others who study this field that consultations and “stakeholder meetings” have become a form of abuse by the NHS and the government: we’re included nonperformatively – given time to speak in order to legitimise the process of ignoring us.

    In years to come, this will rightly be viewed as a scandal. But it’s going to harm many more people before that happens.

  • Sadistic pencil-pushers

    There’s a superb piece in Dazed by Sasha Baker, who explains how a vocal minority of religious and social conservatives has managed to dismantle trans healthcare and human rights in the UK without a single law being passed or revoked.

    The British gender critical movement purports to represent a silent majority, but knows it does not command enough support to publicly shred the documents guaranteeing our rights. Instead it has adopted the methods of sadistic pencil-pushers – its true constituency – burying human rights laws in reams of secondary legislation, statutory and non-statutory guidance, grey literature, and fudged equality impact assessments.

    As the article notes, a key part of that is the Cass scandal: a supposedly clinical review that was created and staffed in order to achieve a pre-determined political outcome, and which – despite repeated claims to the contrary in the press – found no evidence whatsoever that puberty blockers are dangerous or that their use should be curtailed.

    You’ll read a lot about “evidence” in connection with the Cass scandal. Here’s one of the crucial bits of so-called evidence on which Cass leaned heavily.

    In February, Sallie Baxendale, a psychologist, published a terrible academic paper that claimed to look at existing studies on the negative effects of puberty blockers on trans children’s cognition. In reality, most studies surveyed were performed on animals, with only one case study showing that a single trans child scored lower on an IQ test after taking puberty blockers… it was rejected by three journals and met with scathing comments from peer reviewers [but] Dr Hilary Cass chose to cite it four times in her final report, and determined that puberty blockers should not be prescribed to trans kids outside of an upcoming clinical trial, in part because of “potential risks to neurocognitive development”.

    What we’re seeing on a frankly frightening scale is the very opposite of evidence-based policy; the policies are decided first, and the evidence cherry-picked, distorted or manufactured to support them. This will not end with us.

  • Don’t talk about the dead

    We know that more than a dozen trans teens have taken their lives since the puberty blocker ban was introduced in the UK, despite the government’s best efforts to cover that up: its small inquiry into trans suicides discounted documented trans suicides. So it’s particularly disgusting to see Hilary Cass, the author of the politically motivated and utterly discredited Cass scandal that’s being used to dismantle trans healthcare, to proclaim that “What is worrying is when people say that if children don’t get these drugs, they will die, because clearly that’s not true.” It is “irresponsible for people to shroud-wave in that way.”

    Not for the first time, Cass is parroting the stories of hateful, genital-obsessed weirdos. Morgan Page writes:

    The spectre of the trans death, particularly through suicide, hangs over all of the attacks on trans life. No one wants to admit that this is the desired end goal — that trans people simply cease to exist, whether that be through detransition or death seems to matter little. As Janice Raymond famously put it, the goal is for trans people to be “morally mandated out of existence.” Indeed, “shroud waving” threatens to stir up some empathy for the plight of this embattled minority, and we can’t be having that. Anti-trans actors have gone so far as to accuse trans people of acting like abusive husbands who threaten to kill themselves if their wives leave.

    It’s a useful strategy, this attack on the idea of trans death, because most cis people will never know a living trans person, let alone a dead one.

    It’s worth pointing out yet again that despite its very best efforts the Cass study found no evidence that puberty blockers harmed kids. It did, however, see plenty of evidence that limiting access to healthcare and support kills some of them.

  • Stacking the deck

    Yesterday, Wes Streeting made the UK ban on puberty blockers for trans kids permanent. The ban does not apply to cisgender children; puberty blockers are apparently magic medicine that are uniquely dangerous to trans and gender non-conforming kids.

    The decision was subject to a consultation, which – at the Government’s invitation – featured significant input from anti-trans, pro-conversion therapy organisations with no expertise in healthcare generally or trans healthcare specifically. And despite blatantly stacking the deck with those anti-trans groups, the consultation could still not produce evidence to justify the ban. It did, however, make it clear that the ban would have terrible effects on trans kids’ mental health. We’ve already seen more than a dozen children take their own lives as a result of the temporary ban.

    Streeting simply ignored the evidence and imposed the ideologically motivated ban on the UK, including Scotland. Pressure from the UK government ensured a similar ban was passed in Northern Ireland with the support of Sinn Fein. There’s bleak humour in seeing UK Labour and Sinn Fein finding common ground in killing children.

    I’ve long since given up on trying to get people to care about trans people. But an evangelical government minister banning medically necessary healthcare by prioritising the thinky thoughts of newspaper columnists and religious and social conservatives over evidence and international medical consensus is a terrifying precedent for everybody.