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Letters

Gender incongruence in children, adolescents, and adults: response to Dr White

Margaret McCartney, Susan Bewley, Damian Clifford and Richard Byng
British Journal of General Practice 2019; 69 (685): 379. DOI: https://doi.org/10.3399/bjgp19X704753
Margaret McCartney
Glasgow. Email:
Roles: GP
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  • For correspondence: margaret@margaretmccartney.com
Susan Bewley
King’s College London, London.
Roles: GP, Professor of Obstetrics and Women’s Health
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Damian Clifford
Locum, Cornwall.
Roles: Consultant Psychiatrist
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Richard Byng
University of Plymouth, Plymouth.
Roles: GP, Community and Primary Care Research Group
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We are delighted to clarify the evidence in our editorial for Dr White1 (a full point-by-point response is available online).2

White states there is ‘no inaccurate information’ from All About Trans3 when countering our claim that charities and non-NHS groups use ‘inaccurate information, including exaggerated risks of suicide’. The blog post claims that ‘hormones can be “life saving” for young people’. It describes a volunteer saying ‘hormone blockers’ were ‘life saving and empowering for young people’. The site states ‘Attempted suicide amongst trans people in the UK is 48% ...’.4 This figure (not confirmed via medical records) comes from a subgroup of 27 people responding to a survey, whose average age was 38, with a third considering themselves disabled. This is unlikely to be a representative, relevant, or generalisable relevant sample.5

We support children being able to dress and present in the way they wish. The study White cites as supporting children in their socially preferred gender role, and showing benefit of social transition,6 is exactly that: it refers to social, not medical, transition. No medical treatments were used. If anything, it suggests that medical intervention in this group was not necessary and points to socially assigned gender roles being harmful.

It is vital that doctors do not foreclose discussion by distorting the little evidence base that does exist. Admitting uncertainty is uncomfortable, but is the vital step to obtaining better research data to improve the care of current and future patients.

  • © British Journal of General Practice 2019

REFERENCES

  1. 1.↵
    1. White MI
    (2019) Br J Gen Pract, Gender incongruence: not representative of current knowledge and evidence, and nor of best practice. [Letter]. DOI: https://doi.org/10.3399/bjgp19X704741.
  2. 2.↵
    1. McCartney M,
    2. Bewley S,
    3. Clifford D,
    4. Byng R
    (2019) Br J Gen Pract, Gender incongruence in children, adolescents, and adults — Response to Dr White. [Letter]. DOI: https://doi.org/10.3399/bjgp19X701909. https://bjgp.org/content/69/681/170/tab-e-letters#gender-incongruence-in-children-adolescents-and-adults---response-to-dr-white (accessed 9 Jul 2019).
  3. 3.↵
    1. Hutchinson K
    (2017) Kate Hutchinson: Wrexham to Euston — my journey to meet the General Medical Council. https://www.allabouttrans.org.uk/kate-hutchinson-wrexham-euston-journey-meet-general-medical-council/ (accessed 9 Jul 2019).
  4. 4.↵
    1. Starr O
    (2015) A foot in the door at the New Statesman. https://www.allabouttrans.org.uk/a-foot-in-the-door-at-the-new-statesman/ (accessed 9 Jul 2019).
  5. 5.↵
    1. Nodin N,
    2. Peel E,
    3. Tyler A,
    4. Rivers I
    (2015) The RaRE research report. LGB&T Mental Health — Risk and Resilience Explored, http://www.queerfutures.co.uk/wp-content/uploads/2015/04/RARE_Research_Report_PACE_2015.pdf [accessed 9 Jul 2019].
  6. 6.↵
    1. Olson KR,
    2. Durwood L,
    3. DeMeules M,
    4. McLaughlin KA
    (2016) Mental health of transgender children who are supported in their identities. Pediatrics 137(3):e20153223, doi:10.1542/peds.2015-3223.
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British Journal of General Practice: 69 (685)
British Journal of General Practice
Vol. 69, Issue 685
August 2019
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Gender incongruence in children, adolescents, and adults: response to Dr White
Margaret McCartney, Susan Bewley, Damian Clifford, Richard Byng
British Journal of General Practice 2019; 69 (685): 379. DOI: 10.3399/bjgp19X704753

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Gender incongruence in children, adolescents, and adults: response to Dr White
Margaret McCartney, Susan Bewley, Damian Clifford, Richard Byng
British Journal of General Practice 2019; 69 (685): 379. DOI: 10.3399/bjgp19X704753
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