Why Therapy is Crucial for Dysphoric Girls – A letter to Marsha de Cordova

Today we write to Marsha de Cordova, shadow Secretary of State for Women and Equalities, to express our concern with the standard of care for young dysphoric girls in the UK and to stress the importance of therapeutic practice in their treatment.

Dear Marsha,

We are concerned at the answer you received to your recent parliamentary question regarding surgery for transmen. Hopefully the minister’s answer will satisfy transmen that their needs are being taken seriously and the deficit in provision is being addressed. However, whilst we can appreciate the frustration of those on interminable waiting lists who have elected to have surgery we were alarmed to hear how far this experimental surgery has been accepted into mainstream.

Prof Robert Winston described the phalloplasty procedure as experimental butchery. A large international study published this year reinforces this view, exposing high complication rates, surgical revisions and poor mental health outcomes. Therefore, we believe that a pause in developments until the Cass review has been completed is imperative to prevent more girls taking irreversible medical routes in haste and without the full picture, which they may later regret.

This is of concern to us as Lesbians because a significant proportion of the 4000% increase in girls presenting with Rapid Onset Gender Dysphoria (ROGD) are gender non-conforming girls who, left to mature naturally would settle into same-sex attraction. Instead, now there are huge pressures on these girls to identify out of Lesbianism. They meet two powerful obstacles:

  1. The heteronormative assumption that only opposite sex attraction is valid, normal and acceptable. Therefore if they are sexually attracted to women they must be a man. This transing of Lesbians is deeply homophobic.
  2. Societal expectations that women and girls should behave and dress in a certain manner, under a very real threat of harassment/corrective rape.

For these girls to hear about advances in medical science that could turn them more “convincingly” into a “boy” can seem like a perfect solution to their struggles with sexuality and misogyny. However, the true reality of such lifelong medicalisation rarely lives up to these expectations. This is reflected in the growing numbers of detransition groups such as Post Trans, the Detransitioner’s Advocacy Network and The Pique Resilience Project. Internalised homophobia and sexism as well as comorbid conditions are commonly reported among detransitioners, which exposes the dearth of rigorous psychological support and assessment prior to medical transition.

We would therefore like to propose a follow-up question to inquire what provision there is to fund adequate counselling for those seeking gender reassignment treatment.

We feel certain that the Keira Bell case and the concerns raised about the lack of appropriate counselling at the Tavistock clinic are only the tip of the litigious iceberg.

I hope you find this information useful.

Comradely greetings,

Lesbian Labour