LGBTQ Breaking News Service

LONDON (Thomson Reuters Foundation) – Almost as soon as she could speak, Nina told her parents she was not a boy and she has lived as a girl since she was seven. Until recently, she was happy.

But now aged 12 and wanting to stop the onset of male puberty, a ruling by Britain’s High Court has plunged Nina and dozens of other children struggling with gender dysphoria into limbo by restricting access to puberty-blocking drugs.

The judges ruled that under-16s were unlikely to be able to give informed consent to such medication, and doctors must now get a judge’s approval – a so-called “best interests order” – to prescribe them to adolescent patients.

Days after the ruling, Nina’s appointment the following week with specialists – whom she hoped would prescribe the medication – was cancelled and no new date was scheduled.

With the court ruling leaving a void in treatment, some parents are now filling the gap left by seeking drugs for their children from privately funded services.

“I feel like I’m living in a nightmare,” said Nina’s mother, Juliet, whose daughter has attended England’s sole youth gender clinic – the Gender Identity Development Service (GIDS) – since she was five.

“If in your head you are female but your body starts to develop as a male in your teenage years, it just must be the most horrendous thing,” said Juliet, whose name – along with those of all parents and children in this article – has been changed to protect their identities.

The ruling came as rising numbers of adolescents globally seek to change gender, dividing those who fear doctors are too hasty in prescribing puberty blockers and cross-sex hormones and those worried about access to medication they deem life-saving.

Puberty blockers, which are used to prevent the onset of sexual maturity, have become the focus of a fierce global debate about the age at which a child can decide to transition gender.

In Britain the number of children referred to GIDS has risen nearly 30-fold in the past decade and waiting lists are more than 18 months long.

About 2,660 under-18s were referred to GIDS in the year to March 2020, while 161 were referred on by GIDS to specialist endocrinologists who prescribe puberty blockers, according to the clinic’s data.

The World Professional Association for Transgender Health, a U.S.-based body of doctors specialised in treating trans people, said puberty blocking drugs can be used to help alleviate gender dysphoria and give children time to consider future options.

The medication can stop irreversible physical changes for patients, such as their voice breaking, WPATH’s guidelines state.

But the drugs’ use is controversial. There is little research about the long-term effects and critics say they are prescribed too freely – putting sometimes-vulnerable children on a course to more permanent transition treatments.

Keira Bell, who took puberty blockers aged 16, testosterone at 17 and had a double mastectomy at 20, brought the court case that resulted in puberty blockers being restricted after coming to regret the medical treatment she had to transition.

Bell, now 23, told reporters after the Dec. 1 judgment that she was delighted by the outcome and wished it had been made before she “embarked on the devastating experiment of puberty blockers”.

‘ABSOLUTELY DEVASTATED’

Tom, a 12-year-old patient of the London-based youth gender clinic run by the Tavistock and Portman NHS Foundation Trust, had been waiting for an appointment with an endocrinologist when the High Court issued its ruling, said his mother, Naomi.

“When the (court) outcome came, he was just absolutely devastated,” she said. “Straight away he just went completely down. And since then he’s stopped eating.”

Some former staff and parents of children with dysphoria, however, have welcomed tighter restrictions on the use of puberty blockers at GIDS, voicing concern about whether children as young as 10 can be sure about their gender identity.

“No child can be born in the wrong body,” said David Bell, a retired adult psychiatrist and a former staff representative on the Tavistock and Portman NHS Foundation Trust’s Council of Governors.

While he said he had not worked with trans children specifically, Bell said he was contacted in 2018 by 10 former and then-current GIDS clinicians who were concerned puberty blockers were being prescribed too easily.

But another GIDS clinician, who spoke anonymously because of not being authorised to speak publicly, disputed the assessment of the medical professionals who raised concerns with Bell.

“The idea that people are being rushed into decisions is simply not true,” the clinician said. “As a service we are actually very conservative in the way we approach gender identity.”

‘TIME TO THINK’

Like Nina, Tom’s mother Naomi said he had been “adamant” about being a boy since he started to talk, but COVID-19 had delayed his assessments for medication even before the court ruling.

“I’m just pinning all of my hopes on the best interests (court) order,” said Naomi, referring to the new requirement for patients aged under 16 to secure a judge’s approval to access the medication.

Parents such as Naomi told the Thomson Reuters Foundation they had received little guidance so far on how to seek a court order, and so far none have been issued.

A Tavistock and Portman NHS Foundation Trust spokeswoman said patients such as Nina and Tom, who were referred to endocrinologists before Dec. 1 but had not started taking the drugs, would soon be advised on applying for the court orders.

The trust is appealing against the High Court ruling, which prompted England’s National Health Service (NHS) to tighten its rules on accessing the drugs.

The High Court “set out a clear need for an additional layer of safeguarding for children which is why the Tavistock and Portman NHS Foundation Trust themselves decided not to make new referrals”, an NHS spokeswoman said by email.

Caroline’s daughter Lily starting living as a girl at the age of six, having said she was a girl from the age of three.

Lily was due to have an endocrinology appointment when she turns 12 in March, but now that is in doubt Caroline has paid a private gender care service to secure puberty blockers for her daughter.

She said she would continue to skirt NHS channels to secure supplies of the drug while the uncertainty triggered by the court ruling continued.

“She knows her body, she’s not stupid,” Caroline said. “It’s giving her time to think about it, to discover herself and think about it. We’re not opposed to her going back to being a boy. She can do what she likes.”

Some health care professionals allow their bias toward lesbian, gay and bisexual persons to show when diagnosing borderline personality disorder, says a University of Michigan researcher.

This bias for borderline personality disorder, or BPD—a chronic mental illness known for impulsive behavior, people’s uncertainty about themselves and relationship difficulties—is more pronounced for sexual minorities than heterosexual individuals, says Craig Rodriguez-Seijas, U-M assistant professor of psychology.

“LGB persons are more likely to be given the diagnosis particularly when health care professionals are not paying attention to whether or not the behaviors observed among LGB persons cause any significant distress or impairment,” said Rodriguez-Seijas, lead author of a study that appears in the online journal Assessment.

Rodriguez-Seijas and Brown University colleagues used data from the National Epidemiologic Survey on Alcohol and Related Conditions-III to compare the differences in BP diagnosis among lesbian, gay and bisexual persons with heterosexual persons. The survey, conducted in 2012-2013, involved responses from more than 36,000 participants between 18 to 90 years old. About 1,100 (3%) identified as lesbian, gay or bisexual, while the rest were heterosexual.

BPD was diagnosed in 11% of the entire sample. The prevalence of the illness was almost double among sexual minorities (20%) compared with heterosexual (11%) individuals. However, when the diagnosis was made with specific attention to whether or not the symptoms of BPD cause significant distress or impairment, the prevalence was comparable for sexual minority (2%) and heterosexual (1%) individuals.

Health care professionals evaluating patients for factors linked to BPD might ignore environmental stressors that LGB persons face or be unable to competently assess the extent to which the behaviors signify BPD or normative reactions to stress, Rodriguez-Seijas says.

For example, BPD can involve struggles with one’s identity, he says. LGB persons might change the way they present differently to other people for safety reasons, such as avoiding discrimination, bullying or even murder. Such behaviors help manage the impressions that other people have and are relatively normative for LGB persons since they grow up and exist in stigmatizing environments, he says.

If health care professionals fail to ask the right questions to disentangle this protective way of managing one’s identity from pathological and impairing struggles with identity they may not accurately diagnose the patients, according to Rodriguez-Seijas.

In addition, the research showed that sexual minority individuals reported a greater prevalence of nonsuicidal self-injury and impulsive sexual and financial behavior problems.

The findings offer implications for treatment. Rodriguez-Seijas says that while there are helpful evidence-based interventions for individuals diagnosed with BPD, some approaches to treatment might inadvertently re-stigmatize LGB persons by disproportionately attributing genetic variables as the causes of BPD symptoms.

However, this fails to factor in that some maladaptive behaviors—which might prevent a person from making changes in their own best interest, such as avoidance or withdrawal—represent ways that LGB persons learn to cope with a continually stigmatizing social environment, he says.

The study is a follow-up of previous research by Rodriguez-Seijas and colleagues that found that health care providers show bias in diagnosing BPD among LGB patients in actual practice. In one partial hospital setting, psychiatrists and psychologists diagnosed BPD among LGB patients at higher rates than heterosexual patients, regardless of any true differences in BPD pathology based on sexual orientation.

Other authors include Theresa Morgan, clinical assistant professor of psychiatry and human behavior at Butler Hospital, and Mark Zimmerman, professor of psychiatry and human behavior at Rhode Island Hospital. Both Morgan and Zimmerman are faculty at the Warren Alpert Medical School at Brown University.

More information:

I’m all for an energetic coach or motivational at-home YouTube workouts, but every so often, I’m not in the mood for someone else’s pep. If I come to a workout with a five energy level and the instructor greets me with a 1,005, it’ll take all my strength to not turn around, walk away, and crawl back in bed. Clearly, the writers at Saturday Night Live feel similarly, and they’ve infused those vibes into a hilarious sketch poking fun at Peloton specifically.

During Feb. 13’s episode, SNL cast members Kate McKinnon, Bowen Yang, Ego Nwodim, Beck Bennett, and more imagine a world where “Pelotaunt” instructors try to humiliate and, by default, motivate exercise bike users. “I feel mentally broken down, but hey, I can see my abs,” Bennett quips. The skit certainly resonated with viewers online, who joked they’d try out the Pelotaunt IRL — we’ll unpack what that means later, I guess. In the meantime, check out the unfortunately funny skit in full above.

An anti-mask gym patron assaulted a trainer at Anytime Fitness in Chicago and caused a major scene before being arrested for violating COVID protocols on Thursday. And his tantrum was caught on video (below) that’s now going viral across social media.

“It’s a joke. You’re ruining my f**king country,” the male gym “Karen” yelled at the trainer and other members before aggressively poking and pushing the trainer, who was trying to keep the anti-masker away from the other members.

Trainer Adrian Aguilar wrote on Facebook that he spotted the maskless gym patron wandering around violating the gym’s mask policy.

Wrote Aguilar: “As I approached him, his mask was at his throat, not near his face. I said, ‘yo! I need you to put your mask up in the building, man.’ He whirled around and immediately said I was too close to him and that I was within 6 feet of him. I don’t think I was and according to footage, I wasn’t, but like a normal human I took a big step backwards and said, ‘sorry about that! I need you to put your mask up if you’re in the building.’”

Aguilar said the man then launched into the unhinged tirade and refused to put his mask on. The gym’s owner was called and the gym patron was told his membership had been revoked and he had to leave. A small crowd of members had gathered.

“I then went and positioned myself between the members and the trouble, just in case,” wrote Aguilar.

“Hooboy he REALLY didn’t like that,” added Aguilar. “That was what led to this video. I kept far from him and continuously kept my hands high or behind my back to indicate that I meant him no harm. I also continuously told him, ‘I’m not going to touch you or do anything to you.’ Despite all of that, he closed the distance and got physical. At some point, he called the cops himself and told them that I was a threat and a danger and that he didn’t feel safe in my presence…

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Aguilar said that when police arrived the gym patron tried to convince them that he was the victim, but the cops weren’t persuaded given the video evidence.

Wrote Aguilar: “Eventually, a combination of us filing a report for battery against me, and trespassing against the gym (the owner) he was arrested and led out of the gym around 5:15pm. It’s worth nothing that on his way out, in the most low-budget, Scooby-Doo villain, hilarious way, he said ‘This isn’t over…’ It’s also worth noting that WHILE I was writing that sentence, he called the gym and threatened me. Just now! In real time! Very cool. Anyway, his name is Austin Tony Myers and that is all I care to know. Do with that information what you will. I think he is a very sick individual and I hope that he receives some help from somewhere, very soon.”

Another stream of the same video.