The NHS (National Health Service) is removing the gender-affirmative care approach in all gender clinics in favor of holistic support.
The Autonomous Communities should update their "trans protocols" if they want to stop the attacks on the health of children with gender dysphoria.
Joaquín Díaz Atienza
(Revised on 14/07/2023)
Sand we analyze the Law 4/2023 of February 23, the "Trans Law"We observe that the greatest threat to children's health is committed by considering them sexual identity problems as a normal evolutionary aspect and definitive throughout the entire development trajectory, as well as its adherence to the depathologized "gender incongruence" of the WHO's ICD-11((International Classification of Diseases of the World Health Organization)) and its rejection of the designation of APA DSM-5 Gender Dysphoria((American Psychiatric Association)). If we exclude these two aspects, the laws currently in force in the Autonomous Communities They are more radical and harmful than state legislation. Hence the silence from the regional authorities. Political silence or silence born of a guilty conscience?
Some concepts
Childhood is initially determined by one's genetic makeup. Based on this, and on one's social and family environment, especially influenced by attachment, one's emotional, cognitive, psychomotor, and moral development will take shape. All of these aspects have been extensively studied scientifically. Jean Piaget, Sigmund and Ana Freud, Lawrence Kohlberg and Mary Ainsworth, among many others. Child development has been extensively studied; we know it both in its standard and harmonious presentation, and in as many variations as possible. evolutionary disharmonies may present throughout it.
Here we are interested in addressing the vicissitudes of psychosexual development throughout childhood and adolescence. Thus, we observe that Sex is biological and binary.: girl (XX chromosomes) or boy (XY chromosomes). When other variants are observed, it is due to certain genetic, chromosomal, gestational or endocrine abnormalitiesThe most frequent ones are those called intersexualities (XXY, XXYY, etc) and the congenital adrenal hyperplasiaAmong other things. Furthermore, psychosexual development does not necessarily manifest itself in the same way throughout development: it is quite indeterminate during the first three years of life, becomes imprecise in many children until the age of six, and gradually becomes more defined until adolescence. Thus, a child may present an undefined sexual orientation and identity, experience homosexual or heterosexual orientations at certain times, or have an undefined sexual identity.
The seriousness of the current situation stems from the way these aspects of confusion during development are viewed. The abnormality arises from the erroneous interpretation that any child who, at some point in their development, can verbalize any uncertainty about their orientation or identity, is systematically He is guided in confirming that his doubt is a certaintyThe entire environment is mobilized for this purpose, and any clarifying dialogue is forbidden, as it is considered harmful and a product of transphobic or homophobic prejudices in society. This is what is known as affirmative approachThat is, to reassure the child that their doubts are certainties.
For this reason, it has become established in common language. the word gender, without being recognized by the Royal Academy of the Languageas the synonym for sexThus, the feminine gender is used as the semantic equivalent of female, and the masculine gender as male. From this arise the following expressions: gender politics, gender identity, gender fluidity… Gender, not sex, is the determining factor in psychosexual development. Furthermore, since gender is constructed within a specific cultural context, it is argued that it can vary over time and according to the individual's judgment. It can be self-determined as he deems appropriate, since genetics would lose its evolutionary influence.
If culture is the determining factor, a person can biologically belong to the male or female sex, although to live and feeling like the opposite sex to the one "assigned" at birthThis subjective and emotivist experience is a product of culture and, therefore, cannot be included in the various evolutionary disharmonies and its variantsso common in child development. If it is not a health problem, logically, it should not be examined, evaluated, or treated according to the various categories found in diagnostic manuals. The healthcare system is only necessary to respond to the subjective desires of an individual who wants to change their biological phenotype by biological phenotype of people of the opposite sex. The false belief that this is possible has become normalized, when it is known that biologically it is not. Only hormonal intervention that counteracts natural processes, as well as surgical (prosthetic) "reconstruction" of the breasts and external genitalia, are possible.
Current approach to childhood and adolescent transsexuality in the Autonomous Communities (Andalusia)
I will refer to the Integrated Care Process of Andúcía (PAI). Healthcare for transgender people in childhood and adolescence1
The PAI is based on the same principles that have motivated England, Sweden and Finland to thoroughly review their protocols:
- Use of the concept of gender incongruence versus gender dysphoria.
- Consideration of childhood and adolescent transsexuality as variant of normality.
- Depathologizing perspective throughout the process.
- Psychological intervention called affirmative or trans-affirmative care (Ttrans- affirmative Care)((Guidelines for Psychological Practice With Transgender and Gender Nonconforming People. WATER)). It is defined as that intervention aimed at "To affirm homosexual, bisexual, trans, intersex and queer people within the collective, understanding the mechanisms of the construction of their identity in order to help them overcome the problems arising from discrimination and social pressure".((Sarah Gómez Cocco. Affirmative Therapy, in https://praxis.com.do/es/articulos/item/terapia-afirmativaAccessed: 16/03/2023
- And most seriously, it begins with the start of the social transition and subsequent hormonal transition. Regarding the latter, there is insufficient scientific evidence (it has not been previously evaluated in controlled clinical trials regarding its medium- and long-term side effects).
- The PAI adheres to the protocols of the World Professional Association for Transgender and the American Psychological Association, precisely the protocols that have been abandoned by England, Sweden and Finland due to their low reliability and security.
Changes introduced in the Transgender Care Protocols of Sweden, Finland and England
Although not explicitly stated, it has been detected that the protocols for assisting transgender children and adolescents conceal interests unrelated to their objectives and have not followed the established safety controls and scientific evidence. The audit revealed serious dysfunctions that have severely harmed the health of children and adolescents affected by gender identity.
- Unreasonable increase in demand for children and young people due to alleged gender incongruence.
- Negligence in assuming office, as demonstrated by the high prevalence of associated pathologies and unexpected diagnoses.
- Limited scientific evidence (existence of clinical trials) in clinical decision-making.
- Harmful effects of "social transition" on the psyche and personality when implemented following the Affirmative Model.
Below are the most significant changes introduced by the NHS, which are identical to those introduced in Sweden and Finland:2
- The so-called "Clinical Care Model and Affirmation Therapy" is eliminated:
- The children will be cared for in standard care centers.
- Affirmative therapy is replaced by a holistic approach.
- The evaluations will be carried out considering the entire development process.
- Only the most serious cases will be treated in specialized centers.
- The start of treatment will only be indicated in cases of greater clinical consistency and considering any other clinical need unrelated to gender.
- The Treatment Plan will be personalized and other interventions may be implemented according to your needs.
- The social transition of gender, not just the hormonal one, will require informed consent:
- Social transition is discouraged in prepubertal children.
- The need for informed consent for social transition will also be necessary in adolescents.
- Psychotherapy and psychoeducation are established as the first line of treatment:
- Psychotherapy will encompass the whole person and will be treated within standard child and adolescent mental health care services.
- The decision to prescribe (hormonal) medication will only be made by the NHS.
- Hormonal treatments are drastically restricted and, in any case, may only be performed in clinical research settings. Sex reassignment surgeries may not be performed on minors.
- New research protocols (clinical trials) will be established for all aspects of hormonal prescriptions. Clinical trials will continue throughout adulthood. (undesirable long-term effects).
- The importance of biological sex is reaffirmed. Data will be retained for research purposes and long-term outcome evaluation.
- The DSM-5 diagnosis of gender dysphoria is given preference for assessing the need for treatment. The WPATH SOC 8 guideline is discontinued.
- Multidisciplinary teams are created that include pediatricians, mental health professionals, neurodevelopment experts… in order to be able to care for patients from a holistic perspective.
- Primary change indicators are established, such as clinically significant distress and the quality of social functioning. for the start of the social transition.
- Patients or family members who choose to circumvent the requirements set by the NHS will not be treated, and legal action may be taken in cases where risks to the child's health are detected.
OBSERVATIONS
The various lobbies related to the gender ideology queer, the interests of the pharmaceutical industry and specialized clinics, as well as the increasingly ingrained belief in society that Is it possible to change biological sex?This has led to the possibility of a real sex change being seen as something natural and safe. security perceptionThe "risk minimization" approach has been sustained both by propaganda through governments and their protocols, the media, social networks and the many self-help groups, and by "therapeutic" procedures called affirmation, which trap the child, the adolescent and their families in a web from which it is difficult for them to free themselves.
Another aspect, highlighted by most of the research, is diagnostic errors at this stage of development in which Confusion and uncertainty prevail by confusing the incipient homosexual orientation with transsexualityHence, the need for the problems related to the child and adolescent psychosexual development These issues can be addressed freely and taking into account the extensive knowledge we have of the different developmental stages and their challenges. Professional help for children and adolescents who need it cannot be subject to legal proceedings.
Such a disastrous law should be repealed. The United Kingdom, Sweden, and Finland await us.
- You can obtain the document on the website of the Andalusian Government
- Hylary Cass. Independent review of gender identity services for children and young people (English). https://cass.independent-review.uk/
