Content note: iatrogenic harm, suicidality
Within the last year, how many headlines have you seen about ‘trans children’?
Behind those headlines are real children who, by design of the medical-industrial complex, are not given the chance to speak for themselves. Transgender children are not afforded the luxury of privacy — their bodies and minds are excavated by their doctors, psychiatrists and gender clinics for the media to wildly speculate on. There is rarely discussion on how such institutional lack of privacy affects the mental health of trans children, who are not allowed to have complex or contradicting inner worlds, as many other teens are, because such complexity will be weaponised against their identity and used to restrict access to healthcare. This might sound sensationalist, but as I will discuss, the violation of trans children’s privacy is becoming the norm; last year, I discovered that my entire medical record had been excavated, studied and published under the name of ‘public interest’, and I am not alone.
I was never told about this: no letters, emails or phone calls from the General Medical Council or my psychiatrist. My records were seized in order to prosecute Dr Helen Webberley, the GP who had prescribed me testosterone when I was sixteen.
I have decided to publish this piece under the moniker Patient B. This is the title I was given in the Webberley v. GMC trial. This prosecution was a high-profile legal case which has directly contributed to the restriction of hormones and hormone blockers for under eighteens in England. If you search, there is a lot of information about Patient B available online. None of it was put there by me, and I never consented to any part in the prosecution process. I was never even informed.
Imagine finding out as an adult that your childhood medical records have been seized and publicised online for years without your knowledge. That, when Dr Webberley’s clinic was closed down and I told my psychiatrist that my head was “all over the place”, my words would be cited in the press as an example of how I was too mentally unstable to transition. All the times I was hospitalised, emails I had written regarding my gender transition care; each used as representations of a mentally ill, unstable, and possibly autistic child who was unable to consent, with endless speculation about my teenage body. One report pronounced my decision to not engage with NHS gender clinics as “autistic rigidity” — if they had bothered to ask, it was actually because I would not have survived the long wait for treatment.
Finding this out has altered the course of my life. I barely left the house for weeks and weeks as I tried to process and understand the scale of what had happened to me. I quit my new job soon after; I had to, because all that entered my mind, every waking minute, was how my teenage body was used and violated in court and no one had the courtesy to even inform me it was happening.
It has been an assault. Literally, in how my body was stripped and picked apart, but also in the repeated acts of violation: my medical records are now on the internet, and can never be taken down. But I have no recourse for justice because the violation itself was perfectly legal, and is happening to more transgender children.
Last summer, Sussex Integrated Care Board launched an investigation into the WellBN GP practice in Brighton for prescribing medication for gender dysphoria to under eighteens. WellBN has halted all new prescriptions, those receiving treatment now face their medication being taken away, and clinicians are now “reviewing” every child’s medical records. The leaked scope of the inquiry reveals the scale of the invasion of privacy, and Sussex ICB specifically noted that there was “no need” for the children in question to meet with those reviewing their medical records.
From my own case, I know that my medical records were often written by apathetic, disinterested or overtly hostile doctors who portrayed me as a one-dimensional, permanently unstable child. But in the absence of avenues to challenge their words, their definition of who I am has been allowed to go unchallenged. Sussex ICB openly shutting down the possibility for a child to give their own perspective on how this treatment has affected them loudly says that trans children are, to them, nothing more than what is written about them.
Aside from the physical implications of suddenly halting medical treatment, the mental health of these children is under severe threat. Sussex ICB’s Impact Assessment on this investigation concluded that affected children could experience “increased risk of suicidal ideation and/or mental health problems including disengagement from schools.” There are few named mitigations for this explicit admission of guilt; that what they are doing will directly contribute to mental instability, and potential suicide.
Transgender children are prioritised as subjects of data extraction instead of as young people requiring medical treatment and multi-disciplinary care, because they are seen as collateral damage. What is written about them in their medical records is more important than safeguarding them from mental decline.
I had a panic attack when I first read about this case, because I realised that the same violation which derailed my life will now happen to hundreds more transgender children. And it will continue to happen, as the PATHWAYS clinical trial for puberty blockers further normalises it.
PATHWAYS will make access to puberty blockers contingent on research participation and embed coercive dynamics where children may feel obligated to join the trial if they want to receive timely treatment — they must become datapoints within a research project that will repeatedly subject them to questionnaires, tests, physical exams, X-rays and MRIs. It reinforces the idea that their bodies and lives are subject to scientific scrutiny rather than respected as individuals, as real children, with rights to confidentiality, dignity and bodily autonomy for their own healthcare. The question of whether consent can be truly free and informed, especially for children experiencing acute gender dysphoria for whom access to puberty blockers is a lifeline, is questionable at best. Will these children be able to have open, frank and honest conversations with their doctors? Or, like with my flippant comment about being “all over the place” being taken out of context, will they be refused the privilege of a complex inner life for fear of having their life-saving care revoked?
In Histories of the Transgender Child, Jules Gill-Peterson defines the child as a dehumanised social form, constantly surveilled and reduced to mannequins for medical research: “trans children have been forced to pay one of the heaviest prices for the sex and gender binary, silenced as the raw material of its medical foundation.” This trial is a continuation of how transgender children have always been treated. Whether the data is anonymised is not the point. It is the normalisation of annexing life-saving medical care within the context of mining vulnerable children’s data at the expense of their wellbeing.
It is possible for transgender children to become transgender adults. I am one of them. I am not just Patient B, and I am refusing to let that define me. But in the current climate, this is a battle that will take a lifetime.