March 31 each year is International Transgender Day of Visibility, which honours transgender individuals, spreads awareness about the discrimination they encounter globally, and acknowledges their positive impact on society.

Why is visibility so important?

Visibility can provide much-needed role models. The importance of this is beautifully illustrated by this touching photo of a toddler in a wheelchair in a department store, who stopped to gaze in awe at a poster of an older boy also in a wheelchair. His mother took the picture as she realised it was the first time he had encountered such a positive representation of someone just like himself.

You can find the full story at –

https://people.com/human-interest/wheelchair-bound-toddler-overjoyed-after-seeing-target-ad-features-boy-just-like-him/

If you never encounter people like yourself, it’s all too easy to believe that achieving what others achieve is beyond reach. Yet, when you witness someone who shares your identity accomplishing feats, it awakens the possibility that you can do the same. Without belief in this possibility, how can one strive to make it a reality?

More important now than ever!

Currently, there’s an overwhelming amount of negativity directed towards trans people, evident in news coverage and amplified by countless hostile reactions in social media. For a community already grappling with significant mental health challenges, the negativity and hate can be harmful and dangerous. Thus, it’s now more important than ever for trans people to have positive role models and to see that they have supportive allies. Transgender Day of Visibility does just this!

Shouldn’t we show allyship all year round, not just on a single day?

Of course we can show allyship all year round, but days such as Transgender Day of Visibility give an excellent opportunity for your organisation to arrange an event or host a speaker. You really could profoundly impact someone’s life for the better.

Keynote speech – Matt Ellison
Macmillan Cancer Support conference 2023

Who is Matt Ellison?

Matt Ellison is an engaging and highly sought-after transgender speaker, who uses his own personal experiences to help inspire others. With his talks created to be 100% accessible and relevant to any audience, Matt’s dynamic and unique presentation style will leave your guests with plenty to think about, guiding them to making the changes they need to live a happier and more fulfilling life.

Book Matt or ask a question here!

Matt’s clients include –

Stella O’Malley is a public speaker and psychotherapist who is vocal on transgender issues. She made the Channel 4 documentary Trans kids: It’s time to talk and opposes the use of hormone blockers, despite the tremendous good that blockers can do (as I explain below).

It’s worrying that such views are still being aired. Yet Birkbeck, University of London booked Ms. O’Malley to deliver a workshop this week for therapists titled “Working with Gender Identity”. Birkbeck have said ‘it’s important to hear all sides of the debate’ and that ‘the presenter’s perspective is one of many.’

But, as the old saying goes, ‘a little bit of knowledge is dangerous’. The writeup which Birkbeck provides ‘About the trainer’ suggests that she has her facts wrong and doesn’t know how gender dysphoria is treated:

Stella O’Malley, 44, of Offaly, Ireland, believed she was a boy until puberty hit and says had she been a young child living in today’s society she is ‘absolutely certain’ that she ‘would have transitioned’

The idea that this plants in the reader’s mind is that ‘today’s society’ would have been all too eager to induce her to undero irreversible changes at an impressionable age which would have prevented her from developing her into the woman and mother she now is.

But that’s nonsense. With today’s systems, Stella O’Malley would not have transitioned at such a young age. Today’s gender specialists are highly trained and knowledgeable, and she simply wouldn’t have progressed to any form of physical treatment. Nothing irreversible would have happened, no harm would have been done.

By contrast, if people accept the line she is taking against hormone blockers, a great deal of irreversible harm will occur to children who, unlike her, truly are transgender.

Gender dysphoria can’t be medically treated until puberty begins.

Until a child reaches puberty, there is simply nothing to treat medically. Ms. O’Malley’s claim that she would have transitioned is implausible to say the least: she went through what experts would consider a ‘phase’, and grew out of it upon reaching puberty.

Social transition

Before puberty, children who experience gender dysphoria may transition socially. This does not involve any type of medical transition, and simply means wearing clothes the child is comfortable in and changing their name and pronouns. This is completely reversible. It enables a child to find what’s right for them. And for those who truly are transgender, it plays a huge role in alleviating the crippling symptoms of gender dysphoria.

In Stella O’Malley’s case, she would have only reached this stage, and been able to reverse it has her true nature emerged.

Cross gender play

Today’s gender experts are entirely aware of the kind of the childhood experience described by Ms. O’Malley. Endocrinologist and gender expert Dr Norman Spack says in his TED talk:

“It is quite normative for children to act in a cross-gender play and way, and that in fact there are studies that show that even 80% of children who act in that fashion will not persist in wanting to be the opposite gender at the time when puberty begins. But at the time that puberty begins….by that particular point the child who says they are in the absolute wrong body is almost certain to be transgender, and is extremely unlikely to change those feelings, no matter how anybody tries reparative therapy or any other noxious things.”

The young Stella O’Malley simply would not have progressed past the point where any physical treatment could have taken place. The experts would have done the right thing.

Dr Normal Spack explains the role of hormone blockers

Harm is done by not treating

Doing nothing for transgender children actually does a great deal of harm. Irreversible physical changes start at puberty and without medical help a transgender child will be trapped inside an adult body at variance with their psychological reality. These changes almost inevitably have negative repercussions for the rest of their lives.

However, there is a very successful way of tackling this problem at the onset of puberty, which is reversible, but buys a little more time for evaluation and doing the right thing.

Blockers: a safety net which prevents harm but does no harm

Puberty blockers have an important role in successfully treating transgender children, by delaying the development of what are potentially the wrong secondary sex characteristics. They are delayers: their effects are reversible.

A child’s puberty can be placed on hold while further psychological assessments take place. Then, if and when appropriate, the patient can commence cross-sex hormones and develop in a way that is in keeping with their internal gender identity. Blockers mean that transition, if and when it is chosen, can be physically far more successful for the patient.

If it’s decided that gender transition is not the right thing for the patient, then blockers will be halted and the child will progress through the puberty of their birth gender. In a case like that of Ms. O’Malley, who says she only felt like a boy ‘until puberty hit’, it’s most unlikely that she would even have got as far as taking blockers, as professionals would have recognised that she had only been experiencing a ‘phase’. Had such a child taken blockers, it would simply have bought a little more time to establish that medical transition was inappropriate for her.

Harm done by misinformation

It’s disturbing to think that the xyz’s who take Stella O’Malley’s workshop at Birkbeck College will be seriously misled. Anti-trans people can so easily prey on people’s fears, for example the fear of parents that an over-enthusiastic politically-correct system will encourage and authorise a profound and irreversible change to their children.

The fact is that the system has knowledgeable practitioners who are trained to do no harm. On the other hand, alarmist claims spread by the likes of Stella O’Malley can cause a great deal of harm – to those children who, unlike her, are truly transgender. Such children desperately need safe treatment to be given at an appropriate point in their lives to prevent potentially devastating harm.

It’s great and exciting news to hear that Jake and Hannah are going to be parents. It’s also great news that they are able to be open and share this part of their journey with the world. To help educate others and show that in fact being trans means you’re normal, can have a normal life, and do normal things, that normal people do is so incredibly important.

Read the mail online article about Jake & Hannah’s exciting news here

Yep you guessed it, I’m about to throw a but in here. I stress though that this ‘but’ isn’t to dampen Jake and Hannah’s amazing news in any way, which is absolutely great. Or the fact that they are sharing this news with the world. But…..what I find incredibly frustrating is the way these stories are all too often portrayed in the media incorrectly.

The daily mail says –

“For they are set to be the first parents in Britain who are both transgender.”

This part is not true. They might possibly be the first openly trans couple in Britain to be parents and the first to shout about it but they are certainly not the first trans couple to become parents in Britain.

I have a friend, a trans guy, who a few years ago he and his trans female partner both came off their hormones to conceive their child. Because both were trans and hadn’t had surgery that would make them infertile, they were able to conceive and carry the child themselves. So he carried the child and provided the egg, and she provided the sperm. So what’s even more interesting about my friend and his partner is that no surrogacy parent was needed.

As mentioned this was a few years ago, so the above article is not correct when stating they are the first parents in Britain who are both transgender. I’m sure there will have been more too that I, and the rest of the world, haven’t heard about.

I also read another article shortly after my friend gave birth to his child shouting about the first trans man to carry their own child. But yet again, nope, definitely not the first. I know of even more trans men, post transition, who have done this too, before that article was published.

So why does this keep happening? With repeated incorrect claims of ‘it’s the first time’? Because luckily, and contrary to many peoples beliefs and understanding, the majority of trans people ‘pass’. That means, like my friend and also myself, they are read by others as their chosen gender. So you would never know that person is transgender. My friend is also ‘stealth’ meaning he is not out to those around him, so not many people knew of his pregnancy and it certainly wasn’t in the media. As you can imagine, it’s not something many people would be comfortable sharing, so it goes unnoticed.

Because passing is possible most trans people disappear back into society without a trace. Living ordinary lives, doing the same every day ordinary things that everyone else does. So ‘ordinary’ in fact that no one knows about it.

Of course this is great for the trans person and is what many in our community wish and hope for. They can have their fairy tale ending and live happily ever after. What that’s not so great for is educating the world around us and moving understanding of trans issues forward.

This is where I wish the media would do a better job, not just educating people on the important issues such the wonderful news from Jake and Hannah in the above article, but reporting things accurately, finding out more accurate information and then letting the world know that in fact these things are happening around us without us even realising.

There are far more trans people around us than we realise, and this is a very important thing to understand if trans education is to move forward and enable a fairer, more understanding and accepting world for everyone to live in.

Yes some trans people do not pass, either because they are still too early in their medical journey, or perhaps they do not wish to transition medically (some choose to transition socially and this is enough for them), or for whatever physical reasons maybe they just won’t ever pass fully or 100% of the time, but what most people don’t realise is in fact how many trans people do pass and just blend in 100%. And how would people know this, because of course you never ‘spot’ a trans person who passes.

Here pops up another story that I’m passionate about around hormone blockers, as the use of blockers can prevent the permanent changes that happen at puberty that are the leading reasons for some trans people being unable to pass. However this is for another blog, or book.

There has been a lot of debate recently about LGBT, same sex relationships and transgender education in schools. Some parents think the topic should be in the curriculum whereas others think they should be able to opt-out, often because they feel their children are too young for the topic or that it will harm their child in some way.

My experience with my own transition whilst working with children in my own music school has only been a positive one. A lot of this has been because the children have covered the topic at school. While I was transitioning I had many parents telling me when they told their child I was about to transition, their child responded in a very matter of fact way with things such as “Oh yeah, we’ve done that at school” and then just continued with whatever they were doing, showing it really was no ‘biggie’. In fact in many ways the children took things in their stride far easier than the adults did. Not that any of the adults struggled, everyone I have told about my transition has been fully supportive.

My thoughts are schools should be educating their pupils about the world. So for example take religion, whether you believe in, agree with, or disagree with a religion, it is important to know about them. Why? They exist and there are people who live by each religion, and so we will all come across them at some point. When we do it’s far better that we have some degree of understanding.

I feel the exact same with LGBT issues. It doesn’t matter whether you yourself are gay, straight, transgender, or in a same sex relationship, these are all things that exist so we will all, and this includes children, come across LGBT situations. Therefore to be clued up about these topics is a must!

Also, I suffered a lot as a child because I shut up about my gender dysphoria for fear of what others might think. In the late seventies and early eighties there was no internet and it certainly wasn’t a topic taught in schools, so I knew nothing about what was possible. This meant I hid my feelings and so grew up very unhappy, not myself, was held back in many areas of life, and ultimately was prevented from achieving my best as a result.

I think it’s a real shame that it’s often a lack of education and understanding by parents that lead them to believe their own children shouldn’t be educated about LGBT issues either.

Educating children won’t turn them gay or transgender, but it will allow those who are gay or transgender to understand themselves better and this will give them a far better opportunity to be themselves, and to truly achieve the best they can in their life.

It will allow those who aren’t gay or transgender to fully understand, and therefore accept and support those around them who are. This makes for a more positive environment. It allows teams to function better, will enable better productivity at work, and stronger relationships between family, friends and work colleagues.

Allowing people be their true selves can really only be a win, win, win for everyone!

At the age of 39, after decades of fear, I chose to make one of the most fundamental and disruptive changes a person can make. Gender transition has seen me become a different person, a better person, and one who even now, years later, is still growing and achieving as a result.

I’ve been asked “What makes you‘re story so different to the many other inspirational speakers out there?”

I think one of the biggest differences is ‘Choice’!

I’ve been inspired by those who have shown great courage in the face of life changing adversity, maybe due to accident or illness. These instances are testament to the fact that humans are remarkably resilient, can overcome the unthinkable and still thrive….when we are forced to.

However I made the choice to face the changes I made. I battled my inner demons of nearly 40 years, overcame them, and as a result elevated my quality of life.

Fear usually plays a big part in holding back change, but as fear and understanding are inversely proportionate, knowledge is key to facilitating change.

In this fast paced world of change we MUST initiate change to keep up. To stand still is literally to go backwards! So the only way to keep ahead of the game, or your competitors, is by making fundamental changes.

Here’s just one example from my journey.

Sometimes you can’t see past your own blocks. I was incredibly scared about what people would think of me if I transitioned. If people thought it was freaky, or that I myself was a freak, then potentially my life could be ruined, and not worth living. I found the thought of losing everything very scary.

However, upon educating myself (in this case through seeing an experienced gender counsellor/psychotherapist) I learnt that given time, I would be passing as male 100% and as new people came into my life they would be unaware of my ever being anything other than Matt. That’s all they’d know.

This understanding was fundamental in enabling me to move forward and make one of the biggest and disruptive changes a person can make.

If I’d had the courage to make this change 20 years earlier I would have been a long way past that stage, and life would now be just great. So at worst, all I had to do was get through maybe a year or two of potential difficulties, and then I’d be on the other side and life would be far better. My fear then dissolved and I could move forward with ease and confidence.

Of course there were other considerations, but again all quite easily overcome with greater understanding (these stories are for another blog).

How is this relevant to others, and in particular the business/corporate world?

Ask yourself, what is it that’s holding you back from initiating the changes you need to make? Look at those things. If need be take a step back and try and see past that initial fear. Work out what actually might happen if you make that change? Very often we latch onto the worse case scenario and simply can’t see past it. We can’t see the forest for the trees so to speak. So try and look through that block. Also look at the positives that may happen as well the negatives.

Of course you do need to examine the negatives, otherwise you might blindly go ahead with change that goes spectacularly wrong. But ask yourself, even if the worse does happen, what would be the consequences of that? How could you over come it? How long would that take? Once resolved would you be in a better place?

If you can see a way through your worse case scenario (which probably won’t happen) with things improving overall despite this scenario, then what is there to fear in initiating that change and elevating your life or your business? To really thrive? Yes that’s right, NOTHING!

Another working example

Geoff, my partner, teaches English pronunciation and is well known in his field. Language evolves and changes just like everything else in life. If it didn’t we would still be speaking how Shakespeare did. Geoff is trying to update how phonetics is taught because the current teachings still relate to old-school Queen’s English (RP or Received Pronunciation for any of you in the know). Nowadays hardly anyone speaks like this and it’s considered very old fashioned. Yet he faces a lot resistance to updating. One of the reasons given for this resistance is “…but it would confuse the students to change everything”.

This example relates directly to my example above. Given a couple of years new students will be coming through who won’t know the old way of doing things so won’t have anything to get confused with. They will be taught up to date material that is actually useful and relevant for them NOW. Yet so many teachers are simply too scared to make these changes, clinging onto out of date ways of doing things. They latch onto a reason not to make change, genuinely thinking it would be a disaster if they tried to.

Geoff’s latest book on English after RP – https://www.amazon.co.uk/English-After-RP-Standard-Pronunciation/dp/3030043568

Coping with the challenges that change inevitably throws at you

One of the things that makes change feel scary is that you can never know for sure what will happen. It’s bound to throw some challenges at you that you couldn’t foresee.

This doesn’t mean the change was wrong, or bad, or that things will turn out worse for you or your business. We all deal with difficult challenges regularly, often without giving them a second thought. Yet when it’s something new it can feel different. It’s easy to feel bad if it was our own actions and choices that brought about these challenges, and that maybe we made a mistake by doing what we did.

My worse case scenario didn’t happen at all, yet even so I found many challenges popping up throughout my journey. With just a little thought about how to deal with them I was able to overcome every single one of them, and quite easily too. At the very least a compromise was met, and even on those occasions things were still a lot better than before. I soon learnt that these challenges weren’t anything to be scared of and in no time I was taking them in my stride with no stress or worry. I actually found in many ways they made life interesting. Often leaving me with funny anecdotes to re-tell later down the line. I believe learning to deal with these challenges is just practice. However if you never make change, how can you gain that practice?

Lessons learnt

I found I had constructed a wall (no, please don’t mention Trump!) and I couldn’t see past it. I was looking so strongly at the short term I couldn’t see ahead at what could be. Sometimes things might initially be a struggle, but if working through that struggle enables you to elevate your life, whether that’s on a personal or corporate level, then surely the struggle is worth it.

Many people, I’ve found, think that the medical interventions are the hard part of being transgender.

In fact they are often the most exciting part.

The hardest things to deal with, usually, are hiding your identity before deciding to transition, or dealing with discriminatory behaviors from those around you. And these pains are invisible. If you can’t see something, it’s hard to understand how difficult it is. The pre-transition times are usually the most damaging times for a transgender person.

The results of surgery can be liberating and thrilling. I liken it to having a large growth on your face. Many people would tell you it doesn’t matter what other people think. Even if people don’t stare at it, you will be very self conscious and would rather it wasn’t there. Now if a surgeon comes along and says they can remove it for you, you’re going to be very excited by that prospect. Yes, it will leave a visible scar, but that is far preferable than living with the growth. And I think this is pretty close to how a transgender person feels about surgery, and hormone treatment too. Things will never be 100% perfect, but will be greatly improved for sure. Most people who need surgery or need to take medication, do so to stop something bad from happening, in the hope of continuing life at the same level as before. This is why most medical interventions carry a negative feeling. But for a transgender person, everything that happens with treatment brings positive changes and is raising their life to a higher level.

One of the most risky periods for a transgender person is often between asking for help and then receiving medical intervention. They’ve reached a point where they are ready to make huge changes, but now they are faced with a long period of time before those changes start to happen. There are guidelines [W-Path Guidelines] that physicians the world over follow before initiating treatment, and as a result of these guidelines the assessments can be a lengthy process. The wait to even begin the process can be lengthy, thanks to long waiting lists or the need to raise funds before seeking treatment.

A great comparison is a child waiting for Christmas. If it’s a long way off, it’s easy to wait. But as the time approaches, the waiting can become almost painful. When you’re ready to make huge, fundamental changes to your life, and to remove such heartache from it, time seems to pass slower. It also becomes psychologically harder to cope with the bad things. Stresses already there can be heightened; any risk of self-harm or suicide may be increased during this period. This is one reason GP’s can prescribe bridging prescriptions for hormones during this vulnerable time, to reduce the risk of harm to their patient.

Not everyone wants to follow the same path, some people may choose hormones and all the surgeries that are available, while others may choose just some of these. Some people decide not to have any medical intervention at all, choosing just to transition socially. Each of these choices are as valid as the others.

For those who take hormones, this can be a very exciting part of transition. Hormones are a very effective way of changing and maintaining secondary sexual characteristics. They change the shape of the face, muscle mass, fat distribution, texture of skin and hair, and much more.

Hormones can have drastic effects on the appearance. But there are still a lot of people who have no idea quite how effective hormone therapy is, even including many within the medical profession. I once heard of a trans man (that is, he had transitioned from female to male) whose status as ‘transgender’ had been revealed to a work colleague; the colleague, convinced he was born physically male and was wanting to transition to female, told him he’d never be a real woman because he looked too much like a man! Just goes to show!

Imagine taking a child, dressing them in clothes that are strongly the opposite gender and taking them out or forcing them to school like this?

How distressing would this be? Not to mention the detrimental psychological effect, especially if done long term.

Yet this is exactly what happened to me (and many other trans people) every day of my life, for years!

Clothes are an expression that trans people miss out on

The choices we make with our appearance (inc. hairstyle, tattoos etc) convey information to those around us about who we are and what we stand for.

So consider the implications for a trans person who’s spent most of their life living within the wrong identity, and whose entire wardrobe simply can’t reflect who they are.

After nearly 40 years living this nightmare, I know this all too well.

Coping strategies

For each trans person you ask you’ll hear a different story, but for me, once I was old enough to choose my own clothes I went along the ambiguous route.

I simply couldn’t do feminine so lived as a tomboy, but I also felt too uncomfortable going any further along the masculine route than society deemed acceptable, so couldn’t wear most of the clothes I yearned to. I lived in jeans and sweaters, as this was the only way I could survive.

I would wear baggy tops to hide my breasts and would suffer for as long as I could in the heat of summer before removing my jumper to reveal an oversized t-shirt. Then I’d slouch forward, being far too uncomfortable at the thought of anyone seeing the rounded shape of my chest.

I very clearly remember the occasion, aged around 5, that I’d noted boy’s waists sat lower than girl’s, and looking at myself in the mirror, I positioned my trousers onto my hips. I felt this looked much better. They have sat there ever since! Although I have taken them off occasionally to wash them!

Impact on career

As clothes become more formal and move away from jeans they typically become more gendered.

Because of my inability to wear anything formal/feminine I made career choices that enabled me to wear casual, gender neutral clothes such as jeans. This had huge implications on the direction my whole life took, and also affected my income and therefore my standard of living.

Fitting rooms

It’s great to try clothes on before you buy; it saves the hassle of returning any unwanted articles. But unfortunately these spaces are usually gendered, and gendered spaces often cause distress for a trans person.

This adds to the numerous problems around clothing, for myself not least because with a female shaped body, buying men’s clothes meant it was harder to find clothes that fitted, so I really wanted to try them on first.

School

At school in the 70’s/80’s I was forced to wear a skirt, and hated every moment. I was very jealous of the boys who, simply because they’d been born into a boy’s body, could wear trousers. It seemed dreadfully unfair.

I did used to wear boys shoes however, as there were no rules prohibiting this. I am very surprised I wasn’t bullied, as this was a time before any female fashions were styled on men’s designs, as many are today.

Police cadet

I was a Police Cadet at 16 and to my horror, although at this time Police Women were allowed to wear trousers on certain occasions, my uniform was issued with only a skirt and no option allowed for trousers. I left the cadets shortly before my 19^th Birthday and that was the very last time I ever wore a skirt!

Matt’s Police Cadet Hat – He hated wearing this too!

Formal occasions

Even the mere mention of a formal occasion would distress and panic me with instant thoughts of “But what will I wear?”. I dreaded things like weddings or funerals, or even parties.

I was called for Jury service and this posed particular problems. As you can’t ‘opt-out’ I was feeling particularly trapped simply due to the problem of what to wear, and this distressed me.

Finally Free

Imagine my relief upon finally becoming Matt and being able to wear just what I wanted. Before I used to walk past the men’s clothes sections in stores knowing they were out of bounds for me. I just had to switch off, suck it up, and accept it wasn’t allowed.

Then all of a sudden this changed. As a male, society now gave me ‘permission’ to wear these clothes.

At first it felt like a dream, or even a game, and that it was going to end. But slowly as my mindset changed, I began to realise that this was actually real, and was forever!

I now long for formal occasions so I can get suited and booted.

Getting fads out my system

There were many male clothes I’d wanted to wear when I was younger which weren’t always the best fashion choices, and of course fashions have changed a lot since then too. I still find that I want to wear these things and can’t see past that until I’ve got the fad out my system. So I’ve ended up buying clothes that in fact I never actually wear, or at least not for very long before I replace it with something more current.

Topman Personal Shopping

I’ve done a few Topman Personal Shopping Experiences, which have been amazing.

I’ve found myself in a trendy men’s clothes store, with my own fashion expert, whose job it is to make me look good. And they’re good at their job! Picking out styles you’d never have chosen but that suit you to a tee.

I’d highly recommend this experience to trans or cis people alike. Topman’s clothes (or Topshop for women) are trendy, look great, are very reasonably priced and with no minimum spend you’re not obliged to purchase anything. I guarantee you’ll want to though. You’ll feel like a celebrity being styled and made to look stunning.

As a trans-man who’s life long struggles with clothes had a very negative impact and who hadn’t found his style/look, this experience was truly liberating and literally LIFE CHANGING!

Please note: I have no sponsorship from, shares in, or affiliation with Topman!

(I was honored to witness other’s delight too at being liberated with their clothes after organising Topman Personal Shopping for the trans support group FTM London when I was co-chair.)

Matt, Topman 2018

Matt, Topman 2018

Matt, Topman 2014

You might assume if you’re listening to a qualified, experienced and well-respected psychiatrist, such as Dr Lucy Griffin, that what she has to say about an area of healthcare would be well informed and correct. Especially when the points she makes sound like common sense. [See Daily Mail article here]

But without working regularly with high numbers of transgender patients over a period of time, it’s impossible to have full insight into the difficulties this patient group experience and therefore how best to successfully treat those patients.

First off my warning bells were alerted by the fact she is calling trans-women men and trans-men women. Mistakes such as these are often the first tell-tale signs of someone with little knowledge or experience of this patient group.

Here is an analogy that I hope will help people understand why you need to be a gender specialist to comment on the care of transgender patients.

If it appears someone has broken their back, medical advice is not to move them. Common sense, yes? Then we see a group of Dr’s who start quickly pulling the injured away from the scene of the accident, risking paralysis! Other Dr’s publically chastise these actions, sighting their many insights from their professional knowledge and training as to why this is wrong and is ‘risking harm’ to the patient. The public agree with what seems like common sense coming from a qualified source.

Without the full picture, what the chastising Dr’s, and the public, don’t realise is that in these particular cases the patient needs to be moved quickly because of a greater risk. For example, maybe they are in a car which is on fire – one risk can outweigh another.

Transgender people can be harmed immensely by having to live the wrong life year after year. By waiting until they are 18 for medical intervention, not only have they already experienced great distress at seeing their bodies change in ways that is not correct for them but they then have permanent physical changes that are either difficult or impossible to correct.

To ‘do nothing’ is not always the best way to ‘do no harm’. Early intervention for a transgender patient is often life changing with very positive long-term outcomes.

Gender transition is a big step and certain questions do need to be asked and addressed. But the reasons against hormone blockers that Dr Griffin sights are not an informed view – she hasn’t seen the fire, so to speak!

So let’s take a look at some of the issues:

 
Age of consent

Many people still believe that a child is too young to make such a life affecting decision.

Gender dysphoria is not something that develops, it is something you are born with. Gender specialists are trained and experienced in diagnosing true gender dysphoria and distinguishing it from a passing phase. They also see the possible devastating consequences suffered when treatment can’t be accessed or is delayed.

The problem with waiting until transgender patients are adults is that irreversible changes have already happened to the body by going through the wrong puberty and these changes usually have a very negative affect on quality of life.
 

What if it’s a phase?

Children can go through phases of cross-gender play and dressing, many girls are tom-boys etc. This is very different to gender dysphoria although the two can be confused if you don’t know what to look for. So any treatment for gender dysphoria does need to be carefully considered.

Normal Spack is a US endocrinologist with vast experience of treating transgender patients with hormone blockers. He states that if a child is going through a phase they will almost certainly have grown out of the phase by the time they reach puberty.

You can watch Norman Spack’s very informative Ted Talk on this topic here

Stringent assessments performed by trained gender specialists ensure that before patients can access any irreversible treatment that they do indeed have true gender dysphoria and are not simply going through a phase.

Safety net

The use of hormones blockers provides a safety net and ensures no harm is done. Rather than induce the patient’s desired puberty at the age puberty would normally be experienced, blockers temporarily hold off or slow any form of puberty. This is fully reversible and buys time. While on hormone blockers professionals can assess the patient who can also receive counselling. When they reach the age of consent for treatment if they still feel gender transition is right for them they can start treatment and begin their desired puberty. If at any point the patient or the gender professionals decide that transition is not the right step, the blockers can be stopped and the patient will go through their biological puberty with no harm done. They will develop just as they would have, just at a later time. And to address Dr Griffin’s concerns over fertility, they will still be fertile.
 

Benefits of blockers

When we reach puberty our body starts developing secondary sex characteristics and many of these changes are irreversible. Some changes can be corrected with surgical procedures, but of course this means undergoing that procedure, which isn’t pleasant, and then living with the scars it leaves behind.

Unfortunately some of the changes can’t be altered at all, and the transgender person has to live for the rest of their lives with sexual characteristics that are not in keeping with their gender identity.

Some of these changes include:

• Height
• Voice breaking
• Width of hips
• Size of hands
• Size of feet
• Breast growth
• Body and facial hair growth
• Bone structure (including facial)

Other than being distressing and triggering, many of these irreversible characteristics also hinder the transgender person’s ability to pass in their acquired gender. This plays a huge role in quality of life due to how society perceives and accepts them. It can make life highly challenging, and is something they have to deal with day in, day out for the rest of their lives. Yet such distress is preventable with the use of hormone blockers.

Summary

Hormone blockers are an effective way to slow down the changes that happen at puberty. There is a safety net because they are reversible and buy time while the patient and the gender specialists work out what the best course of treatment, if any, is for the patient.

By preventing the distressing and irreversible changes that occur during puberty hormone blockers can greatly improve long term quality of life. They enable a transgender person to develop in a way that is correct for their internal gender. This can reduce distress and allows them to live the rest of their lives in the ‘right’ body. The benefits they bring help with passing and therefore to alleviate problems that still occur in today’s society’s due to misunderstanding and non-acceptance.