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Rise in child transgender referrals
The number of children referrred to the NHS as a result of transgender feelings and confusion about their gender has quadrupled in five years, new figures show
The number of children aged 10 or under who have been referred to the NHS because of transgender feelings has more than quadrupled in five years, according to new figures.
The Tavistock and Portman NHS Trust said referrals over the period included 47 children aged five or under, and two children just three years old.
The trust, the UK’s only centre specialising in gender issues in under 18s said that in total, the number of under 11s referred to the unit has risen from 19 in 2009-10 to 77 in 2014-15.
Parents said they had sought help after children became deeply distressed about their gender.
Two children, Lily, six, and eight-year-old Jessica - which are not their real names - were born boys but became unhappy with their gender from an early age, according to their parents.
Jessica said there was a time when she was unable to go to the toilet at school because they boys “thought she was a girl” while was not allowed to use the girls’ toilets.
The child got to the stage where she stopped drinking water at school to try to avoid the trauma.
In another incident, it took five teachers to calm her down after dinner lady thanked her for picking up some cutlery by saying “good boy”.
The child told the BBC’s Victoria Derbyshire programme: "I really didn't want to be a boy. It was really frustrating for me. It feels like I'm in the wrong body."
Jessica's mother Ella – also not her real name – said she had been accused by a relative accused her of "conditioning" her child.
An anonymous call was made to the NSPCC claiming Jessica's parents were "forcing their boy to live as a girl".
Her mother split up with Jessica’s father some years ago and is now in a long-term relationship with a woman.
Ella said she had considered whether her relationship had contributed to her son’s feelings, but points out she has two older sons raised the same way.
"There is nothing we have done to make this happen,” she said. “You couldn't put a little boy in a dress if he didn't want to wear it."
Jessica stays with her father every other weekend, who has found it difficult to accept that his son wants to live as a girl, and until recently wouldn’t allow her to bring skirts and dresses to his home, the programme heard.
The trust said that when young children were referred to them, they were monitored closely, and given counselling and support sessions.
While such cases “may fulfil the criteria for a gender dysphoria diagnosis, we wouldn't consider it generally helpful to make a formal diagnosis in very young children,” a spokesman said.
When children are approaching puberty, they may be offered hormone blockers, which delay physical changes, allowing a young person time to live as a man or woman in the longer-term.
The drugs, known as hypothalamic blockers, stunt the development of sexual organs so less surgery is required if a child chooses to change sex after reaching adolescence.
Monthly injections into the stomach suppress the production of testosterone and oestrogen. In girls that halts the menstrual cycle and the development of breasts. In boys, they stop facial hair growing and voice changes.
Gender confusion is rising amongst the under tens (Ivan Bajic/Getty Images)
Although the gender treatment is reversible, concerns have been expressed about possible long-term effects on brain development, bone growth and fertility.
From the age of 16, patients can be offered cross-sex hormones, and gender reassignment surgery after 18, at an estimated cost to the NHS of around £10,000.
The trust, which has clinics in London and Leeds, said gender dysphoria in young people is a "complex and rare condition" which is "frequently associated with distress which may increase at puberty".
A spokesman said: "It is probably fair to say that young people are increasingly interested in exploring gender.
"There is not one straightforward explanation for the increase in referrals, but it's important to note that gender expression is diversifying, which makes it all the more important that young people have the opportunity to explore and develop their own path with the support of specialist services."
Last year doctors at the trust completed a three year trial involving 12- to 14-year-olds diagnosed with gender dysphoria, who were able to take hormone blockers.
Only eight of the 32 children went on to start the sex change process, reports said. Leaders of the trial said children as young as nine or ten could be offered such drugs in future.