How I took on the puberty blocker orthodoxy – and won

Oxford University's Dr Michael Biggs was one of the first academics to question the puberty blocker orthodoxy, and he's written on the obstacles that the modern, bureaucratically oriented academy often throws up in the way of dissenting academics.

As reported in the Telegraph, children will be banned from receiving puberty blockers on prescription under NHS rules that come into effect immediately. Government ministers said the “landmark decision” was in children’s “best interests” and would help to ensure youngsters who feel their gender is not the same as their sex are being treated using medical evidence.

Critics have long argued that in prescribing puberty blockers to under-16 year-olds, the NHS Gender Identity Development Services (GIDS) clinics had been rushing” children into irreversible, “life-altering” medical procedures without proper consultation, and, as Prof Kathleen Stock puts it, “handing out harmful drugs to gender-confused youth as if they were sweets”.

“Hundreds of lives may have been blighted, some irreversibly,” said a leader in the Telegraph back in 2022. “Such is the price of dangerous dogma ignoring caring common sense for far too long.”

But bona fide medical concerns were ignored too. As per the findings of NHS England’s interim Cass Review last year, clinicians at the Tavistock GIDS clinic said they felt under pressure to adopt an unquestioning affirmative approach in a manner that was at odds with the standard process of clinical assessment and diagnosis that they had been trained to undertake in all other clinical encounters.

One clinical psychologist at Leeds GIDS expressed concerns to a colleague and was promptly branded “transphobic”. The clinic’s child-safeguarding lead, Sonia Appleby, tried to report staff concerns to management, but was subsequently described as “hostile” and accused of having an “agenda”. In 2018, Dr David Bell, staff governor at the Tavistock and a distinguished psychiatrist, wrote a report that captured the concerns of ten GIDS clinicians who were frustrated and horrified about what was happening at the clinic, only to see it suppressed by GIDS. In 2019, a governor of the NHS trust in charge of the clinic resigned, claiming the “debate and discussion required is continually being closed down or effectively described as ‘transphobic”’. And so on and so forth.

The fact that clinicians who raised concerns were met with dismissal at best and venom at worst contributed to a lack of critical thinking and questioning at GIDS.

Writing for the Telegraph, Dr Michael Biggs, an associate professor of sociology at the University of Oxford who was one of the first academics to question the “puberty blocker orthodoxy”, highlights some of the obstacles that the modern, bureaucratically oriented academy all too often throws up in the way of dissenting academics.

“Almost exactly five years ago, the Telegraph broke the news that eventually led to the closure of the Tavistock and Portman NHS Trust’s GIDS,” he writes.

The Tavistock started an experiment giving puberty blockers to adolescents as young as 12 in 2011. In 2018, when I started looking for outcomes, nothing had been published. This absence raised my suspicions because I know that favourable results are speedily published. I searched for evidence using Freedom of Information requests and I made a formal complaint to the Health Research Authority.

What I discovered was disturbing: conference presentations where the Director of GIDS admitted that the results were not as they hoped; data from 30 of the patients after a year on puberty blockers showing more negative changes than positive ones.

Submitting my findings to an academic journal would have been an uphill battle. The prevailing wisdom was that puberty blockers were lifesaving medication for “transgender kids”. Instead, I announced my findings on Transgender Trend, a blog run by Stephanie Davies-Arai, a critic of the medicalisation of gender-nonconforming children, whose writing had helped to shift my views.

This blog led to that first Telegraph article, my full-length paper on the experiment, and my appearance on BBC Newsnight. I was an expert witness in the judicial review brought by Keira Bell. Eventually I did publish the outcomes of the experiment in a psychology journal, six months before their belated publication by the Tavistock’s clinicians. Would they have published without my discoveries?

My extensive research was possible only because the University of Oxford paid my salary and the Department of Sociology let me pursue my curiosity without hindrance. Few academics in Britain enjoy such privilege, as bureaucratic managers exhort their underlings to maximise their consumption of external grant funding and their mass production of “outputs”. Naturally these managers punish any line of research that strays from what is deemed orthodox by activist scholars and students, because dissenting research will not receive grants or achieve publication and will alienate fee-paying customers.

Pursuing this research on puberty blockers entailed personal costs. Many colleagues warned me that I was being “very courageous”, a message familiar to viewers of Yes Minister. I have surely made myself unappointable to any other post; I have lost students, invitations to seminars, and friends. But there is no need for another victim narrative. If you express unpopular views, then you can hardly complain about being unpopular.

It is fortunate that my university also provides space to lone academics to pursue lines of research that dissent from the prevailing orthodoxy – even beyond the confines of their discipline. Academic freedom comes at a price, of course. It enables scholars to pursue research which might seem frivolous. It protects weird cranks as well as truth-seekers. Only in retrospect, however, can they be distinguished. Academic freedom bestows a grave responsibility on those who enjoy its privilege: to pursue truth, even – or especially – when it offends our peers.

Worth reading in full.