It seems David Batty, Guardian “journalist”, has come out of his self-imposed retirement on writing about Trans issues to produce a rather obviously spun story on Doctor Richard Curtis, a private doctor who practices in London.
For those not aware of the history, David Batty has a history of attacking anyone or anything involve in Trans healthcare, including articles about Russel Reid’s GMC hearing, a matter that is now regarded by much of the community as a witch-hunt against him by other doctors. I don’t have many details of the latest complaint beyond what was in the Guardian article, but it has been confirmed that one of the complainants is Dr Barrett. Yes, the same Dr. Barrett who was involved in the complaint against Russell Reid many years ago.
So with that background, let’s have a look at today’s article. Here’s what he’s detailed the complaints as, and I’ll deal with them point by point with reference to the WPATH Standards of Care (PDF Link).
Commencing hormone treatment in complex cases without referring the patient for a second opinion or before they had undergone counselling
There is no requirement for a second opinion or counseling prior to prescribing hormones, despite the attempt to insinuate that there is. The requirements are persistent gender dysphoria, capacity to give informed consent, being an adult (Kids have different rules) and other medical or mental concerns being “reasonably well-controlled.” (Page 104)
Administering hormone treatment at patients’ first appointments
See the above list of requirements for HRT. There is no reason not to prescribe hormones if the persistent gender dysphoria is well documented. (For example, the patient may already have transitioned, may have seen other doctors before going private or may have been on NHS waiting lists for an extended period of time)
Referring patients for surgery before they had lived in their desired gender role for a year, as international guidelines recommend
This is routine, as for transwomen genital electrolysis (Hair removal) cannot be rushed due to the growth cycle of hair, meaning some months of advanced planning is needed. The international guidelines (I.e. the WPATH SoC) state you cannot have surgery prior to the 12 month point (Pages 105-106) but make no mention of referrals.
I am assuming this is referring to genital surgery. For top surgery (Either breast enlargement or removal, depending on which way someone is transitioning) the requirements are less strict. (Page 105)
With one patient allegedly undergoing surgery within 12 months of their first appointment
There is no minimum treatment period, only a minimum period of documented real life experience which does not need to be under the care of a doctor. If there was a violation, why isn’t the surgeon concerned also be under investigation by the GMC, or the doctor who issued the second required signature for surgery?
He is also accused of administering hormones to patients aged under 18 without an adequate assessment
There is also a later reference to referring to prescribing at 16 and probably the point of greatest concern, but it’s not clear where the cutoff between adolescent and adult care begins. In terms of the WPATH SoC, it simply states the “age of majority in the country concerned” as being the cutoff between adolescent and adult provisions. The is no clear age of majority in the UK, and even the General Medical Council’s own guidance isn’t clear if it’s at 16 or 18 (Or younger) for medical purposes.
Wrongly stating that a patient seeking gender reassignment had changed their name.
If we’re having to drag what sounds like an administrative error (And this happens more often in the NHS than private practice) then we’re really grasping at straws.
He goes on:
One of the most serious cases concerns a female patient who regrets switching to a male role. She underwent hormone treatment and had her breasts removed. The woman is one of the complainants in the current GMC investigation.
There’s nothing in here to suggest malpractice. Just a statement that someone regretted transition. Of course, there are those who will be horrified that someone had their “breasts removed” and no doubt this paragraph is designed to stoke the emotions of such readers.
Of course, Batty knows what is and isn’t acceptable and is no doubt aware of these holes in his character assassination of Dr. Curtis. He’s been after us for long enough and knows about the WPATH Standards of Care. He even quotes them later on in the article, despite the fact they indicate many of the “complaints” he lists are not themselves malpractice but rather a list of potentially routine tems that those with no knowledge of the topic might see and an example of why Trans healthcare, either NHS or Private, is fundamentally Evil.
Is all this noise significant? At this stage we don’t know. Even Batty may not know, because I’m sure if he had hard examples of WPATH SoC guidelines, he would have published them with glee. A sentence later on in the article revels that the council still have to even decide “if there is a case to answer” so really we just don’t know yet.
Whatever happens, there needs to be a mechanism for resolving what is acceptable care that does not jeopardize careers, reinforce outdated and harmful practice, facilitate witch hunts and damage access to healthcare for the whole Trans community.
Last week, a government committee produced what was a switched-on report on Internet filtering. (PDF link) In it, they rejected calls for a default-on internet filter, pointing out that “default filtering can create a false sense of security” and that “there was no great appetite amongst parents for the introduction of default filtering“.
Personally, I’ve always preferred the educational approach to keeping kids safe online. In our house, the computers are all kept in public areas so when they were younger, before they had smart phones, we had some idea what they’re up to. (Which mostly consists of doing their homework and looking at videos of Ponies, Minecraft and cute cats on YouTube) The trouble with blocking is that parents and carers assume it will work, but it doesn’t. It will block the obvious sites, but might fail to find more obscure items. And if there is one thing kids are good at it’s finding obscure sites.
Oh, actually, there are two things kids are good at with computers. The second thing is bypassing blocks put in place by parents and ISPs. There’s even a project part-funded by the US Military to allow people to bypass such filters, often used by those in oppressive regimes such as China or, uh, the UK.
On filtering, the government report stated they “work to filter out certain kinds of internet content but do not prevent… online bulling… sharing personal sexual content… online grooming… sharing personal information online“. There is also the risk of blocking positive content, such as help sites for LGBT+ youth or even content for other adults in the house who are being emotionally or physically abused.
Sadly, the evidence that blocking is unhelpful isn’t enough to deter Claire Perry MP and the Daily Mail from their “WON’T SOMEONE PLEASE THINK OF THE CHILDREN” campaign. Potentially increasing risk to children isn’t enough reason to stop such campaigns of course. It appears they’ve dragged David Cameron along with them. He’s announced today that publicity-seeking Claire Perry is to be put in charge of plans to create internet filters, which contrary to the recommendations in the report parents will be forced to choose between.
Well, I say parents. Actually, it will be whoever sets up the computer. Because nobody will ever give their 13 year old the new X-Box to set up on Christmas Day, will they? Vague plans that people will need to prove their age to be able to configure these things do make me wonder if anyone involved has even even been online.
Are you 18 or over? Please click “Yes, honestly, I’d never lie to you” or “No”.
The Prime Minister’s announcement was very motherhood-and-apple-pie, even containing the statement “These should be distinct and precious years, full of security and love, untainted by the worries and complexities of adulthood.“. How much engagement do Tory MPs have with their kids if they think you can protect a 13 or 14 year old from “the worries and complexities of adulthood”. That’s exactly when you do need to deal with such issues if you want to become a healthy, well-adjusted adult.
I just had a very quick initial scan of the Government’s response to the Equal Marriage consultation. (PDF Link) Headline issues of particular interest to Bi and Trans folk are as follows:
Civil partnerships will be retained, but open to same-sex couples only. This is disappointing, as it’s effectively giving same-sex couples more rights than mixed-sex couples. There is a legal challenge in the works already to try to open this up to mixed-sex couples, and presumably that will now go ahead.
Civil Partnerships (CPs) can be converted into marriages, either for transition or just because a couple wishes to do so. This will be required for those transitioning but already in a CP, because mixed-sex CPs will not be allowed. Conversion due to transition will become part of the Gender Recognition process, but will require written consent of the spouse as well as the transitioning person. Once an interim Gender Recognition Certificate has been obtained, the choice is either to convert to marriage or go through the current system and annul the existing marriage.
The handling of paperwork on transition, e.g. would a replacement marriage certificate be issued still showing the initial marriage date, is still up for discussion.
In an announcement that I know will upset a great many people, marriages stolen under the old system of forced-divorce will not be reinstated.
Interestingly, 3% of respondents indirectly stated they were Trans and married, a surprisingly high proportion. Another 3% were identified as being spouses. In both cases, 79% of people said they would like to use the option to retain their existing marriage.
Opposite sex couples will continue to be able to annul their marriage on the grounds of non-consummation. This may be of particular interest to some non-op Trans folk as well as other groups, such as those with disabilities where consummation is physically impossible and both people knew it when they got married.
And finally, the one you’ll no doubt read in the mainstream sources: Religious (Not just civil, as I’d initially thought from earlier statements) marriage in religious premises will be allowed as long as both the minister and the wider church agree to it.
As a result of Freedom of Information request responses, the figures for all three major political party’s conference accreditation schemes have been released. When I looked at the numbers for 2010, Labour conference attendees were around twice as likely to be blocked as Conservative conference ones, with the LibDem conference somewhere in the middle.
The results for this year and previous years are as follows:
|LibDem||0.018% – 1 / 5,585||0.045% – 3 / 6,650||No accreditation|
|Labour||0.032% – 3 / 9,403||0.19% – 25 / 12,032||0.20% – 24 / 11,988|
|Tory||0.04% – 4 / 9,612||0.19% – 24 / 12,800||0.04% – 6 / 13,767|
The first thing to notice is that 2012 conference attendance is well down across all three parties – 15% for the Liberal Democrats and over 20% for both Labour and the Tories. Secondly, conference rejection rates this year have been lower than earlier years, which may be the effect of additional focus caused by the liberal backlash against the process. It is also interesting to note that the difference between the Tory and Labour conferences in 2010 was a one-off, and has not been reflected in later years.
It always puzzled me how the figures for this could be so low, given the significant number of people I know who have been willing to apply but been stopped by accreditation – I know personally of at least three people this year who were unable to attend the Liberal Democrat 2012 conference. If we ask the police the number of people who tried to attend but didn’t complete accreditation, the numbers are much higher:
|LibDem||0.70% – 39 / 5,585||No data||No accreditation|
|Labour||1.69% – 159 / 9,403||3.76% – 452 / 12,032||No data|
|Tory||1.04% – 100 / 9,612||3.42% – 438 / 12,800||No data|
So it seems that accreditation is having a more serious effect on excluding people than the headline rejection figures would initially show. For example, one cases I am aware of includes a situation where someone had moved around and the police asked for additional proof and information on previous addresses, too late for it to be reasonably produced. In the case of the Liberal Democrats, these people will never reach the Party President and Federal Conference Committee chair for consideration, so they will not even have the chance to argue their case as would someone who had been outright rejected.
Finally, although not available in all cases, the 2011 Tory conference response included number by type of applicant. The disparity between rejection/non-approval rates and types of applicant show we should be at least a little cautious with the above figures.
|Political Party Members||0.046% – 5 / 10,921||1.48% – 162 / 10,921|
|Ancillary||0.90% – 15 / 1,672||16.0% – 268 / 1,672|
|Security||1.93% – 4 / 207||3.86% – 8 / 207|
Some welcome (On the surface) news today, that the UK is no longer the most spied upon population online, going by Google’s data. The most recent half-yearly Transparency Report shows that, when analysed per-capita, we’ve dropped down into 4th place.
(Requests refers to the number of user data requests submitted to Google in the half year period, per million people)
Sadly, the real story is a little more depressing. The number of requests in the first half of 2012 has remained relatively static at 23 requests per million people. The UK has lost it’s top spot purely because other countries – the US, France and Australia – have all increased their activity.
China, traditionally regarded as more authoritarian online, remains relatively low down the list coming in at 31st with just 0.1 requests per million. This is probably due to the lower internet usage in that country, coupled with greater state snooping allowing them to figure out users identity without involving Google.
Please don’t sign it.
The petition misses some important caveats that are critical to ensuring Trans folk continue to get healthcare and it is not clear if the authors of the petition realised this.
Many people believe that if being homosexual could be removed as a disorder, so can gender dysphoria. But you don’t need a doctor to be gay. I don’t need a doctor to be Trans either, but access to surgery and HRT makes life liveable. If Gender Dysphoria is no longer recognised by the WHO, Health Services will see less need to provide services. In many countries, including the UK, health care for Trans folk is already poor to non-existant in places.
For an example of the details have a look at the European Parliament motion they reference on the same topic: they asked the WHO “to withdraw gender identity disorders from the list of mental and behavioural disorders while ensuring a non-pathologizing re-coding in the 11th version of the International Classification of Diseases (ICD-11).”
The latest petition misses the nuance and just calls for “ICD 11…to stop considering transexuality as an illness.“
We love you really. Particularly after “I’m sorry”.
We were good boys and girls and folk of no particular gender and didn’t make noises about unseating you at conference, because we don’t believe that’s a good idea. (Even if the press would love it)
But you really, really need to learn to stop talking sometimes.
At conference during your Question and Answer session, you were asked about the draft Communications Data Bill. As you probably know this does not make headlines in the Guardian every day but is still something that worries many liberals. When Mark Pack asked you a question on it, you initially responded well with some spot on phrases:
“It’s a draft bill“.
“Unprecedented levels of scrutiny“.
“Julian Huppert“. (Julian’s mention being enough for a round of applause)
And finally, you confirmed what’s become known as “the Huppert Veto“. Despite the name, this is not the latest Tom Clancy thriller.
But after about three minutes of not particularly intense questioning, it started falling apart. George Potter asked you if you’d taken any advice on the bill, or even read it before initially endorsing it. It’s fine to say the Home Office misled you. Really, we won’t mind. It happens, and we’re there to catch that sort of thing before it makes it into law. That’s the nice thing about the Liberal Democrats: We can do that, when other parties can’t.
Parroting out the lines that the “principles of the bill are extending existing powers” just makes you sound like you’re reading from a Home Office press release. It’s not just about “extending [existing] powers to other forms of communication, particularly Voice, Skype or whatever“. It’s far more than that, and we know it.
At least when the third questioner challenged you, the response was a reference to “Nasty people”. I’m pleased that we’ve dropped the tired old “paedophiles and terrorists” line. But the “Yeah, yeah” as if you understood what a VPN was didn’t make you look clever.
This is really, really technical.
If I was having to defend a highly technical motion related to the safety of nuclear reactors, or use of certain drugs in hospitals, I’d not even try. I’d get people in who understood the stuff, liberals I trusted, and let them get on with it. Please don’t pretend to understand it because we’re completely OK with the idea that it’s really not that easy.
Frankly, you’ve got other things to do. A country to run. We, lead by Julian, can handle this one.
Instead, just remember these simple four words when questioned on the Communications Data Bill:
“I agree with Julian“.
Last night, I attended a fringe event on Civil Liberties at the Liberal Democrat Conference. Many topics were covered and as a number of prolific tweeters were present (Myself, Sarah Brown and Caron Lindsay) it had a fair bit of coverage on Twitter.
Many topics were discussed, but one in particular attracted the Twitter attentions of Tom Harris, Labour MP for Glasgow South. That was ASBOs, where concern was expressed that they can be used to punish behaviour that would normally not be imprisonable. For example, if you are homeless on the street you can be given an ASBO preventing you from drinking, something that in itself isn’t illegal. Without help, that homeless person is just going to have a drink and this time they’ll go back in front of the Magistrates and get put in jail for 7 days for breach of the ASBO.
The next time, 14 days. Then, 28 days. And so on.
The only people to really benefit from this are private companies running the prisons. There’s certainly little being done in some cases to address the underlying causes.
Enter Tom Harris:
— Tom Harris (@TomHarrisMP) September 23, 2012
You’d think Tom would have learnt to be careful on twitter, given he’s already lost his post as Labour’s New Media advisor after some ill-advised tweets.
But no, society has no responsiblity to help people according to Tom. Instead it’s all about “Personal Responsibility”. He goes on to recount a story (Which he sounds proud of!) where he made someone homeless because they had a drink problem.
@caronmlindsay What about compassion for decent, good neighbours? Recently managed to evict a drunk making neighbouring family’s life hell.
— Tom Harris (@TomHarrisMP) September 23, 2012
— Tom Harris (@TomHarrisMP) September 23, 2012
@tomharrismp was the alcoholic not your constituent as well? Helping secure treatment & help for them would have worked too.
— Caron Lindsay (@caronmlindsay) September 23, 2012
@tomharrismp and making that person homeless helped how, exactly?
— Caron Lindsay (@caronmlindsay) September 23, 2012
@caronmlindsay It helped my constituents and their children. Job done.
— Tom Harris (@TomHarrisMP) September 23, 2012
— Zoe O’Connell (@zoeimogen) September 23, 2012
But wait! Surely, being a decent MP, Tom Harris tried to help this person? Perhaps he’s just not mentioned all the hard work he did in that regard. No, not at all. He wanted to evict this person without considering the alternatives…
— Tom Harris (@TomHarrisMP) September 23, 2012
So next time you pass someone homeless on the street in Glasgow, or some other city with a Labour MP, stop and think: What caused them to end up on the street? Is it because the local MP put them there, knowing homeless people don’t vote?
The whole affair pretty neatly illustrates the difference between many Labour supporters draconian and authoritarian approach to crime and punishment, versus the Liberal Democrat view.
(Tin Tower has also written up this exchange)
Way back in May, four months ago, I submitted a Freedom of Information request to Sussex Police. It is not anything unusual and requests information I have asked other police forces, such as what equalities impact assessments they carried out into party conference accreditation. They duly acknowledged it.
But after 20 working days, no response. This isn’t that unusual in FoI requests, despite 20 working days being the legal limit, so I politely chase them. No response. So I request an internal review. Again, no response. Not even an acknowledgement.
Next, I write to the Information Commissioner. They take their time (about 6 weeks!) but eventually write directly to Sussex Police, telling them they need to reply in 10 working days. Those 10 working days are up and I still haven’t had any response from Sussex Police.
They know they can not ignore a Freedom of Information request forever, which makes me think they are trying to delay publication of something until after conference. What possible correspondence might Sussex Police have that’s so embarrassing they’re willing to ignore the Information Commissioner purely as a delaying tactic?
Last week, in the Home Affairs Select Committee, Dr Julian Huppert quizzed the Metropolitan Police commissioner on what he might spend £1.8bn of cash on. Those familiar with the draft Communications Data Bill will probably recognise that number: It’s the Home Office estimate of the total cost of implementing the Bill.
Q403 Dr Huppert: Commissioner, if for all of policing, including counter-terrorism and all the other things that you do, you found you had an extra £1.8 billion over the next 10 years, what would be your number one priority for how you choose to spend that money?
One would expect Mr Hogan-Howe to be “on message” when it comes to this as he was quite vocal when the draft bill was announced, describing the powers as necessary to wage a draconian-sounding Total War on Crime. This guy is one of the leading voices asking for the bill. Surely he must think it is good value for money?
Surprisingly, Communications Data would not be a priority. He’d rather spend the cash on other things such community policing and general IT.
In fact, Communications Data didn’t even get a mention.
Bernard Hogan-Howe: It is a good question, and I would need a bit of time to think about it, but there are probably two main things. One would be to enhance the neighbourhood and community policing response. I think there is an opportunity there for us to do more. The second thing is I want to invest more in technology, not to replace the people necessarily, but we in the Met spend about £220 million a years on IT. Across the country policing generally spends £1.2 billion on IT. My point would be that it is more green screen than it is iPad, I am afraid, and it does not seem to catch criminals. Lots of lists, but ANPR catches criminals, facial recognition helps, fingerprints, DNA quick turnaround. These are things that I think over time can make a real difference, and of course it links us into the community and the victims in a far better way in which you see business deliver a service. I don’t think we are anywhere near that yet. So that is the two big areas that I would probably invest in. Probably the other one would be training. We have embarked on a quality programme and I think in the past probably the police service has seen training as a cost not an investment. For me it is an investment provided it is done properly and it is invested towards crime-fighting, which I think is vital.
(You can view this exchange on Parliament TV, starting from 11:02:23)
We already know that the proposals are incredibly expensive compared to the existing system and now even the police force primarily responsible for anti-terrorism don’t believe it’s good value for money.
So why are we doing it?