This is the first piece in a new series. I am going to take the long-form interviews shaping public understanding of trans healthcare, sit with them properly, transcript open, and ask what is actually being said, what is being layered on top, and what the listener is being led to conclude.

A note on Claudia, before any of this

Claudia’s life has held more pain than most people could carry in several lifetimes. Childhood violence. The loss of her father in dreadful circumstances. Decades of homophobic abuse. Surgery she has come to deeply regret. The loss of the great love of her life. Repeated near-fatal assaults. Her testimony is a human document, and the criticism in this piece is not of her. It is of how her account is being used.

What Claudia actually says

Listen to her, in her own words, set apart from the narration around them. She describes being a feminine, gender-non-conforming child in 1960s Glasgow, in a Catholic family with an extremely violent father. She describes saving her mother’s life at the age of eight by running through the ghetto to fetch the police. She describes years of homophobic mob attacks at school, a year in hospital after being kicked nearly to death at the age of ten, an abscess at the base of her spine that she hid for three years out of fear, and the partner she loved deeply, Richard, who told her she would lose him to a woman if she did not transition.

She tells us that Richard was unfaithful, that he loved the changes hormones produced in her body, and that, in her own words, he kept coming back because he liked it. She names the violence she lived through with extraordinary precision, a man on a train who tried to kill her once he realised her ticket said Mr, a man at a nightclub with a tear gas canister, a defence barrister at her own attempted-murder trial who called her a whore in open court.

She also tells us, very gently, this. For everyone here who is trans and happy, I say Brava, God bless you all. She is not asking anyone to follow her out of medicine, she is telling her own story, and she is telling it with grace.

What gets layered on top

Listen to how Bindel sets the conversation up before Claudia speaks for herself. Claudia is positioned as a pioneer against transgender ideology, as a witness against self-identification, as someone railing against men in single sex spaces. None of that language is Claudia’s. Read the transcript carefully and you will not find the words self-identification, single sex spaces, or transgender ideology anywhere in her own speech. She does not discuss contemporary trans politics at all. She talks about her own life.

This is the move I want this series to keep returning to. A person tells the story of their own life. The interviewer takes that story and uses it to argue for a position the person did not actually argue for. The reader, who hears the framing first and then hears the interviewee’s words sitting inside that framing, comes away believing the interviewee has confirmed something she has not actually said. That is not really interviewing, and it does not really serve Claudia.

The medical care she received, and what should have happened

This is the part that matters most to me. I have spent over a decade standing alongside trans people in healthcare and in society, and I know what good gender care looks like. I also know what it looks like when it is not done.

Claudia describes being assessed, signed off, and routed to surgery while she was in a coercive relationship. Her partner had told her he would leave her if she did not transition. She had been through extreme childhood abuse. She had been through years of life-threatening homophobic violence. She had a serious back injury and an unhealed abscess. She was using prescribed sleeping medication. She was, by her own description, broken. She was paying privately, which always creates pressures of its own. She was assessed once, and then she was on the operating table.

What does good gender care look like in a situation like that? It slows everything down. It sits with the whole person. It asks who else is in the room. It asks whether transition is being chosen by the person in front of you, or whether it is being asked of them by someone who has made it the price of love. It looks at the trauma, the violence, the relationship, the body, and the future, and it does not move towards an irreversible step until the person can choose freely. None of that happened for Claudia, and a young, gay, traumatised twenty-something deserved very much better than she got.

What does that actually mean? Claudia’s care was a real failure that deserves to be named for what it was. It does not tell us anything about the millions of trans people for whom transition has been the right path. The published rates of regret after gender-affirming care are consistently very low, somewhere around one to three per cent depending on how it is measured, far lower than the regret rates for many other procedures we accept without controversy. Detransition stories deserve respect. They should not be used to deny care to the much larger group who do not regret. What Claudia’s story tells us is that gender care needs to be done with time, with skill, and with attention, not that it should not be done at all.

Richard, and the story that does not quite get told

Bindel sets up Richard as the man who pressured Claudia into surgery on the logic that if he was straight, she must be a woman. That is part of the picture, although it is not the whole picture, and Claudia herself draws something more complicated.

Claudia describes confronting Richard directly. She tells him, darling, you are here because you like it, and Richard, in her words, looks as though she has slapped him. She describes him loving the changes in her body at every stage. She names what was happening between them, in her own words, as a kind of sexual interest he could not admit to in himself.

What is Claudia actually describing? A man who was attracted to a feminine, gender-non-conforming young person from the night they met, who liked her becoming more feminised, and who used the threat of leaving as a coercive tool to push her towards a body he found more appealing. That is a story about a partner’s coercion and a partner’s hidden desire. It is not a story about trans medicine creating a delusion in someone who would otherwise have been fine. Bindel uses it as the latter, and Claudia, listened to closely, is describing the former.

When the interviewee is asked to defend the interviewer

Here is a moment in the conversation worth pausing on, for anyone thinking about the ethics of this kind of work. Mid-interview, with the recording running, Bindel turns to Claudia and asks her to vouch for Bindel’s own reputation. People think Julie is transphobic, she says, so why would she and Harriet have me in their home. Claudia, kindly, gives her the answer she is being asked for.

That is the moment the interview stops being about Claudia. A woman in her sixties, in considerable pain, sitting at a launch event organised through Bindel’s own networks, is being asked on the record to defend her interviewer’s politics on a contested public question. Whatever anyone thinks of Bindel’s positions, an interviewee is there to be listened to, not to be recruited.

What good interviewing looks like with someone in this much pain

There is a real craft to interviewing someone who has lived through deep trauma, and the principles are not complicated, even if they are demanding in practice.

You let the person lead. You do not place words in their mouth before they have spoken. You do not narrate their life before they have told it. You do not arrive with a frame already built and try to fit them into it. You stay alert to the moments when they say something you were not expecting, and you follow that thread rather than steering them back to your story. You do not ask them to validate you. You let them say things you disagree with, and you do not edit those things away.

You also remember that someone who has been hurt as much as Claudia has been hurt is not a witness for anyone’s argument. Her account belongs to her, and the job of the interviewer is to make a careful, attentive space for that account, rather than to put it to work.

Why this matters

When a regret story is conscripted into a general argument against trans healthcare, every trans person who is doing well, every parent of a happy trans child, every clinician trying to deliver careful gender-affirming care, has to push back against the implication that their story is the lie and the regret story is the truth. That implication is doing a lot of damage right now, in policy, in clinical practice, and in family conversations up and down the country.

Claudia herself does not make that argument. She wishes the happy trans people Brava. The wider argument is being made on top of her account, by an interviewer with her own long-settled views, using Claudia’s pain as evidence for a conclusion that Claudia has not drawn.

This is the pattern I want to keep watching across this series. Not because individual interviewees are villains. Very often they are not, and Claudia is not, and her account deserves to be read with full seriousness. The format itself is being put to a particular use at a particular moment, and the people most harmed by that use are trans people who never get to speak in these rooms at all.

What does a woman look like?

Picture this. An alien lands in the United Kingdom tomorrow and is shown four British women: Julie Bindel, me, Claudia McClean, and Kemi Badenoch. The alien is asked what makes these four people the same kind of thing.

Where would the alien start? Different ages, different ethnicities, different builds, different voices, different ways of dressing, different ways of moving through the world. Different jobs. Different politics. Different religions. Different beliefs about who counts as a woman, and very different beliefs about what should follow from that.

What does a woman look like? On the evidence in front of the alien, there is very little that is shared, and that is exactly the point of the exercise. There is no visible characteristic that captures what a woman is. There is no body shape, no haircut, no voice, no walk, no item of clothing that all women share and no men do. There is no single biological measure that does the work either. Try to define woman by chromosome pattern and a long list of women drop out, intersex women among them. Try by reproductive system, by anatomy, by hormone levels, by the sex assigned at birth, and the same thing happens. The category of woman is held together by something other than what can be seen from the outside, and it always has been.

Two of the alien’s four women, Bindel and Claudia, have spent decades inside the public argument about who counts as a woman. They would not agree with each other on the answer. They are, both of them, plainly, women.

What I would say to the alien is what I would say to anyone. Ask the women who they are, and listen to what they tell you. That is the only honest way to find out.

Listen for yourself

Bindel’s interview with Claudia is published as a podcast episode on Bindel’s Substack.

India’s lower house of parliament (the Lok Sabha) has just passed a Bill that changes the country’s main law on trans rights. It still has to pass the upper house (the Rajya Sabha) before it becomes law. Here is what it does, in simple terms.

It takes away the right to be yourself. The old law said trans people had the right to their own self-perceived gender identity. That line has been deleted.

It puts a medical board in charge of who counts as trans. Instead of a trans person being recognised for who they are, a government-appointed medical board now decides. A trans person will have to present themselves to this board to be legally recognised.

It narrows the definition of who is trans. Words like trans man, trans woman and genderqueer have been removed from the law. Intersex people are redefined in much tighter medical language. A worrying little phrase has been added that tries to strip recognition retrospectively, meaning it reaches back in time to unpick rights already given.

It calls gender-affirming care mutilation. Throughout the Bill, surgery and hormones are described as mutilation, emasculation, castration and amputation. That language is written into the law itself, which stigmatises both trans people and the doctors who care for them.

It forces hospitals to report trans patients. Any medical institution carrying out gender-affirming surgery must send that patient’s details to the District Magistrate and the medical authority. No other group of patients is singled out this way.

It does include some stronger sentences for serious crimes. Trafficking, coerced castration, and forced begging networks now carry much tougher penalties, which is a genuine improvement. The trouble is that the same broad language could also catch supportive parents, doctors providing hormones, and families of gender-questioning children.

What this means

If this Bill becomes law, India will move from a framework built on self-determination to one built on state medical gatekeeping, with the language of crime wrapped around ordinary gender-affirming care. It is one of the most significant regressions for trans rights anywhere in the world this year, and it deserves far more international attention than it is currently getting.

A call to action

The Rajya Sabha has not yet voted. There is still time. If you care about trans rights, please do any of the following.

Share this summary. Tag Indian trans rights organisations, including the National Network of Trans Persons and Sampoorna Working Group. Write to your own MP or representative if you are in a country with diplomatic ties to India, and ask them to raise it. If you are a clinician, speak out against the framing of gender-affirming care as mutilation, because that language will travel, and it will be used elsewhere. If you are a journalist, please cover this. The Bill passed on 24 March 2026 and has had very little coverage outside India.

Trans people in India are watching this unfold in real time. Solidarity means being loud about it while there is still a chance for the upper house to pause, amend or reject the Bill.

Analysis

When the two texts are read side by side, the direction of travel is clear, and it moves firmly away from the 2014 NALSA judgment and from much of what the 2019 Act was intended to stand for.

Some of the changes in the Bill look administrative on the surface. Others reach deep into the lives of trans and intersex people, and they change what the law will recognise them to be. Let me take each area in turn.

The definition of transgender person

Under the 2019 Act, a transgender person was defined as someone whose gender did not match the gender assigned at birth. That definition explicitly included trans men and trans women, whether or not they had undergone surgery, hormone therapy or any other intervention. It included people with intersex variations, genderqueer people, and people with socio-cultural identities such as kinner, hijra, aravani and jogta.

The 2026 amendment replaces that entire definition. The new definition has two limbs. The first limb covers only the socio-cultural identities listed above, together with people who have a narrow, medically specified set of intersex variations, covering primary sexual characteristics, external genitalia, chromosomal patterns, gonadal development, endogenous hormone production or response, or such other medical conditions. The second limb covers, in effect, people who have been compelled to transition, whether with or without consent.

The words trans man, trans woman and genderqueer have all been removed. A trans woman who has lived and worked as a woman for decades, or a trans man who has built a family as a father, is no longer within the meaning of transgender person under this Act, unless that person falls within the specific intersex criteria or is read into the compelled to assume limb.

The proviso at the end of the definition is worth reading slowly. It says the definition shall not include, nor shall ever have been so included, persons with different sexual orientations and self-perceived sexual identities. The phrase nor shall ever have been so included carries retrospective effect. It attempts to strip recognition that has already been granted, and it does so historically, which is unusual drafting for a welfare and rights statute.

The loss of self-determination

Section 4(2) of the 2019 Act was short, but it carried real weight. It said that a person recognised as transgender shall have a right to self-perceived gender identity. That single clause carried the spirit of the 2014 NALSA judgment of the Supreme Court of India into statute.

The 2026 amendment simply deletes sub-section 4(2). The right to self-perceived gender identity, as a statutory right, is no longer there.

Of all the changes in the Bill, this is the one that carries the most weight, because everything else follows from it. Once self-perception is no longer a statutory right, medical authorities are placed in the position of deciding who is recognised and who is not, and the individual loses primary authorship of their own identity in the eyes of the law.

The new medical authority

A new definition is inserted at section 2(aa). It defines authority as a medical board, headed by a Chief Medical Officer or a Deputy Chief Medical Officer, appointed by the Central Government, a State Government or a Union territory Administration.

Section 6 is then amended so that the District Magistrate, when deciding whether to issue a certificate of identity, must examine the recommendation of this authority, and if the Magistrate considers it necessary or desirable, may also take the assistance of other medical experts.

The trans person is no longer the primary voice in their own recognition. A medical board becomes the gatekeeper. There is no statutory timeline in the amendment for the board to report, no appeal mechanism written into these provisions, and no standard for what the board is meant to assess. That silence is itself a source of risk, because it leaves each medical board free to apply its own assumptions and its own prejudices, without any clear procedural check.

For a trans woman in rural Tamil Nadu, or a hijra community member in Uttar Pradesh, this change will mean presenting herself before a medical board in order to be recognised as who she is. That is a profound shift, and it moves power away from the person and towards the state.

The framing of gender-affirming care as mutilation

The language throughout the Bill repeatedly describes gender-affirming surgery and hormone therapy as mutilation, emasculation, castration, amputation, or any surgical, chemical, or hormonal procedure. That phrase appears in the new definition of transgender person, it appears in the new offences at section 18(e) and 18(f), and it runs consistently through the drafting.

I want to pause on this, because it matters clinically as well as legally. Gender-affirming care, delivered with informed consent and in line with international clinical guidelines, is not mutilation. Describing it in those terms in black letter law criminalises the language of care. It stigmatises the clinicians who provide it, and it frames the trans person as a victim of their own treatment, rather than as a person making an informed decision about their own body.

The new offences, and what they might capture

Section 18 has been substantially rewritten. The original section 18 set out four offences, each carrying six months to two years of imprisonment. Those four are preserved as clauses (a) to (d) in the new section, with the same sentencing range.

Four new offences have been added, at clauses (e), (f), (g) and (h), and each of them introduces materially higher sentences than anything in the 2019 Act.

Clauses (e) and (f) criminalise kidnap or abduction of an adult or a child, where the kidnap is combined with causing grievous or permanent harm by mutilation, emasculation, castration, amputation, or any surgical, chemical, or hormonal procedure, and where this is done with the intent of, or in the course of, compelling such person to assume, adopt, or outwardly present a transgender identity. For an adult, the sentence is ten years to life, with a fine of not less than two lakh rupees. For a child, the sentence is rigorous imprisonment for life, with a fine of not less than five lakh rupees.

On one reading, these provisions target trafficking, coerced castration, and forced recruitment into communities. Those are real harms, and they have historically affected hijra communities in particular. Read in that way, the provisions carry genuine protective value, and they are stronger than anything the 2019 Act offered.

On another reading, the language is broad enough to reach gender-affirming care itself. The definition of transgender person at section 2(k)(ii) describes compelled transition as something capable of occurring either with or without consent. The offences describe hormones and surgery as mutilation. Read together, these provisions could in principle bring a clinician providing hormones to a trans adolescent, or a parent consenting to early intervention for a child with an intersex variation, within scope. Whether such a prosecution would ever occur is a matter of political and prosecutorial discretion, not of statutory safeguarding.

There is a further point worth flagging in clauses (f) and (h), which deal with children. In the adult offence at (e), the language includes the requirement that the compulsion is against the will or consent of such person. In the equivalent offence for a child at (f), the phrase against the will or consent is absent. The word allurement, which appears in the offence language, is very broad. Parental support for a gender-questioning child, social transition, and clinician-led paediatric care could all be described as allurement by a hostile actor. That is a very real concern for families and for paediatric clinicians.

Clauses (g) and (h) criminalise compelling someone to present outwardly as transgender and then using that person in begging, solicitation, servitude, or any other form of forced or bonded labour. Sentences are five to ten years for an adult and ten to fourteen years for a child. This part of the provision reads as an attempt to address forced begging networks that do, in practice, exploit gender-diverse people in some Indian states. Its practical effect will depend entirely on how police and prosecutors choose to use it.

The mandatory reporting duty on medical institutions

Section 7 is amended so that a medical institution in which a person has undergone gender-affirming surgery must furnish details of that person to the District Magistrate and to the medical authority.

Read carefully, this is a significant erosion of medical confidentiality. A hospital that performs gender-affirming surgery will be required by statute to send the patient’s details to two arms of the state. There is no carve-out for patient privacy, no consent threshold, and no statement in these provisions that the details are to be used only for narrow administrative purposes. It singles out one group of patients for mandatory state reporting, in a way that would not be accepted for any other category of medical treatment.

The redefinition of intersex

The 2019 Act contained a separate definition of person with intersex variations at section 2(i), describing someone born with variation in primary sexual characteristics, external genitalia, chromosomes or hormones from the normative standard of male or female body.

The amendment omits that separate definition and folds intersex into the transgender definition, using narrower and more medicalised language. Some intersex advocates will welcome being carved out of the transgender category, since intersex and trans experiences are distinct. Others will read the change as an erasure of intersex as a standalone identity in Indian law, and as a tightening of the medical criteria by which an intersex person is recognised.

The name change provision

Under the 2019 Act, a person could change their first name in the birth certificate and in other official documents once they held a certificate of identity or a revised post-surgical certificate. The amendment preserves the right to change the first name, though it links that right to the person being declared as a transgender person within the definition under this Act. Given how narrow the new definition is, the practical consequence is that fewer people will be eligible.

The National Council

Section 16 is amended so that representatives of the State Governments and Union territories on the National Council for Transgender Persons must be not below the rank of Director in the concerned Ministry or Department. This change bureaucratises the Council further. It does not in itself harm trans people, though it tilts the Council towards senior civil servants and away from people with lived experience, and that tilt matters when the Council is advising on policy that affects those lives.

What this means for trans people in India

If this amendment is brought into force by notification, the position of trans people in India will have changed in several concrete ways. Self-identification, as a legal right, is no longer in the statute. Recognition now depends on the assessment of a medical board. Trans men and trans women are no longer named in the definition in any straightforward sense, and intersex people are redefined in narrower, more medicalised language. Gender-affirming care is described, in black letter law, as mutilation. Clinicians providing such care face a statutory framework that uses criminal language for their practice, and medical institutions carry a mandatory duty to report their trans patients to state authorities. The retrospective wording in the proviso signals a legislative attempt to reach back and unpick recognition already given to people whose lives have been built on it.

Where there is genuine protective value in the Bill

It would be wrong to read the Bill as wholly bad. The increased sentences for trafficking-style offences, coerced castration, and forced begging networks are a real step up from the sentencing framework in the 2019 Act. These are serious harms, and they have historically fallen on hijra and other gender-diverse communities in very concrete ways. The 2019 Act was criticised, with good reason, for treating serious sexual and physical violence against trans people with the same light sentencing as discrimination or name-calling. If these stronger sentences sat within a Bill that also preserved self-identification, preserved the 2019 definition, and affirmed gender-affirming care as legitimate medicine, they would be a meaningful step forward. In this Bill, the protective elements sit alongside definitional and evidential changes that undo much of the 2019 settlement.

Overall assessment

Taking the Bill as a whole, the direction of travel is a significant regression for trans rights in India. The statutory right to self-perceived gender identity has been removed. The definition of transgender person has been narrowed, so that trans men, trans women and genderqueer people are no longer within it in any clear sense, and the proviso contains retrospective language that seeks to strip recognition already granted. A medical board has been placed as a gatekeeper for identity recognition. Gender-affirming care is described as mutilation throughout the drafting. Medical institutions carry a mandatory reporting duty for post-surgical patients. The Bill does include some stronger sentences for serious offences, including trafficking and coerced castration, and those sentences are a genuine improvement on the 2019 Act, though they sit within a framework that has become markedly more hostile to trans people overall.

For trans people in India, what this Bill asks of them is to submit to a medical board in order to be recognised, to live within a legal definition that no longer describes them, and to accept care that the statute itself calls mutilation. That is the picture as it stands after the Lok Sabha’s vote on 24 March 2026, and it is the picture the Rajya Sabha will need to weigh carefully before the Bill is brought into force.

Dr Helen Webberley, Gender Specialist and Medical Educator

www.helenwebberley.com

Resources

1. THE TRANSGENDER PERSONS (PROTECTION OF RIGHTS) AMENDMENT BILL, 2026

2. THE TRANSGENDER PERSONS (PROTECTION OF RIGHTS) ACT, 2019

It was not removed, narrowed, or diminished by the Supreme Court’s ruling on sex last April. It remains in the legislation, intact and enforceable.

Yet at this moment, in response to policy decisions by major registered charities, senior figures associated with those organisations are publicly describing transgender girls not as girls, not as children with a protected characteristic under the law, but as boys.

Not in private, but in press statements, in newspaper coverage, and in public statements to the media. I want to think clearly about what that means, what the law actually does and does not provide in that situation, and why the gap matters so much.

What the Equality Act actually says

Section 7 of the Equality Act 2010 defines gender reassignment as a protected characteristic for any person who is proposing to undergo, undergoing, or having undergone a process for the purpose of reassigning their sex. You do not need a Gender Recognition Certificate. You do not need to have had any medical treatment whatsoever. You need only to have taken steps, however initial, towards living in a gender different from the one recorded at your birth. That threshold is deliberately low, because the legislators understood that protection should not be contingent on proof of medical intervention.

The Act provides protection against direct discrimination, indirect discrimination, harassment, and victimisation in relation to that characteristic. Harassment, under Section 26, is defined as conduct related to a protected characteristic that has the purpose or effect of violating a person’s dignity, or creating an intimidating, hostile, degrading, humiliating, or offensive environment. These are substantive and enforceable legal obligations that apply to employers, service providers, educational institutions, and clubs and associations.

There is also a different and more powerful provision that receives far less attention in this debate. Section 149 of the Act, which sets out the Public Sector Equality Duty, requires any body that is exercising public functions to have active regard to the need to eliminate harassment and to foster good relations between people who share a protected characteristic and those who do not. This is a proactive duty, not a reactive one, and it is not limited to individual relationships. Whether a registered charity whose stated purpose is to influence public policy and public institutions is exercising a "public function" within the meaning of that section is a genuinely arguable question, and one that I think deserves much more scrutiny than it has received.

The current climate in the charity sector

The past year has brought significant and, for many families, deeply painful changes across UK civil society. Following the Supreme Court’s ruling in For Women Scotland v The Scottish Ministers, a number of organisations have been persuaded to revise their policies on membership and participation. Girlguiding, which serves around 300,000 young people aged four to eighteen, announced in December 2025 that trans girls would no longer be able to join, and in March 2026 it confirmed that current trans girl members must leave its groups by 6 September 2026. The Women’s Institute has ended formal membership for transgender women from April 2026.

The legal context here is complex. There are real tensions between the Equality Act’s provisions on sex and its provisions on gender reassignment, and those tensions are still being worked through in guidance, policy, and case law. I do not think it serves anyone well to pretend that the legal questions are simple, because they are not. What I will note is that Girlguiding itself, even while implementing these exclusionary changes, has consistently referred to the affected children as trans girls in its own official communications. That consistency of respectful language within their own statements is worth noting.

What I am addressing here is not the policy decisions on membership themselves, but the language that has accompanied those decisions in wider public commentary. In coverage of the Girlguiding announcement, figures at organisations that hold charitable status have described transgender girls in public statements not as girls, not even as transgender children, but in terms that deny their gender identity entirely. This has been documented in national media. It has been said by people whose organisations hold, or seek to hold, charitable status with the Charity Commission.

What trustees are actually responsible for

When an organisation registers as a charity in England and Wales, its trustees take on a set of legal duties under the Charities Act 2011. They must act in the interests of the charity and its beneficiaries. They must act with reasonable care and skill. They must act with integrity, and they must not act in ways that would bring the charity into disrepute or damage its reputation. These duties apply not only to formal governance decisions made at board level, but to how trustees and their organisations represent themselves and their work in public.

The Charity Commission has the power to investigate charities where there is concern that trustees have breached these duties. The Commission has acknowledged that it is an active regulator in this space and has received formal complaints relating to the conduct of charities touching on trans-related matters. Its regulatory framework includes not just membership policy, but the broader standards of behaviour expected of those who hold the privilege of charitable status.

There is a question that I think deserves more attention than it is currently receiving. If a charity’s objects include promoting human rights, advancing education, or operating for the public benefit broadly defined, how do those objects sit alongside public communications that deny the identity of children who hold a protected characteristic under UK law? This is not a question about whether those charities should or should not change their membership rules. It is a question about what standard of language and dignity we ought to expect from organisations that have asked for, and been granted, the privileges that charitable registration confers.

The real and human cost of this gap

I want to be very clear about who bears the cost of this gap between what the law provides and what it actually reaches. It is not an abstract policy problem. It is a seven-year-old girl who hears herself described as a boy on the news. It is a ten-year-old who has earned her badges, made her friends, and built her sense of belonging at Brownies, and who is now receiving a letter telling her that she must leave by September. It is a parent trying to find the words to explain to their child why some adults do not see her as she is, even when those adults are associated with organisations that are supposed to serve children.

Trans girls and their families are navigating an already deeply difficult landscape. The NHS waiting lists for gender identity services are, in some regions, measured in years. Access to age-appropriate healthcare is severely limited. Now children who have found community and confidence in organisations like Girlguiding are being asked to go. While that happens, the language being used about them in wider public discourse is not the language of their protected characteristic. It is language that erases them.

That language has consequences. The research on the mental health and wellbeing of transgender young people is consistent: the way trans children are spoken about by adults and institutions has a direct and measurable impact on their wellbeing. Being misgendered is not a minor or trivial experience for a child who is already navigating gender dysphoria and facing barriers to care and to social belonging. It is a further harm, and it is a harm that the law, as currently constituted, does very little to address.

What I believe needs to change

I want to set out three things that I believe would help, not as demands, but as genuine suggestions from someone who has spent a long career thinking about the welfare of trans people and about how institutions can do better.

1. The first is clearer guidance from the Charity Commission on the standards of language and communications expected of trustees and of organisations operating in their name, particularly when those communications concern people with protected characteristics. This does not mean compelling charities to take a particular policy position. It means making clear that the duties of integrity and of protecting a charity’s reputation extend to how organisations speak about the people their decisions affect, including children.

2. The second is engagement from the Equality and Human Rights Commission on the gap between the protection that gender reassignment formally provides under the Act and the public discourse that is currently surrounding trans children. The EHRC is the statutory body responsible for promoting and enforcing equality law in Great Britain. It has a responsibility to name the places where that law’s coverage falls short and to provide clarity about what standards of conduct it expects, even in contexts the Act does not directly regulate.

3. The third, and perhaps the most straightforward, is an appeal to the people who lead and speak for these organisations. Referring to a transgender girl as a boy is not legally required by anything the Supreme Court ruled. The For Women Scotland judgment made no finding about how trans children should be addressed or described in public communications. Describing trans girls in demeaning terms is a choice, and choices about how we speak about children, particularly children who are already navigating great vulnerability, say something about the kind of society we want to be.

The truth always wins. Gender reassignment is, and remains, a protected characteristic in UK law. That protection was built into our legal framework because legislators understood that trans people, including trans children, deserve dignity and respect. The challenge now is to extend that protection into the spaces where it is most needed, and to hold institutions to a standard of language and conduct that matches the values our equality law is supposed to express.

Dr Helen Webberley, Gender Specialist and Medical Educator

www.helenwebberley.com

Resources

- Equality Act 2010, Section 7 (Gender Reassignment)

- EHRC: Gender Reassignment Discrimination Guidance

- For Women Scotland v The Scottish Ministers [2025] UKSC 16

- Charity Commission: The essential trustee: what you need to know, what you need to do

- Girlguiding updated membership policy (March 2026)

Somewhere in Portsmouth, a woman is waiting for a diagnosis. She has been in pain for years, maybe a decade, told that it is normal, told to manage it, told to come back when it gets worse. She has cried in a GP’s office and been handed a leaflet. She found Endometriosis South Coast because someone told her about it, or because she typed her symptoms into a search engine at two in the morning when the pain would not let her sleep. She found a charity run by people who care, who fight, who show up at Parliament to make sure her condition is not invisible. She is not furious about who runs that charity; she is grateful.

The headlines, though, are using the word “fury.” The Times, GB News, the Daily Mail: all of them reaching for “fury” and “outrage” to describe the reaction to Steph Richards being appointed as parliamentary engagement officer for Endometriosis South Coast. What we might reasonably ask is: fury at what, exactly?

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The Question Nobody Is Asking

Steph Richards has spent more than two decades in women’s healthcare advocacy. She worked alongside two pregnancy charities as a consultant and researcher, contributed to work that saved hundreds of babies’ lives, won an Inspirational Women of Portsmouth Award in 2023, and built TransLucent into a respected voice in human rights. She knows how Parliament works. She knows how to get a condition onto an agenda, into a committee room, in front of the people who can actually change things.

So the question worth asking is whether not having endometriosis personally disqualifies someone from this role. Let us ask that question in a few other directions. Does a cardiologist need to have had a heart attack? Does a paediatrician need to be a child? Does an oncologist need to have experienced cancer? Laura Kerby leads Prostate Cancer UK and she does not have a prostate. Simon Cooke leads MSI Reproductive Choices, an organisation that provides reproductive healthcare primarily to women, and he is not a woman. Are there headlines about fury and outrage over those appointments? Is anyone calling them “absolutely ridiculous” or “fundamentally discordant”?

The fury, when we look honestly at the coverage, has nothing to do with the role and everything to do with who Steph Richards is.

What “Lived Experience” Actually Means in Healthcare

The trouble is that the argument about lived experience sounds reasonable on the surface, and that is exactly what makes it worth examining carefully.

Of course lived experience matters. When a woman sits in a consulting room and describes pain that has been dismissed for years, it matters that her advocate understands what that dismissal feels like. It matters that the charity speaks in a language that reflects the reality of the people it serves. Nobody is arguing otherwise, and nobody should.

The question is whether the parliamentary engagement officer must personally have endometriosis in order to advocate effectively for better policy, more funding, shorter diagnosis times, and greater awareness. That is a very different question. A parliamentary officer’s role is to understand the condition deeply, to listen to the people who live with it, and to translate that experience into language that moves policy. Steph Richards has spent her career doing exactly that kind of work in women’s health.

The charity’s own founder and trustees all have endometriosis or adenomyosis. The lived experience is there, in the room, shaping every decision. What they needed was someone who could walk into Parliament and make things happen, and they chose the person they believed could do that. That is how organisations work.

“Fury”

I want to name something directly, because I think people deserve honesty about what they are seeing in these headlines.

The word “fury” is doing a great deal of work. It presents transphobia as a legitimate emotional response, as something so reasonable that it deserves a headline, a quote from a novelist, a comment from a gender-critical MP. It packages a prejudice as a concern.

Rosie Duffield, the independent MP for Canterbury, says she is “uncomfortable.” Amanda Craig calls the appointment “absolutely ridiculous” and “fundamentally discordant and wrong.” The Daily Mail reaches for “fury.” GB News reaches for “outrage.” These are not words about healthcare policy or endometriosis advocacy. These are words about a trans woman existing in a space where some people have decided she has no right to be, and dressing that decision up as principle does not make it something other than what it is.

The Pattern

This is not the first time this has happened to Steph Richards. She served as CEO of Endometriosis South Coast from late 2023, and stepped down in May 2024 after sustained media pressure. In the week of that backlash, the charity received a year’s worth of donations in a single week, which tells you something important about how many people understood what was really happening. She left not because she had done anything wrong, but because the noise became impossible to sustain.

Now she is back, in a different capacity, doing advocacy work she is genuinely qualified to do. The press has found the story again. The same words are being deployed: fury, outrage, inappropriate, uncomfortable.

We need to be honest about what this pattern is. It is a sustained effort to push trans women out of public life, out of professional roles, out of charities and committees and meeting rooms, dressed up as concern for the very women those organisations exist to serve. It is happening across multiple sectors, and it falls on real people who are simply trying to do useful work in the world. We should be able to put the best person in any role, judged on their skills, their record, and their commitment, not prejudiced by their identity or any other personal characteristic.

To the Women With Endometriosis

If you have endometriosis, you have been let down by healthcare systems for a very long time. According to the most recent data from Endometriosis UK, the average time to receive a diagnosis in the UK has now reached nine years and four months. Nine years and four months of pain that gets dismissed, minimised, and misattributed. You deserve advocates who will fight for you in every room that matters, loudly and without apology.

Steph Richards is one of those advocates. Her birth sex is not the thing that matters here. What matters is whether she will show up, do the work, and make noise in the right places, and her track record across more than two decades of healthcare and human rights advocacy suggests she will.

The fury in those headlines is not yours. It was manufactured for you, by people with a different agenda entirely. Whether to accept it as your own is your choice, not theirs.

The future for trans people in public life is one where this kind of campaign loses its power. Every time we name what “fury” actually means, we bring that future a little closer.

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If this piece resonated with you, please share it. The more people who can see what “fury” actually means in this context, the better.

Dr Helen Webberley, Gender Specialist and Medical Educator

www.helenwebberley.com

Resources and Further Reading

• GB News: Trans row, outrage after transgender woman appointed as endometriosis charity representative: https://www.gbnews.com/news/trans-row-transgender-woman-appointed-endometriosis-charity-amanda-craig-rosie-duffield

• ITV News: Endometriosis charity slams transphobic reaction to appointing trans woman as CEO (2023): https://www.itv.com/news/2023-11-14/endometriosis-charity-slams-transphobic-reaction-to-new-trans-ceo

• Civil Society: Health charity CEO steps down after transphobic reactions to appointment (2024): https://www.civilsociety.co.uk/news/health-charity-ceo-steps-down-after-transphobic-reactions-to-appointment.html

• Endometriosis UK: New report highlighting alarming increase in endometriosis diagnosis times (March 2026): https://www.endometriosis-uk.org/endometriosis-uk-release-new-report-highlighting-alarming-increase-endometriosis-diagnosis-times

• Endometriosis South Coast: https://endometriosissouthcoast.com

• TransLucent: https://translucent.org.uk

• Steph Richards: National Diversity Awards 2025 shortlist: https://www.nationaldiversityawards.co.uk/2025-shortlist/steph-richards/

• Prostate Cancer UK: Laura Kerby, Chief Executive: https://prostatecanceruk.org/about-us/who-we-are/our-people/laura-kerby

• MSI Reproductive Choices: Simon Cooke, CEO: https://www.msichoices.org/who-we-are/our-team/simon-cooke/

@helenwebberleyYesterday I went on @lbc to discuss the recent ban of trans women competing in the Olympics. If this is about fairness… why is it only targeting trans women? What about equality?

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What the IOC Has Actually Decided

The new policy uses SRY gene screening to determine eligibility for women’s events at the Olympics. The SRY gene usually sits on the Y chromosome, and the IOC takes its presence as evidence that an athlete has experienced male sex development. If you screen positive, you are excluded from the female category at Olympic Games from 2028 onwards, with a narrow exception for athletes with a diagnosis of Complete Androgen Insensitivity Syndrome or certain other differences of sex development in which testosterone provides no performance benefit.

The IOC has described the test as evidence-based and expert-informed. What it has not told you is that the scientist who discovered the SRY gene, Professor Andrew Sinclair, has publicly opposed using it for exactly this purpose. He has written that the test is not cut-and-dried. All it tells you is whether the gene is present. It does not tell you whether a testis formed, whether testosterone was produced, or whether any testosterone produced could even be used by the body.

Biology Has Always Been More Complex Than XX and XY

Most of us were taught in school that women have two X chromosomes and men have an X and a Y. That is a majority pattern, not a complete picture of human biology. There are people with a single X chromosome, a condition known as Turner syndrome. There are people with XXY, known as Klinefelter syndrome. There are women who carry a Y chromosome but whose bodies do not respond to testosterone at all. There are many other variations, and human bodies have never conformed neatly to a simple binary model.

Variations in sex development are present in the population at roughly the same prevalence as having red hair. When you apply population-level genetic screening to female athletes, you will inevitably find results that nobody anticipated, in women who have been raised as girls, have lived as women throughout their lives, and have never had reason to question their biology. That is not a hypothetical concern, given what we know about the prevalence of DSD conditions, but a clinical certainty that deserves to be taken seriously.

Imane Khelif Was Not a Trans Athlete

It is important to say this clearly, because the confusion and hostility around her case has shaped the political environment in which this policy was created. Imane Khelif, the Algerian boxer who won gold at the Paris 2024 Olympic Games, is a cisgender woman. She was assigned female at birth. The controversy around her arose because some people do not think she looks the way they imagine a woman should look, and that is not a scientific or clinical argument: it sits in the territory of prejudice, not medicine.

The IOC’s new policy has been shaped, at least in part, by the media and political environment that her gold medal victory generated. That is not a foundation for sound science or equitable policy-making. The people making decisions within large organisations are individuals, and they bring their own perspectives, and sometimes their own biases, to the table. We rarely get to see who holds the loudest voices in those rooms, but we do see the consequences of the decisions they make.

Who Gets Hurt by This Test

This is where I feel most strongly, and why I wanted to speak on LBC this week. A woman who has lived her whole life as a woman, who has never had reason to question her biology, could attend an Olympic qualifier and receive a positive SRY screen. She would not be allowed to compete. In all likelihood, given the level of media attention that elite athletics attracts, her result would become public knowledge before she had even had a chance to process it herself.

That woman has done nothing wrong. She is not seeking an unfair advantage. She has a variation in her sex development that she did not choose and may not have known about. The policy removes her from competition anyway, and it does so publicly, and with no apparent consideration of the harm that causes.

There are women competing in elite sport right now who would screen positive for SRY and have no idea. That is a near-certainty, given what we know about the prevalence of DSD conditions in the population. They deserve better than this.

If You Make a Space for Women, All Women Belong in It

The principle here is straightforward, even if the politics around it are not. If you create a category called women’s sport, all women should be able to compete in it. If you want to create a performance category that limits participation based on particular physical characteristics, then make that your category. Do not call it women’s sport and then exclude women from it.

Women’s elite netball, as I mentioned on LBC, is played predominantly by athletes who are well over six feet tall. That does not make them ineligible. Women who are tall, or broad, or strong are still women. Women who have DSD conditions are still women. Trans women who have transitioned are women. The category exists for all of them.

We have seen this kind of reasoning used to exclude women from shared spaces before, and we should recognise it for what it is. When we allow the exclusion of one group, we make it easier to exclude others. The history of women’s sport is in part a history of being told that certain women do not fit, and that story has never ended well for anyone.

Diversity Has Always Existed. Inclusion Is Not Optional.

The IOC talks about protecting the female category. I want to protect female athletes, all of them: the ones whose biology is more complex than a saliva swab can capture, the ones who have transitioned, and the ones who have always lived as female and will now be subjected to genetic scrutiny they never asked for.

Real people are being hurt by decisions like this one. The voices celebrating this policy should ask themselves what, exactly, they are celebrating. We should never celebrate exclusion. History is very clear on that point.

Diversity exists. It has always existed. The human body is not a simple binary system, and no policy built on that assumption is going to serve women in sport well. What we need is inclusion, equity, and human rights: for all women, in all of their wonderful complexity.

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If this matters to you, please share it. The truth always wins.

Resources

IOC Policy on the Protection of the Female (Women’s) Category in Olympic Sport, March 2026:

https://www.olympics.com/ioc/news/international-olympic-committee-announces-new-policy-on-the-protection-of-the-female-women-s-category-in-olympic-sport

Andrew Sinclair on SRY gene testing, The Conversation, 2025

UN Human Rights Council concerns on mandatory genetic sex testing in sport, February 2026

CNN: IOC bans transgender women from competing in women’s events:

https://www.cnn.com/2026/03/26/sport/olympics-transgender-women-athletes-banned

NPR: The Olympic committee bans trans athletes from women’s events:

https://www.npr.org/2026/03/26/nx-s1-5762579/ioc-bans-trans-women-events-genetic-testing

Euronews: Transgender women athletes banned from competing in female Olympic events:

https://www.euronews.com/2026/03/27/transgender-women-athletes-banned-from-competing-in-female-olympic-events-in-new-ioc-polic

Dr Helen Webberley, Gender Specialist and Medical Educator

www.helenwebberley.com

I am writing to you as an open letter on the 31st of March, which is Trans Day of Visibility, a day observed around the world to celebrate the lives of trans people and to affirm that they are seen, that they matter, and that they deserve to live openly and with dignity. It feels like exactly the right day to stand alongside you.

I wanted to write to you directly to offer my support following the recent press coverage of Ipswich Borough Council’s decision to fly the Progress Pride flag, and to reassure you that the criticism you have received is neither legally sound nor rooted in the kind of evidence-based analysis that should shape public debate.

The organisations quoted in the article raising concerns about your council’s decision are For Women Scotland and Sex Matters. Both are listed on Wikipedia as anti-trans organisations. For Women Scotland is described there as a group that has been described as an anti-trans group by multiple media outlets, and Sex Matters is described as a “British gender-critical, anti-transgender advocacy group.” [1] This context matters, because these are not neutral observers raising legitimate legal concerns. They are campaigning organisations with a stated agenda, and that agenda is the rollback of trans rights and visibility in public life.

Flying the Progress Pride flag is a simple, visible act of solidarity. It says to every LGBTQ+ person in Ipswich, including trans people, that they are seen, that they are valued, and that your council stands alongside them. On Trans Day of Visibility especially, that message carries profound meaning. In a climate where trans people face increasing hostility in public life, symbols of welcome and inclusion matter deeply, and your council’s decision is something to be proud of, not to apologise for.

On the legal question, I want to be clear. The Local Government Act 1986 prohibits councils from publishing material designed to affect support for a political party. Flying a flag of inclusion is not party political material. It does not name a party, campaign for a candidate, or seek to influence an election. The claim that it breaches political neutrality laws stretches the purpose of that legislation well beyond what it was ever designed to cover.

There is also an attempt, in some of the commentary around this issue, to tie decisions like yours to the recent Supreme Court ruling in the For Women Scotland case. That ruling concerned a narrow and specific question: the definition of “woman” and “sex” in the Equality Act 2010. It said nothing whatsoever about Pride flags, council symbolism, or the propriety of public bodies expressing solidarity with LGBTQ+ communities. Using that judgment as a lever to pressure councils into removing symbols of inclusion is a misrepresentation of what the court actually decided.

Your council’s decision is a thoughtful, compassionate one. It is entirely lawful, it reflects the values of an inclusive community, and on this Trans Day of Visibility it serves as a reminder that visibility itself is an act of care. It tells trans people in your borough that they are not invisible, that they are not a controversy to be managed, and that they belong.

With warm support and solidarity,

Dr Helen Webberley, Gender Specialist and Medical Educator www.helenwebberley.com

References

[1] Anti-transgender movement in the United Kingdom, Wikipedia

[2] Original article: Labour council under fire over trans Pride flag

When a local authority publishes a formal gender statement for its schools, it is making a statement about who it believes matters. East Lothian Council published its Gender Statement: Supporting Transgender Children and Young People in Schools in January 2026, and presented it to the Education and Children’s Services Committee on 17 March. Having read it carefully, I want to start by saying something that does not get said often enough in the current climate: this is genuinely good work. It is compassionate, legally grounded, and it puts children at the centre. There are things I want to highlight, and one significant concern I will not shy away from, but the people who put this together deserve recognition for producing something that many local authorities across the UK have yet to attempt.

At a Glance: Policy Review Summary

🟢 Genuine consultation with staff, children and young people, and Time for Inclusive Education

🟢 Chosen name and pronoun support, led by the young person, with flexibility as preferences evolve over time

🟢 Gender-neutral uniform options available for all learners across all East Lothian schools

🟢 Inclusive PE: transgender learners placed in the group matching their gender identity

🟢 Non-binary learners asked which group they feel most comfortable in

🟢 Residential trips: provision for separate or gender-affirming room allocations where needed

🟢 LGBTQIA+ education integrated across the curriculum at all stages

🟢 Strong confidentiality protections: no disclosure to parents or carers without the young person’s knowledge and consent

🟢 Grounded in the UNCRC, now incorporated into Scots Law as of July 2024

🟠 Toilet and changing room provision is legally constrained by the 1967 Regulations and the Court of Session ruling; gender-neutral provision is encouraged but cannot be guaranteed in older buildings

🟠 Parent and carer notification language could be strengthened to make clear that the young person must lead any decision to involve parents

🔴 The Cass Review is listed as a key guiding document alongside the UNCRC and the Equality Act. Its methodology and conclusions have been subject to serious academic challenge and it should not sit as a foundational reference for guidance designed to support trans young people. It was a review of healthcare service, not education provision.

The Starting Point That Matters

The document opens with a principle that should underpin every piece of education policy on this topic: the starting point is the child. East Lothian’s guidance is explicit that all children and young people have the right to the support they need to benefit fully from their education, and that all learning environments should feel safe and nurturing. This is not a radical statement. It is simply good education policy, applied consistently to all children, including those who are transgender.

The guidance was developed through genuine consultation. Staff across all schools were asked about their confidence levels and what additional guidance would help them. Children and young people were consulted through focus groups, and they reported that having this statement would help school staff understand their needs better and support them more effectively. The organisation Time for Inclusive Education reviewed the final version and described East Lothian as taking a positive and proactive approach, calling the statement one of the best they have read. That is not faint praise, and it is clearly well deserved.

What I Welcome

There is a great deal to celebrate in this document, and I want to take the time to name it properly.

On language and names: the guidance is clear that staff should use the name and pronouns a child or young person has asked to be used, and that good practice is to be led by the child or young person themselves. It acknowledges that terminology is evolving, that young people do not need a label to receive support, and that a young person’s preferences may change over time and vary between settings. That flexibility and respect is exactly right.

On school uniform: the guidance states that there should be a gender-neutral option available for all learners, and that specific items of uniform should not be assigned based on gender. Every child should be able to wear what makes them feel comfortable and at ease, within the school’s general guidelines.

On physical education: the document is clear that transgender learners should be allowed to take part in the group that matches their gender identity where classes are organised by sex assigned at birth. Non-binary learners should be asked which group they would feel most comfortable in. Reasonable adjustments should be made across groups, activities, clubs, and competitive opportunities. This approach is inclusive and practical, and it starts from the right place.

On residential trips: the guidance asks schools to consider making alternative arrangements for transgender children and young people, including giving them their own room where appropriate. It also encourages schools to give consideration to enabling all children to share a room with the gender that most aligns to their identity, provided the rights of all those involved are considered and respected. This is a genuinely sensitive approach to what can be a stressful situation for trans young people and their families.

On curriculum: LGBTQIA+ education should be integrated across all curricular areas, and transgender identities should be included alongside other identities in classroom resources and displays. There is also a section on tackling unconscious gender bias from early years, which recognises that limiting messages about gender reach children from a very young age. Addressing this from early learning and childcare onwards is a meaningful commitment.

On confidentiality: the guidance is clear that inadvertent disclosure of a young person’s transgender identity to their family could cause needless stress or put them at risk. It explicitly states that it is vital not to share information with parents or carers without considering and respecting the young person’s views and rights. This is a critical protection, and it is genuinely reassuring to see it stated with such clarity.

What Needs Attention

The toilet and changing room section is where the guidance has to navigate the most difficult legal terrain. The School Premises (General Requirements and Standards) (Scotland) Regulations 1967 require schools to provide separate toilet facilities based on biological sex, as confirmed by the Court of Session ruling referenced in this document. The guidance acknowledges this legal requirement but also notes that recent practice has meant schools are now designed to include gender-neutral facilities, and it encourages schools to ensure all children have a changing space that supports them to feel safe and comfortable.

This is handled with as much care as the legal constraints allow. The hope is that over time, more schools across Scotland will be built or refurbished with adequate gender-neutral provision, so that no child is placed in a position of having to use facilities that feel unsafe or uncomfortable. In the meantime, schools are being encouraged to find individual solutions, which is the right approach given the constraints.

The section on involving parents and carers is thoughtful overall, but there is one line worth watching. Scottish Government guidance recommends that parents and carers should be brought into discussions about a name change at as early a point as possible, as discussed with the child or young person. That final phrase matters enormously and should not be overlooked or minimised. The young person must lead that conversation. Schools should not feel they have a duty to notify parents before the young person is ready. I would welcome clearer and more emphatic language on this point in any future revision of the statement.

What Concerns Me

I want to be honest about one aspect of this document that gives me pause, because I think it is important enough to name directly.

In the list of key legislation, policy, and guidance underpinning this statement, the Cass Review appears as a foundational reference. It is described as outlining the role of understanding the nature of the child’s wellbeing and functioning in their education setting and the quality of peer and social relationships.

The inclusion of the Cass Review as a key guiding document is a concern. The review has been subject to serious and sustained academic criticism regarding its evidence base and methodology. Multiple peer-reviewed responses from researchers and clinicians have challenged its conclusions, and questions have been raised about whether the studies it relied upon would meet standard quality thresholds for systematic review. The fact that it was commissioned by NHS England does not place it beyond scrutiny, and organisations across the international medical and research community have raised significant concerns about how its findings have been applied in policy contexts.

Guidance designed to support transgender children and young people should rest on robust, internationally recognised frameworks grounded in children’s rights, wellbeing, and inclusive education. Listing the Cass Review alongside the UNCRC, the Equality Act, and Getting it Right for Every Child implies an equivalence that I do not think is warranted. I would encourage East Lothian Council to review this reference as part of any future iteration of the statement.

The Bigger Picture

Scotland is not immune to the political pressures that have made life harder for trans young people across the UK in recent years, and some of those pressures are visible in this document, particularly around facilities. The legal landscape has shifted significantly, and local authorities are having to do their best within constraints that were not of their making. Within those constraints, East Lothian’s team has produced something warm, workable, and genuinely child-centred.

What I find most encouraging is not any single policy commitment, but the spirit that runs through the whole document. This is guidance that was written by people who consulted the children it would affect. It was shaped by people who asked their staff what they needed. It was reviewed by an organisation that works with LGBTQ+ young people every day. The result is guidance that treats transgender children and young people as part of the school community, deserving of the same care and consideration as every other young person in their class.

More local authorities should be doing this. If you are a parent, a teacher, a school governor, or anyone involved in education policy, I hope this review is useful to you. Take a look at the original document, share it with the people around you who need to see it, and use it as a benchmark for what good local guidance can look like.

Resources

• East Lothian Council Gender Statement: Supporting Transgender Children and Young People in Schools (January 2026)

• Supporting Transgender Pupils in Schools: Guidance for Scottish Schools (Revised, September 2025)

• Time for Inclusive Education (TIE)

• LGBT Youth Scotland

• Scottish Government Guidance on LGBT Inclusive Education

• Getting it Right for Every Child (GIRFEC)

• Cass Review: Implications for Scotland (Scottish Government)

Dr Helen Webberley, Gender Specialist and Medical Educator

www.helenwebberley.com

• Seeking appropriate healthcare for your child is not a safeguarding concern.

• Being trans is not a risk to a young person’s welfare.

• Having a diagnosis of gender dysphoria, and receiving treatment for it, is no different in law from having any other medical condition and receiving proper care for it.

• What is happening to some families right now is deeply troubling, and you deserve to understand your rights as clearly as possible.

This article sets out the key legal protections that apply to you and your child, what social workers are and are not legally permitted to do, and what you can do if you feel your family is being treated unfairly. At the end, you will find a template letter you can adapt and use to respond formally to any communication you have received. Please do seek proper legal advice for your specific situation, because while I can share information with you, I am not able to give legal advice, and every family’s circumstances will be different.

The Equality Act protects your child

The Equality Act 2010 makes gender reassignment a protected characteristic in England, Scotland, and Wales. This means that trans young people, like all trans people, are protected from discrimination on the basis of their gender identity. This protection exists regardless of age: it covers children and young people every bit as much as it covers adults. A social worker, a school, a GP surgery, or any other public authority has a legal duty not to treat a trans young person less favourably because of who they are. If you believe your family is being treated differently from how a family with a non-trans child in comparable circumstances would be treated, that is a matter the Equality Act is designed to address.

Medical treatment with valid consent is not a safeguarding concern

If your child has a diagnosis of gender dysphoria and is receiving treatment, that treatment has been provided with valid consent, and valid consent is the cornerstone of lawful medical care. In England and Wales, a young person under 16 may give their own consent to medical treatment if they are assessed as being what is called “Gillick competent”, meaning they have sufficient maturity and understanding to appreciate what the treatment involves and what it means for them. This principle was established by the House of Lords in 1986 in the case of Gillick v West Norfolk and Wisbech AHA, and it remains the law today.

For young people aged 16 and 17, the Family Law Reform Act 1969 gives them the same rights as an adult to consent to surgical, medical, or dental treatment. Where a young person’s own consent is supplemented or supported by parental consent, that parental consent is also valid and lawful. Social workers cannot treat consented medical care as evidence of harm simply because they personally disagree with the treatment in question, or because they are uncomfortable with it.

What you need to know about puberty blockers

This is an area that has caused a great deal of confusion and anxiety for families, so I want to be straightforward with you about the current situation. In November 2024, the UK government introduced a restriction on the supply and sale of gonadotrophin-releasing hormone analogues, often called puberty blockers or GnRHa, for gender dysphoria in under-18s within England. This restriction applies specifically to supply and sale within the UK.

It does not make it unlawful for a family to seek this treatment from a provider outside the United Kingdom. It does not create a criminal offence out of possessing medication that has been lawfully obtained. If your child has been receiving puberty blockers through a licensed provider abroad, your family has not broken the law, and your child has not been harmed in the legal sense simply by being on this medication. A social worker who suggests otherwise is on very uncertain legal ground, and you are entitled to ask them to specify the precise legal basis for their concern.

It is also important to be clear that this restriction is the only one of its kind currently in force. Other forms of gender-affirming care, including support for social transition, psychological support and counselling, and in appropriate circumstances hormone therapy, are not subject to any ban. If a social worker or other professional implies to you that all gender-related healthcare for young people is now illegal or inherently harmful, they are not giving you accurate information.

What social workers are and are not allowed to do

Social workers carry out an important role. Their job is to protect children from significant harm, and they work under the framework of the Children Act 1989. That legislation sets a clear legal threshold for intervention: there must be reasonable cause to believe that a child is suffering, or is likely to suffer, significant harm. Harm is defined as ill-treatment, or the impairment of a child’s health or development. It does not mean having a gender identity that differs from the sex recorded at birth. It does not mean receiving medical treatment that someone else disagrees with. Gender dysphoria, properly diagnosed and treated with valid consent, does not constitute harm in the legal sense.

Social workers conducting a Section 47 enquiry, which is the type of enquiry used when there is a concern about significant harm, are required by law to consider your child’s wishes and feelings. They must involve parents in their assessment unless doing so would place the child at additional risk. They must be able to demonstrate, with clear evidence, what the specific concern is and why they believe the legal threshold has been met. If they cannot articulate this clearly and evidence it, they do not have a sound legal basis for taking protective action.

It is also important to understand that recommendations to stop or alter a young person’s medical treatment are not within a social worker’s clinical remit. Any such recommendation must come from the medical team responsible for the child’s care, who will be reviewing that care periodically in line with established clinical guidelines. A social worker may raise concerns, but the clinical decision about whether treatment continues, is adjusted, or stops belongs to the treating clinicians, working with the young person and their family.

Unilateral demands to discontinue treatment, without the involvement and agreement of the medical team, are not appropriate and carry no clinical or legal authority.

Removing a child from their home requires either a court order (an Emergency Protection Order or a Care Order) or the use of Police Protection Powers, which can only last for 72 hours and must then go before a court. Courts apply independent scrutiny to the evidence placed before them. They are not required to accept a social worker’s assessment at face value, and they will consider your evidence as well as theirs.

Your key rights at a glance

• You have the right to know precisely what concern social workers are investigating and what evidence they are relying on.

• You have the right to be involved in any assessment of your child.

• You have the right to have your child’s wishes and feelings properly considered.

• You have the right to seek legal advice and to have someone with you at any meeting.

• Your child’s Equality Act protections apply in every interaction with public authorities.

• Consented medical treatment is not grounds for intervention without additional evidence of harm.

The template letter below is a starting point for responding formally to any communication you have received from a social worker or local authority. Please adapt it carefully to reflect your own situation, and do seek proper legal advice before sending it, particularly if you believe there is any risk of action being taken to remove your child from your care.

Template letter: responding to a social worker enquiry

The letter below is a template. Replace all text in square brackets with your own details. This is for informational purposes only and does not constitute legal advice. Please seek advice from a qualified solicitor before sending formal correspondence in connection with any social care enquiry.

Dear [Name / Sir or Madam],

Re: [Your child’s full name, date of birth] - Reference [case number or reference, if known]

I am writing in response to [your letter dated / our telephone conversation on / your visit on] [date], concerning my child [name]. I welcome the opportunity to address any concerns you may have, and I am committed to my child’s welfare and wellbeing. I am also writing to ensure that this communication forms part of the formal record, and to set out my understanding of the relevant legal position.

My child has a diagnosis of gender dysphoria and is currently receiving [describe treatment briefly, for example: support from a specialist gender clinic based abroad / hormone therapy through a licensed provider / psychological support from a qualified therapist]. This treatment has been provided with [my child’s own consent, as they have been assessed as having Gillick competence / my consent as their parent and legal guardian / both my child’s consent and mine]. Consented medical treatment for a properly diagnosed condition is not a safeguarding concern under the Children Act 1989, and I would respectfully ask you to clarify in writing what specific evidence you hold that the threshold of significant harm has been met in this case.

I note the following points, which I ask you to take into account in your assessment:

1. Gender reassignment is a protected characteristic under the Equality Act 2010. My child is entitled to the same protections as any other person, and to be treated no less favourably than a child in comparable circumstances who does not have the protected characteristic of gender reassignment.

2. The restriction on the supply of puberty blockers within the UK, introduced in 2024, does not make it unlawful for families to seek this treatment through licensed providers outside the United Kingdom, and it does not affect other forms of gender-affirming care. If your concern relates to treatment accessed abroad, I would ask you to specify the precise legal provision upon which you are relying.

3. Under Section 47 of the Children Act 1989, a local authority conducting an enquiry is required to give due consideration to my child’s wishes and feelings, to involve me as a parent in the assessment process, and to demonstrate reasonable cause to believe that my child is suffering or is at risk of suffering significant harm. I would be grateful if you could confirm in writing how each of these requirements is being met in this case.

4. Any recommendation to stop or alter my child’s medical treatment is a clinical matter, not a social care matter. Such a recommendation must come from the medical team responsible for my child’s care, who review that care periodically in accordance with established clinical guidelines. I would ask you to confirm that you are not seeking to direct or override clinical decisions, and that any concerns about the treatment itself will be referred to the treating clinical team in the first instance.

I am happy to meet with you to discuss your concerns in detail, and I would ask that any such meeting takes place at a mutually convenient time, with reasonable notice given in advance. I would like to have a friend, family member, or legal representative present at any meeting, and I ask you to confirm that this is acceptable.

Please note that I am keeping a full record of all correspondence and contact in connection with this enquiry.

I look forward to receiving your written response.

Yours sincerely,

[Your full name]

[Your relationship to the child, e.g., Mother / Father / Legal Guardian]

[Date]

Don’t Give Up

I want to say one more thing to every family reading this. You are not alone in what you are facing, and the fact that you are looking for information and advocating for your child speaks to how much you love them. The law has not abandoned trans young people or their families, even if it can sometimes feel that way. Please do reach out for support, and please do not hesitate to use every legal protection available to you. That is precisely what those protections are there for.

The Equality Act 2010 protects you, with or without a GRC

Under the Equality Act 2010, gender reassignment is a protected characteristic. This protection applies to anyone who is proposing to undergo, is undergoing, or has undergone a process of reassigning their sex. Crucially, this does not require surgery, medical treatment, or a Gender Recognition Certificate. Simply living as your affirmed gender is enough to bring you within the scope of this protection.

This means that an organisation cannot treat you less favourably because you are trans. Repeatedly demanding documents that are not required by law, rejecting documentation without reasonable justification, or creating unnecessary barriers to updating your records, are all actions that may amount to direct or indirect discrimination under the Act.

You do not need a Gender Recognition Certificate to update your records

A Gender Recognition Certificate (GRC) is a legal document issued by the Gender Recognition Panel that changes your legal sex for all purposes in UK law. It is a meaningful document, and there are specific contexts, such as registering a death or getting married, where it has particular legal significance. However, it is not a requirement for updating your name or gender marker with a financial institution, a private company, or most public services.

The Gender Recognition Act 2004 does not make a GRC a condition of being treated according to your affirmed gender in everyday life. The Equality Act, together with the UK GDPR and the Data Protection Act 2018, makes clear that organisations holding your personal data have a responsibility to keep it accurate. If you have legally changed your name and your records still show your old name, that is inaccurate data, and you have a right to have it corrected.

What documents can an organisation reasonably request?

For a name change, the standard and legally sufficient document is a deed poll. This can be an enrolled deed poll (formally registered through the courts) or an unenrolled deed poll, both are legally valid. Most organisations should accept this alongside a current proof of identity in your new name, such as a passport or driving licence updated to reflect your new name.

For a gender marker update, an organisation may ask for evidence of your identity, but they cannot make a GRC a condition of making the change. A statutory declaration or a letter from a doctor or gender specialist confirming your gender identity is frequently accepted as supporting evidence, though even this is not always necessary. Each organisation will have its own policies, but those policies must comply with the Equality Act.

A note on UK driving licences

It is worth knowing that UK driving licences issued in recent years do not display a gender or sex marker on the photocard. If an organisation has suggested that your driving licence is insufficient because a gender marker is absent, this reflects a misunderstanding on their part. The DVLA does hold a gender marker on its internal records, which can be updated without a GRC, but it does not appear visibly on the card itself. A valid, in-date driving licence in your correct name and with your photograph is a legitimate proof of identity.

What about death certificates and burial?

This is a question that matters deeply to many trans people and their families, and it deserves a clear answer. Without a GRC, your legal sex for official purposes remains as registered at birth. In practice, this means that a death certificate would record the sex assigned at birth, because the registrar works from legal records.

A GRC changes this. With a GRC, your affirmed gender would be recorded on a death certificate. If this is important to you and your family, obtaining a GRC is the route that gives you certainty. The process has been simplified in recent years, and for someone who has lived for many years in their affirmed gender, the application is well within reach.

It is also important to say that how you are buried, commemorated, and spoken of is largely in the hands of your next of kin and any instructions you leave in writing, whether in your will, with a funeral director, or in a letter of wishes. Your family’s voice matters enormously in these arrangements, regardless of what a death certificate records. However, if you want the official documentation to reflect who you are, a GRC is the definitive way to achieve that.

What to do if an organisation is being obstructive

If you have provided reasonable documentation and an organisation continues to demand more, moves the goalposts, or suggests that a GRC is required when it is not, there are several steps you can take.

First, put your request in writing, using clear and direct language about your rights under the Equality Act and the UK GDPR. The template letter below is designed to help you do exactly that.

Second, if the organisation does not respond appropriately, you can raise a formal complaint with the Financial Ombudsman Service (for financial providers), the Information Commissioner’s Office (for data protection issues), or the Equality and Human Rights Commission. Organisations such as Stonewall and TransActual can also provide guidance and support.

You should not have to fight for something this basic. The law is on your side.

Template letter: updating your records

Below is a template you can adapt for any organisation that is being unnecessarily obstructive. Replace the bracketed sections with your own details.

[Your name] [Your address] [Date]

[Organisation name] [Organisation address or email]

Dear Sir or Madam,

I am writing to formally request that my records with [organisation name] be updated to reflect my legal name and gender identity.

I legally changed my name by deed poll on [date], a copy of which I have already provided / attach to this letter. My current legal name is [your name]. I am a transgender woman / man / non-binary person and I have lived in my affirmed gender for [X] years.

I understand that some organisations request proof of identity when updating records of this nature. I am happy to provide reasonable documentation in support of this request. However, I want to be clear that I am not required by law to provide a Gender Recognition Certificate. The Gender Recognition Act 2004 does not make a GRC a prerequisite for updating personal records, and under the Equality Act 2010, I am entitled to protection from discrimination on the grounds of gender reassignment regardless of whether I hold a GRC.

Under the UK GDPR and the Data Protection Act 2018, you are required to ensure that the personal data you hold about me is accurate. Continuing to record my name or gender incorrectly, after I have made a valid request to update them, may constitute a breach of your data protection obligations.

I would be grateful if you would update my records as requested and confirm in writing that this has been done. If you require any further reasonable documentation, please specify exactly what is needed and the legal basis for that requirement.

I hope we can resolve this matter promptly and without the need for further escalation. If I do not receive a satisfactory response within 14 days, I will consider raising this matter with the relevant regulatory authority, including the Information Commissioner’s Office and, where appropriate, the Financial Ombudsman Service.

Yours faithfully,

[Your name] [Your contact details]

If this article has been helpful, please share it. There are trans people all over the country facing exactly this kind of unnecessary obstruction, and the more widely this information is shared, the more people it can reach.

Dr Helen Webberley, Gender Specialist and Medical Educator. www.helenwebberley.com

There is something quietly extraordinary about watching the world of sport tie itself in knots over who is and is not allowed to compete, while across the Mediterranean, a city is busy building something that looks a lot like the future. Valencia is preparing to host the Gay Games XII from 27 June to 4 July 2026, and I cannot tell you how much joy that gives me.

What sport has been getting wrong

Over the past few years, governing bodies in sport after sport have introduced policies that effectively exclude transgender women from female competition. The International Olympic Committee, World Athletics, World Aquatics, and others have each drawn their own lines, citing fairness and integrity, while trans athletes have been told, in effect, that there is no place for them at the table. The debate has often been framed as though inclusion and fairness are opposites, as though welcoming trans people into sport necessarily harms someone else. That framing is not only scientifically contested, it is deeply unkind, and it has left many trans and gender-diverse people feeling that sport is simply not for them.

What gets lost in all of this is the reason most people play sport in the first place. They play to feel their body move, to belong to a team, to challenge themselves, to make friends, to feel alive. None of those reasons have anything to do with genetics or testosterone levels. They are human reasons, and they deserve a human response.

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What Valencia is building instead

The Gay Games began in San Francisco in 1982, founded by Dr Tom Waddell, a former Olympic decathlete who believed that sport should be for everyone. The founding principle was simple and radical: participation over exclusion, joy over judgement, community over competition. More than four decades later, that principle is more relevant than ever.

Gay Games XII in Valencia will bring together thousands of participants from around the world across 39 sports, from swimming and athletics to fencing, figure skating, powerlifting, and padel. There is also a rich cultural programme alongside the sports, with choral festivals, film, fashion, art, and more. The Opening Ceremony will be spectacular. The Village will be full of people who came from every corner of the world to simply be themselves and compete.

Crucially, the Games are open to everyone. You do not need to identify as LGBTQIA+ to take part. You just need to want to be there.

Why this matters beyond sport

I want to be honest with you about why I find this so moving. When trans people are told, again and again, by institutions and governments and governing bodies, that they are a problem to be managed, that their bodies are a controversy, that their presence disrupts things, it takes a toll. It takes a toll on young people who are just starting to understand themselves. It takes a toll on adults who have spent years fighting for recognition. It takes a toll on families who just want their children to be able to live fully and freely.

Events like the Gay Games do not fix all of that. They are not a policy solution or a legal framework. What they are is a reminder: a reminder that belonging is possible, that joy is possible, that there are places in this world where you are not a debate or a disruption, but simply a person who showed up to play.

Valencia has long been a city of warmth and welcome. The fact that it will host these Games, with the full support of the Spanish government, the Generalitat Valenciana, and the city council, says something important about what sport can look like when institutions choose inclusion over exclusion.

Come and be part of it

If you have ever felt that sport was not for you, I want you to know that this is your invitation. Whether you are trans, non-binary, gender-questioning, or an ally who simply believes that everyone deserves to move their body in a space free from judgement, this is a place for you.

Registration is open now. You can find all the details, including the sports programme, cultural events, and travel information, at www.gaygamesvalencia2026.com. There are even scholarships available for those who need financial support to attend.

The world of mainstream sport is taking its time to get this right. While it figures things out, Valencia will be showing us all what is possible.

Please share this article with anyone who needs to hear that sport can be a place of welcome, not exclusion. Let us celebrate this together.

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Dr Helen Webberley, Gender Specialist and Medical Educator
www.helenwebberley.com

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There is something deeply uncomfortable about watching an organisation that was built on the radical idea that girls deserve equal opportunity being used to argue that some girls simply do not qualify. Sex Matters has been vocal, persistent, and strategic in its campaign to exclude trans girls from spaces like Girlguiding UK, and what troubles me most is not just what they are arguing, but the language they are using to do it. They frame exclusion as protection. They invoke girls’ happiness, girls’ safety, and girls’ sense of belonging to justify policies that actively harm girls, just not the girls they have chosen to count.

The History They Would Rather You Forgot

In 1909, a group of girls turned up to the first Scout rally at Crystal Palace, dressed in homemade Scout uniforms, and refused to leave. They had not been invited. They had not been included. They came anyway, because they believed they deserved to be there. Robert Baden-Powell eventually responded by creating the Girl Guides, and that founding story, girls pushing back against a boys-only world to claim their place, is not just historical trivia. It is the very DNA of the organisation.

Girlguiding was born from the refusal to accept that gender should be a barrier to adventure, friendship, and belonging. It was created because girls said: we are here, we matter, and we will not be left out.

Forgive me if I find it more than a little ironic that this same organisation is now being called upon to do exactly what its founders pushed back against. The difference is that now, the girls being left at the door are trans girls.

Whose Happiness Are We Really Talking About?

Sex Matters wants us to believe that this is about protecting girls, about preserving safe spaces, about ensuring that all girls feel comfortable. I want to take that argument seriously for a moment, because it deserves a careful and honest response.

The trans girls who want to attend Guides, earn their badges, go camping, build friendships, and develop their courage and curiosity are doing exactly what Girlguiding exists for. They are not a threat to that experience. They are part of it. The evidence does not support the idea that including trans girls harms other girls. What the evidence does tell us, consistently and clearly, is that excluding trans young people causes profound harm to those young people.

So when we talk about happiness, I need us to sit with that for a moment. Whose happiness is actually being prioritised here? The girls who are already inside, whose experience of Guides is not in any meaningful way changed by a trans girl earning her badge alongside them? Or the trans girls who are being told, at an age when belonging matters more than almost anything, that they do not count?

A Message to You, If You Are Reading This

If you are a trans girl, a trans teenager, or a young trans person who has been made to feel unwelcome, I want to speak to you directly for a moment.

What is happening right now is not a reflection of your worth. It is not evidence that you do not belong. It is the last loud gasp of a very small group of people who are frightened of a world that is bigger and more beautiful than they are willing to imagine. They do not speak for most people. They do not speak for the values that most of us hold about kindness, inclusion, and the simple human need to find your people and feel at home.

You are real. Your girlhood is real. Your desire for friendship, for adventure, for a community that sees you and celebrates you is as valid as anyone else’s. The world is changing, even when it feels impossibly slow. There are people in every corner of it who are fighting for you, who believe in you, and who will not stop.

You deserve a Brownie pack. You deserve a camping trip. You deserve a badge for something you worked hard at. You deserve every single thing that every other girl deserves, without condition and without apology.

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What We Should Be Saying to Girlguiding

Girlguiding UK has, at various points, tried to be inclusive. It has policies that attempt to navigate this space, and I am not here to say that Girlguiding is the enemy. What I am saying is that now, more than ever, is the time for organisations like this one to stand clearly on the side of all the girls they serve.

When external groups apply pressure, when campaigns are run to roll back inclusion, the response matters. Silence reads as acquiescence. A quiet retreat from inclusive policy, dressed up in careful language about reviewing guidance, tells every trans girl in your packs exactly where she stands.

Girlguiding was founded by girls who would not be silent. Girls who showed up when they were not wanted and demanded to be counted. You can honour that legacy, or you can betray it. There is no neutral ground here.

Stand up for all your girls. All of them.

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If this matters to you, please share it. Let the people around you know that this conversation is happening, and that there are voices pushing back. Every share, every comment, every quiet conversation at a school gate or in a staffroom is part of how we change things.

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Dr Helen Webberley

Gender Specialist and Medical Educator

www.helenwebberley.com

Think about a trans woman I know. She had finally found a GP she thought might be safe. She had an appointment booked. She Googled them first, the way most of us do, just to get a sense of who they are before walking through the door. She found a post on X. Her doctor had amplified a brand built on excluding trans women from sport, and added their own comment: “Only women are women.”

She cancelled the appointment.

She did not complain to anyone. She did not contact the GMC. She just quietly withdrew from care, the way so many trans people do, because the calculation of risk felt too exhausting to make again. That is the story I want to start with, because everything else in this article grows from that moment, that woman, that cancelled appointment, and the question of whether our professional frameworks have any answer to it.

What Dr Hoenderkamp Posted

This week, Dr Renée Hoenderkamp, a registered doctor with a significant public platform, shared a post from XX Athletics, a brand that explicitly positions itself around excluding trans women from women’s sport. She added the words:

“Only women are women.”

The post was public. The account is verified. The reach was considerable.

This is not a private belief held quietly. This is a doctor using their professional platform to signal, clearly and deliberately, that trans women are not women. The question I want to ask is not whether she has the right to hold that view. The question is what, if anything, the professional framework says about what happens when a patient sees it.

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What the GMC Guidance Actually Says

The GMC’s guidance on Personal Beliefs and Medical Practice is genuinely strong in many of the places that matter. Doctors must not impose their beliefs and values on patients, or cause distress by the inappropriate or insensitive expression of them. Doctors may choose to opt out of providing a particular procedure because of their personal beliefs and values, as long as this does not result in direct or indirect discrimination against, or harassment of, individual patients or groups of patients.

Inside a consultation, there is real weight in that. A doctor who tells a trans patient they do not accept their identity, who withholds care on the basis of that belief, who expresses disapproval in the room, is in direct breach of this guidance. That matters.

The Gap That the Guidance Has Not Closed

The question is, does the GMC’s Personal Beliefs and Medical Practice guidance relate only to professional practice, or does it cover people’s expression of their beliefs or values outside the workplace?

Can a doctor can post “Only women are women” on a public platform with hundreds of thousands of followers? Can they can amplify organisations built explicitly on the exclusion of trans people? Can they build a public identity rooted in the belief that trans women are not women? Is that, under the current guidance, directly within the GMC’s reach?

The woman who cancelled her appointment has no formal recourse based on what she saw online. The barrier to care she experienced was real. The harm was real. The guidance, as written, does not reach it.

Why This Is a Clinical Question, Not Just a Political One

I want to be precise here, because I think this matters. We are not talking about protecting people’s feelings, though feelings matter too. We are talking about clinical outcomes.

Trans people already face significant barriers to healthcare: higher rates of depression, anxiety, and self-harm, delayed presentations, avoidance of screening. A large part of that avoidance comes from fear of exactly what that woman experienced, a doctor whose beliefs will colour the consultation before a word has been spoken. When a doctor signals publicly that they do not accept trans people as who they are, that signal reaches patients. It reaches the teenager scrolling through X at midnight wondering if they are safe to ask their GP about hormones. It reaches the trans man who has been putting off a smear test for years because he cannot face the conversation. It reaches every trans person who is already doing that exhausting calculation.

Delayed and avoided care leads to worse outcomes. That is not opinion. The evidence is there. Public statements by doctors that cause trans patients to avoid care are therefore a clinical concern, and we need our professional frameworks to recognise them as such.

The Consultation That Is Open Right Now

The GMC has just launched a consultation on updated guidance, and this is the first significant update since 2013, intended to reflect legal, social and cultural changes in the years since. The consultation is open until Thursday 11 June 2026.

We’ve got to use it.

Trans people, their families, clinicians who work in this space, anyone who has ever sat with a patient who cancelled because they were afraid: there is a window, open right now, to say directly to the GMC that the gap between clinical and public behaviour matters. That what a doctor says on social media shapes whether a patient feels safe walking through their door. That professional standards need to meet the reality of a world where a doctor’s public platform is not separate from their clinical identity.

What Good Guidance Would Say

It would not silence doctors. It would not prevent them from holding beliefs or expressing them in personal contexts. What it would do is acknowledge that a doctor with a public platform, speaking in a capacity that references their professional identity, is not entirely off duty. Their words shape public trust in medicine. Their words reach patients.

Good guidance would say that a doctor whose public statements about a protected characteristic are likely to cause a reasonable patient from that group to fear or avoid care has fallen below the standard of professional conduct we expect. The Human Rights Act provides an absolute right as far as holding a belief is concerned, but the right to act on beliefs cannot be used to support an action that infringes the rights and freedoms of others. A public statement that drives trans patients away from healthcare is, in the most literal sense, an infringement of their right to access care.

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A Note on What This Is Really About

I am not writing this to pursue one doctor. I am writing this because this is not one doctor. There are doctors with platforms built on questioning trans identity, doctors who appear on television as medical voices while holding views that trans patients would find alarming, and reasonably so. The professional framework has not kept pace with the world in which doctors now operate.

The question is not whether any individual should face consequences. The question is whether a trans patient who has seen that post can trust that the system will protect them. Right now, the honest answer is: not fully. That needs to change, and the consultation that is open right now is the place to start saying so.

The future for trans patients getting fair, safe, compassionate care from every doctor they see is coming. The guidance just needs to catch up with what good medicine already knows.

If this matters to you, please share it. The more voices that reach the GMC before 11 June, the better.

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Dr Helen Webberley, Gender Specialist and Medical Educator

www.helenwebberley.com

Resources and Further Reading

GMC Personal Beliefs and Medical Practice guidance: gmc-uk.org

GMC Personal Beliefs consultation (open until 11 June 2026): gmc-uk.org/news

Dr Hoenderkamp’s post on X: x.com/drhoenderkamp

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Every Human Decision Carries the Possibility of Regret

Regret is woven into the fabric of human life. We ponder the jobs we took, and the ones we turned down. We wonder about the relationships we stayed in too long, and the ones we walked away from too soon. We think about the things we said, and the things we held back. We ask ourselves what might have been if we had taken a different road at a particular moment. That kind of questioning is not a sign of having failed. It is a sign of being alive, and of caring deeply about the life we are living.

In the context of gender transition, regret can take many forms, and it is important that we try to understand all of them rather than reaching for the ones that support a particular argument. There is regret about medicines taken, and regret about medicines not taken. There is regret about having had puberty blockers, and wondering what the path might have looked like without them. There is regret about surgery, or about the outcomes of surgery not matching what was hoped for. There is the profound hope that hormones would bring a kind of second puberty, that you would be able to move through the world as the person you know yourself to be, and the regret that sometimes follows when the experience does not quite match the hope.

There is also regret that has nothing to do with medicine at all. The regret of a life changed in ways you did not fully anticipate: friendships lost, family members who stepped away, a social circle that reformed around you in unexpected ways, a working life or a daily life that felt unfamiliar for a time. All of these are real. All of them deserve our attention and our compassion. None of them should be used as a reason to withhold care from everyone else.

The Part We Talk About Too Little: Non-Binary Identities and How Gender Understanding Evolves

One of the things that makes regret so complex in this space is that our understanding of our own gender identity does not arrive fully formed. For many people, the first realisation that their gender is different from the one they were assigned at birth comes with an assumption: that if they are not the gender they were assigned, they must be the other one. That is an understandable assumption, because it reflects the binary world most of us have grown up in.

The reality is far richer and more varied than that. Non-binary and agender identities, where a person sits somewhere other than clearly male or clearly female, perhaps somewhere along a broad and shifting spectrum, are not well understood and are very little spoken about. Someone discovering their gender identity for the first time may not even know that the full spectrum exists, let alone have any sense of where they sit on it. It might feel like a 50/50 split, or something more like 30/70, or something else again entirely. There is no single destination that is correct, and there is no timeline by which someone must have arrived.

If someone took steps to align with what they understood their gender identity to be, and later found that their understanding of themselves had evolved, that is not a failure on anyone’s part. It is a reflection of how understanding our gender identity works: it develops over time, through lived experience, through the way the world responds to us, through the way we see ourselves in different relationships and different contexts. The care we offer needs to be able to hold that complexity, and to support people through the evolution of that understanding, rather than treating any single moment of decision as the only moment that matters.

The People Around You, and the Weight They Carry

Regret does not only belong to the person who transitioned. It can reach the people around them too, and this is something we do not talk about nearly enough.

If you supported someone through their transition as a parent, a partner, a sibling, a friend, or a professional, and that person later experienced regret about some element of what happened, you may find yourself carrying a weight that is difficult to name. You may find yourself wondering whether you asked enough questions, whether you were too encouraging or not encouraging enough, whether your support was the right kind of support.

Please hear this clearly: supporting someone who comes to you with a trans identity is always the right thing to do. Going through it together, asking questions, talking to specialists, taking the time to understand what your person genuinely needs, all of that is what good and loving support looks like. If the outcome was not what either of you hoped for, that is not a reflection of your love being misplaced or your judgement being poor. It means that you are human, that the person you love is human, and that life does not always follow the path we mapped out for it.

The support that is needed when regret appears is not different in kind from the support that was needed at the very beginning. It is about sitting alongside someone, working out what comes next, understanding what changes might help, whether that means adjusting or stopping medicines, exploring what reversal might look like, or simply finding a way to live more comfortably and more honestly in a different relationship with gender identity. The journey continues, and so does the need for care.

Moving Forward From Regret, Not Away From It

Regret is not the end of the story. It is a signal, a message from your own inner life that something needs attention or that something needs to change. The question it is really asking is not a harsh one. It is not asking why you did what you did. It is asking something much kinder: what do we do now, and how do we get there together?

Finding the right support in those moments matters enormously. Someone who genuinely understands gender-affirming care, who knows the medical and psychological landscape, who comes to the conversation without judgement and with a genuine desire to help, can make a profound difference to someone navigating this kind of regret. This is not about blame, and it is not about anyone having got it badly wrong. It is about continuing to move towards a life that fits.

Gender incongruence is very real. The distress it causes is very real. The decisions people make in response to it are made in good faith, with the knowledge available at the time, and with a deep and genuine desire to live more fully and more authentically. When those decisions bring some regret alongside them, that does not mean the care was wrong. It does not mean the person was wrong. It means they are human, doing the best they can in a world that does not yet fully understand them, and they deserve our continued compassion and our continued support.

I really hope this is helpful to you, wherever you are in your own journey, or in the journey of someone you love.

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If this resonated with you, please do share it with someone who might need to read it. You can leave a comment below, share it or keep the conversation going on whichever platform feels right to you.

Resources

How Many People Detransition? Exploring Detransition – Jack Turban

Factors Leading to “Detransition” Among Transgender and Gender Diverse People in the United States: A Mixed-Methods Analysis

Dr Helen Webberley | Gender Specialist and Medical Educator

www.helenwebberley.com

Please feel free to share your thoughts in the comments or as a Note, Article or Restack, or keep the conversation going on other platforms.

One of the questions I receive most often, from trans women, from parents of trans young people, and from people who are simply curious about their own bodies, is about breast shape. Specifically, people want to know whether a conical or pointed breast shape is normal, whether it means development has not finished, and what it might mean for someone who is taking gender-affirming hormones. It is a really important question, and it deserves a thoughtful, evidence-based answer, because there is a lot of confusion out there and quite a bit of unnecessary worry.

So let me walk you through what the science actually tells us, covering how breasts develop in everyone, what a conical shape means, and what trans women and trans young people can expect when oestrogen is part of their care.

The Five Stages of Breast Development

Breast development follows a well-established sequence that was described by Professor James Tanner in the 1960s and has been used in clinical practice ever since. These five Tanner stages give us a shared language for understanding where someone is in the process of development, and they apply whether that development is happening because of natural puberty or because of gender-affirming hormone therapy.

Stage 1 is the pre-pubertal stage, where the chest is flat and no breast tissue has yet formed. Stage 2 is the beginning of development, when breast buds appear as small, firm mounds beneath the nipple and areola. This is usually when tenderness and some itching begin, as the tissue starts to grow. Stage 3 is when the breasts begin to enlarge more noticeably, with the glandular tissue and fatty tissue both increasing. At this stage, the shape is often described as conical or pointed rather than round. Stage 4 brings a further projection of the nipple and areola, which form what is sometimes described as a secondary mound on top of the breast. Stage 5 is the mature stage, where the breast takes on a rounder, fuller shape and the areola settles back flush with the breast contour.

The key thing to understand here is that the conical shape at Stage 3 is entirely normal. It is not a sign that something has gone wrong. It is simply where most people sit for a period of time during their development, and for many people, including many cisgender women, it can feel like quite a long wait before the breast rounds out into its adult shape.

When the Conical Shape Stays

For most people going through a typical female puberty, development progresses through all five Tanner stages over several years, with the breasts becoming rounder and fuller as time passes. The whole process from the first breast bud to full maturity can take anywhere from two to five years, and it is not unusual for development to feel uneven or asymmetrical along the way.

For some cisgender women, however, the breasts do not round out as fully as expected. This is sometimes described as tubular or tuberous breast shape, and it happens when the connective tissue around the base of the breast restricts the normal outward expansion of breast tissue. The breast stays narrower at the base and retains more of a conical or elongated appearance. This is a variation in development rather than a disease, and while it can cause real emotional distress and body image difficulties, it does not represent a health risk.

It is worth noting because many trans women and trans girls describe a shape that sounds very similar, and understanding the underlying biology helps make sense of what is happening and why.

Breast Development in Trans Women on Oestrogen

When a trans woman begins gender-affirming hormone therapy, her breast development follows the same Tanner stages as in cisgender puberty. The tissue that develops is anatomically and histologically identical to that of cisgender women, including the formation of lobules and ducts. This is not some approximation of female breast tissue: it is female breast tissue, responding to female hormones.

The timeline is also similar to natural puberty. Breast buds typically become palpable beneath the areola within three to six months of starting oestrogen, and most of the growth that will occur takes place within the first two years of treatment. One large prospective study involving 229 trans women across European gender clinics found that the main period of breast growth occurred within the first six months of hormone therapy, with the development curve flattening out after that.

The most important thing to understand about breast development in trans women, though, is that many trans women plateau at Tanner Stage 3. This is the conical or pointed stage. Most trans women are unlikely to reach Tanner Stage 5 through hormone therapy alone, without surgical augmentation. Research consistently shows that breast volume in trans women, while real and meaningful, tends to be smaller than in many cisgender women. A prospective multicenter study found that after one year of hormone therapy, nearly half of participants had a bra cup size of less than an AAA cup, with only around ten percent reaching an A cup or larger.

There are several reasons for this. One is that exposure to testosterone during male puberty may induce structural changes that limit how fully breast tissue subsequently develops in response to oestrogen. Another is that the wider ribcage and shoulder structure that many trans women have means that even where breast volume is comparable to that of many cisgender women, the breasts may appear smaller because they are distributed across a broader frame.

This is not a failure of treatment. It is simply biology, and it is something that every trans woman deserves to know about and be supported through, rather than being left to discover it on her own with no context.

What About Oestrogen Dose and Timing?

One question that comes up regularly is whether taking a higher dose of oestrogen will result in more breast growth. The evidence here is actually quite nuanced. Several studies have found that the final breast volume does not appear to be strongly correlated with the dose or type of oestrogen used. What does seem to matter is avoiding very high doses in the early stages of treatment, because there is evidence from research in related conditions such as Turner syndrome that too much oestrogen too soon can actually limit ductal branching and result in development that plateaus at an earlier Tanner stage.

This is one of the reasons why good clinical practice involves starting with lower doses and gradually increasing them, mimicking as closely as possible the hormonal pattern of natural puberty. Rushing the process is counterproductive, and self-medicating with very high doses outside of medical supervision carries real risks, including the risk of limiting the very development someone is hoping to achieve.

Trans Young People and Gender-Affirming Care

For trans girls and trans young people who are assigned male at birth and are beginning gender-affirming care, there is understandable hope that early intervention will lead to more complete breast development. The picture here is genuinely complex.

Puberty-pausing medications, known as GnRH agonists, can be started at Tanner Stage 2 to prevent the progression of unwanted masculinising changes. When a trans girl then begins oestrogen, breast development proceeds in the same way as in cisgender female puberty, following the Tanner stages from Stage 2 onwards. One study observed breast development to Tanner Stage 3 after two years of hormone therapy in trans girls, which aligns with what we see in cisgender puberty over a similar timeframe.

A careful study measuring breast volume using three-dimensional scanning in trans women found that those who had begun puberty suppression early in puberty, at Tanner Stage G2 or G3, did not have significantly different breast volumes from those who had started suppression later or who had begun hormone therapy as adults. The researchers adjusted carefully for differences in body composition, and once those adjustments were made, the differences were very small. This is an important finding: it suggests that while timing of treatment matters for many other aspects of wellbeing and physical development, breast volume may be influenced by factors that remain partly independent of when hormonal treatment begins.

What we do know is that beginning gender-affirming care before irreversible masculinising changes occur has profound benefits for the mental health and wellbeing of trans young people. The evidence on this is clear and consistent.

Does Progesterone Help with Breast Shape?

Progesterone is a topic that comes up a great deal in trans healthcare communities, with many trans women reporting that adding progesterone to their hormone regimen seemed to help their breasts move from a conical shape towards a rounder, fuller appearance. This is a genuinely interesting observation, and it reflects what progesterone does biologically: in cisgender female development, progesterone is involved in the maturation and differentiation of breast tissue, which is part of the transition from the earlier conical Tanner stages to the rounder mature form.

The clinical evidence, however, is mixed. Most formal studies have not demonstrated a significant effect of progesterone on breast volume in trans women, and the Endocrine Society guidelines note that current evidence neither supports nor definitively rules out a benefit. The honest answer is that we do not yet have the high-quality data to be certain, and for many individuals the question remains open. If you are considering progesterone as part of your care, this is a conversation to have with your prescriber, weighing the potential benefits against the known risks, which include effects on mood and cardiovascular markers in some people.

Body Image, Emotional Wellbeing, and Finding Support

Whatever the physical outcome of breast development, the emotional experience of watching your body change, or not changing as quickly or fully as you had hoped, is significant and real. Trans women who are dissatisfied with their breast development have options, including surgical augmentation, which is the most commonly pursued gender-affirming surgical procedure. Around sixty percent of trans women eventually seek augmentation, and satisfaction rates are generally reported as very high.

For those who are not seeking surgery, or who are not yet at that stage, understanding what is happening and why can make a meaningful difference. Knowing that a conical shape is not a sign that something has gone wrong, but rather that development is sitting at a particular Tanner stage, can be genuinely reassuring. It does not make the dysphoria disappear, and I am not suggesting it should. What it does is give you accurate information, and accurate information is the foundation of good self-advocacy and good healthcare.

I also want to say clearly: whatever shape your breasts are, that shape is yours. Your body is doing something extraordinary in responding to hormones and creating tissue that reflects who you are. That matters, even when it does not feel like enough.

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Resources

• De Blok, C.J.M. et al. (2018). Breast Development in Transwomen After 1 Year of Cross-Sex Hormone Therapy: Results of a Prospective Multicenter Study. Journal of Clinical Endocrinology and Metabolism, 103(2), 532-538.

• Wierckx, K., Gooren, L. and T’Sjoen, G. (2014). Clinical Review: Breast Development in Trans Women Receiving Cross-Sex Hormones. Journal of Sexual Medicine, 11(5), 1240-1247.

• De Blok, C.J.M. et al. (2025). Variations in Volume: Breast Size in Trans Women in Relation to Timing of Testosterone Suppression. Journal of Clinical Endocrinology and Metabolism, 110(5).

• Patel, H. et al. (2021). Chest Feminization in Male-to-Female Transgender Patients: A Review of Options. Transgender Health, 6(5), 244-255.

• Hembree, W.C. et al. (2017). Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. Journal of Clinical Endocrinology and Metabolism, 102(11).

• Marshall, W.A. and Tanner, J.M. (1969). Variations in Pattern of Pubertal Changes in Girls. Archives of Disease in Childhood, 44(235), 291-303.

If this article has been useful to you, please share it with someone who might need it. The more people understand about how bodies work and what to expect from gender-affirming care, the better equipped everyone is to have the conversations that matter.

Dr Helen Webberley | Gender Specialist and Medical Educator

www.helenwebberley.com

Dear Secretary of State,

I listened to your recent appearance on LBC’s Call The Cabinet with Nick Ferrari, and I want to write to you in the spirit of genuine support rather than criticism. Gender in schools is a topic that deserves more clarity than it tends to get in a live radio interview, and I believe I can help you with that.

I am Dr Helen Webberley, a gender specialist and medical educator with more than thirty years of experience in medicine. Much of that time has been spent working with transgender children, young people, and their families. I know this territory well, and I know how much it matters to get it right.

Start with what we know

Transgender adults exist. That is not in dispute. Every transgender adult was once a child. That means transgender children exist too, and they are sitting in classrooms right now, in primary schools and secondary schools across this country.

Once we accept that, the path forward becomes much clearer. We do not need two different approaches, one for children who are exploring their gender and another for children who are transgender. We need one approach: see the child in front of you, hear what they are telling you, and support them as an individual. That is what good teaching already looks like, and it is also what the law already requires.

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The law is already clear

The Equality Act 2010 says that we cannot treat a child less favourably because of a protected characteristic. Gender reassignment is one of those characteristics, and it applies to children in schools.

Think of it this way. No school would call a child by the wrong name. No teacher would deliberately use the wrong pronouns. No policy would send a child to facilities that do not match who they are. We would recognise all of that as unkind and wrong. The Equality Act means that standard applies equally to transgender children. Not as a special rule for a special group, but as the same basic dignity that every child in every school has a right to expect.

The draft school guidance needs to say this clearly. Teachers deserve to know that supporting a transgender child is not only the right thing to do but also the legally correct one.

On boys and dresses

During the interview, Nick Ferrari asked whether a five-year-old boy could decide to wear a dress. I want to gently suggest that this question has a simpler answer than the debate around it implies.

For most of human history, it would not have been a question at all. Boys wore skirted garments as standard childhood dress for centuries. Shakespeare wrote tenderly about his own memory of being a small boy dressed before the age of breeching. The idea that distinctly gendered clothing for young children is somehow natural or traditional is, in fact, a product of the nineteenth century, shaped by things like the rise of Muscular Christianity and anxieties about national military strength after wars in Prussia and South Africa. It was ideology that changed what children wore, not nature.

A child who wants to wear a dress is exploring the world, which is what children do. There is no safeguarding concern in that. There is no policy problem in that. The anxiety that surrounds the question belongs to adults, and it should not be the thing that shapes guidance affecting children’s lives.

One approach, not two

Some children will be exploring their gender and working out who they are. Some will already know clearly and have known for some time. Rather than trying to work out which category a child belongs to before deciding how to treat them, schools simply need to listen to the individual child in front of them and respond with care.

The child who is exploring needs space, warmth, and freedom from pressure in any direction. The child who is transgender needs to be seen and supported as they are. Both of these things can be offered within a single, child-centred framework, and good guidance will give teachers the confidence to provide that support without fear.

Hearing parents, protecting children

When other parents have concerns or anxieties, those should be heard. They are often genuine, even when they come from unfamiliarity rather than evidence of harm, and schools can usually find practical ways to accommodate them.

There is one limit, though, and it is an important one. Another parent’s concerns cannot come at the cost of a transgender child’s dignity or safety. If a parent objects to their child being in school with a transgender child, that parent can be heard and offered alternatives where those are feasible. What cannot happen is that the transgender child is the one who is asked to hide, or to be treated differently, or to feel unwelcome. They are someone’s child too.

The Cass Review was about NHS services, not schools

You cited the Cass Review during the interview as supporting the current approach in schools. I want to offer some important context here, because it matters for how it is used.

The Cass Review was commissioned by NHS England and NHS Improvement to make recommendations about NHS healthcare services for children experiencing gender incongruence. That was its specific brief. It was never about schools. It was never about education. It was not commissioned to advise teachers or to provide a framework for school guidance. Its terms of reference confirm this clearly.

Dr Cass herself has said she does not hold specialist expertise in gender medicine, and the review has attracted serious criticism from major international medical associations. Using it as the primary basis for school guidance means building policy on something that was never designed for that purpose. There are better sources to draw on, and they point in a clearer direction.

What the evidence says

The NSPCC, whose expertise in safeguarding is beyond question, is clear that understanding identity, including gender identity, is a normal and important part of growing up, and that young people need support and empowerment through that process, not restriction or surveillance.

The World Professional Association for Transgender Health states in its Standards of Care that social support, sometimes called social transition, can help children understand and explore their gender as they grow up, and that this is endorsed by major medical associations. Social transition is not a medical intervention. It does not require a referral, a prescription, or any clinical involvement. It simply means being called by a name that fits, being addressed with the right pronouns, and being seen as who you are. The evidence for its benefit to children’s mental health is clear and consistent.

A note on parental involvement and safety

You spoke during the interview about the importance of involving parents, and in most cases I agree with you completely. Families are usually the greatest advocates a child has, and working with parents is almost always the right approach.

There is one important exception that the guidance must acknowledge. For some transgender children, telling their parents is not safe. There are families where that information is met with rejection or harm. A policy that requires schools to notify parents without any consideration of the individual child’s safety is not a safeguarding policy in those situations. It is a risk. Real safeguarding means listening to the child and understanding what is safe for this particular person, not applying a blanket rule that could put the most vulnerable children in greater danger.

What teachers need from you

The teachers I know are not asking for political guidance on gender. They are asking for something much simpler: clarity and confidence. They want to know that when they listen to a child, use the name that child has asked for, and treat them with respect, they are doing the right thing. They want to know the law is on their side and that they will not be penalised for treating every child with equal dignity.

Guidance that creates doubt leaves the most vulnerable children depending on the goodwill of individuals rather than the protection of clear, consistent policy. Teachers deserve better than that. The children they care for deserve better than that.

An offer

I am writing this letter because I believe you want to do right by children, and because I think I can help. The legal framework is already there. The evidence is already there. The guidance that schools need is within reach.

I would very much welcome the opportunity to speak with you or your team, and I make that offer openly and genuinely. The children in our schools need to feel safe and to know that the adults around them are on their side. With the right guidance, every teacher in every school can offer them that.

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Yours sincerely,

Dr Helen Webberley

Gender Specialist and Medical Educator

www.helenwebberley.com

References

Equality Act 2010, Section 7: Gender Reassignment

Keeping Children Safe in Education 2025 (statutory guidance)

Cass Review Terms of Reference

NSPCC: Young people, challenges around sexuality and gender identity (March 2024)

WPATH Standards of Care v8 FAQs

Why Boys Stopped Wearing Dresses: Historical Clothing

Read more

I have been sitting with the Cosmopolitan feature for a few days now, going back to it, reading a passage here and there. It is a remarkable piece of journalism: thirteen people, each with their own story, each with their own way of describing what the past year has felt like since the UK Supreme Court ruled in April 2025 that, for the purposes of the Equality Act, a person’s sex is their biological sex as recorded on their original birth certificate. The pain in some of those accounts is real and I do not want to gloss over it. People have been anxious, isolated, and frightened. Some have taken time off work. Some have changed the way they move through the world entirely.

But something else kept catching my eye. Something that I think deserves to be lifted up and looked at carefully, because in times like these it is very easy to miss it. Between every story of fear and hardship, there was something quieter and more enduring: the extraordinary, stubborn, beautiful fact of people living as themselves.

That is what I want to talk about today.

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First, a word about the ruling itself

I want to be clear, because clarity matters here. The Supreme Court did not define what a woman is. It ruled that, for the specific purposes of the Equality Act, the word ‘sex’ refers to biological sex. That is a legal distinction with real-world consequences, and those consequences are still unfolding. Most public bodies are still waiting for guidance from the Equality and Human Rights Commission on how to implement the ruling. Trans people remain protected under the Equality Act against discrimination and harassment: that has not changed.

The uncertainty, as the Cosmopolitan feature makes clear, has created its own kind of harm. When things are unclear, it is often the most vulnerable people who fall through the gaps. I hold that knowledge carefully alongside everything else I am about to say.

Thirty years of hiding, then four years of love

The story that stopped me completely was Alexis’s. She came out as transgender at fifteen. She was on the path to hormones when society’s weight pressed down on her and she pulled back. Over the next twelve years she built a dancing career, travelled the world, and eventually fell in love with Liam, who proposed just months before she finally told him who she truly was.

His response, when she told him? He said, ‘Okay, how do we make that happen?’ They were married last year. The day the ruling was announced, Alexis was planning her wedding.

In the feature she says this, and I find it one of the most powerful things I have read in a long time: she spent thirty years hating herself, and the past four years made her love herself. No one, she says, can undo everything she has done to get here.

No one can undo that. Not a court ruling. Not hostile legislation. Not any amount of noise in the media. Those four years happened. That love is real. That wedding day was real. Liam, speaking about their life together, says simply that they are a normal Yorkshire couple, and he wants people to look at them and think: ‘Oh, so people like that exist. Maybe we should not be scared.’

The defiance of living fully and loudly

Jude, an artist from Leeds in her twenties, responded to the ruling in a way I find quietly magnificent. She cut her waist-length hair into a flapper-style bob, pushed forward more publicly with her art, and refused to be driven back into conformity. When high-profile anti-trans figures began targeting her work, she did not disappear. She carried on.

She talks about a saying in the vintage community: ‘vintage style, not vintage values.’ You can appreciate the aesthetics of the past while rejecting its bigotry. She points to anarchist, communist, and punk movements as precedents. Her position is that if the people who harass us drive us back into lives of conformity and fear, then they have won. So she carries on, making her art, wearing her clothes, being herself. There is real wisdom in that, and real courage.

Community is not a comfort: it is a force

Munroe Bergdorf has been watching these patterns for sixteen years since her transition. She says the ruling was a wake-up call: we in the UK have grown up with an arrogance about our rights, an assumption that they will simply always be there. She is clear-eyed about the tactics being used against the trans community, and equally clear-eyed about the response. London Trans Pride is now the largest Trans Pride in the world. The community, she says, is more organised and more empathetic than ever.

Alexandra Parmar-Yee, who experienced transphobic abuse on the Tube in the immediate aftermath of the judgment, channelled her anger into action. She organised a mass lobby of Parliament in June 2025, bringing nine hundred trans people and allies face to face with their MPs. She believes it was the largest lobby of its kind in history. She changed her middle name to her late mother’s, carries her spirit with her, and keeps working. Her motivation is not rage, it is love and determination, a commitment to doing everything she can to work towards hope.

Joy is not naive: it is an act of resistance

Nyongbella, who appeared on Drag Race UK, speaks about something that resonates deeply with me. She says that it can get to even the strongest of people, and it is okay to admit that. Then she adds this: she has found that looking for the joys in life, day to day, making life worth living, helps her to persevere. She knows that the best day of her life is yet to come.

She is not pretending things are fine when they are not. She is doing something much harder: holding the difficulty and the joy at the same time, and choosing to orient herself towards the future. That is not naive. In the context of what trans people are living through right now, it is one of the most radical and courageous things a person can do.

A message to young trans people

Ella Morgan, who has appeared on multiple television programmes and is a charity patron for Switchboard LGBT+, addresses young trans people directly in the feature. She speaks honestly about her own struggles over the past year, including the return of an eating disorder she thought she had left behind, and the anxiety of not knowing where she was allowed to go. Then she says something I want every young trans person to hear.

Wherever your transition takes you, she says, physically, spiritually, mentally: never give up. There are always going to be people who are against you. There are also so many people who will be there for you, who will support you and build you up. It is so much better to get to live your life as your true self than to spend it hiding and fearing who you are.

I could not have said it better myself, and I have been trying to say something like it for thirty years as a doctor. Living as yourself is not a luxury or a privilege. It is a human need. When that need is met, people flourish. When it is suppressed, people suffer. The evidence for this is not abstract: it is in the faces and the words of these thirteen people.

What this feature means to me as a doctor

I spent a decade in gender healthcare. The thread that runs through every single consultation I ever had is this: when people are allowed to live as themselves, their health improves, their relationships improve, and their capacity for joy returns. When they are prevented from doing so, everything suffers.

The Cosmopolitan feature is not a collection of statistics. It is thirteen human beings telling us, in their own words, what it feels like to live through a period of profound uncertainty and hostility, and what it feels like to keep going anyway. As a doctor and as a human being, I am grateful to each of them for speaking.

I am also grateful to Cosmopolitan for commissioning it. In a media landscape that often treats trans lives as a debate to be had rather than a reality to be witnessed, this feature does something genuinely valuable: it lets trans people speak in their own voices, without filtering or framing. More of that, please.

To you, reading this

If you are trans and reading this, I want you to know that you are seen, and your life matters. The world is telling a very loud story about you right now, and a great deal of that story is wrong. The quiet, true story, the one in these thirteen lives, is about love and courage and the extraordinary stubbornness of people who know who they are.

If you are an ally reading this, thank you for being here. Please keep talking about these stories. Share this feature. Share the Cosmopolitan piece. Let people who have never met a trans person hear from thirteen of them at once. Zelah Glasson, who was the first trans man cast in the ITV reboot of Big Brother, puts it beautifully: when you sit down with someone and listen to them, beliefs can start to shift. Television, journalism, conversations between friends, all of it matters.

The truth always wins. It just sometimes needs more voices to carry it.

With love,

Dr Helen Webberley

Gender Specialist and Medical Educator

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Resources

Cosmopolitan UK: ‘One Year On: 13 people on the ruling that changed their lives’ by Catriona Innes and Eli Cugini (5 March 2026)

Switchboard LGBTQIA+ national support line: 0800 0119 100 or switchboard.lgbt

Trans+ Solidarity Alliance: lobbying and community advocacy for trans rights

The Trevor Project research on anti-trans legislation and youth mental health

A 90-day public consultation opened on 9 March 2026 with a proposal that could permanently reshape gender-affirming care for trans young people in England. NHS England has published a draft Clinical Commissioning Policy Proposition that would remove access to masculinising and feminising hormones for every new patient under 18 seeking care through the NHS Children and Young People’s Gender Service. If adopted, this policy would leave trans young people in England with no medical pathway to physical transition until they reach adulthood. I have read the full policy document carefully, and in this review I want to walk you through what it actually says, where the evidence really stands, and what you can do before the consultation closes on 7 June 2026.

🔴 Complete removal of access to new hormone prescriptions for all under-18s, with no clinical pathway offered as an alternative.

🔴 Evidence reviews used a PICO framework so narrow that most of the international research base was excluded before quality assessment began.

🔴 Policy is underpinned by the post-Cass 2024 restrictions; the Cass Review is methodologically discredited and not accepted by international clinical bodies.

🔴 No acknowledgement of the substantial evidence that withholding gender-affirming care causes psychological harm to trans young people.

🔴 No fixed policy review date; revision depends only on NHS England receiving information that indicates a review is needed.

🔴 Existing patients aged 16 and 17 must engage in a formal discussion framed around ‘limited evidence’ and ‘potential adverse outcomes’ as a condition of continuing their current treatment.

🟠 Young people aged 16 and 17 already on treatment can continue, but the continuation process is conditional and the language used may be distressing.

🟠 The 90-day consultation allows for public response, though how responses will be weighted against conclusions already reached by the policy working group is not explained.

🟠 Psychosocial support is noted as the primary approach for young people in the service, but no detail is given about what is available or current waiting times.

🟢 A public consultation exists, providing a formal opportunity for trans young people, families, clinicians, and advocates to submit evidence and views.

🟢 Young people currently on NHS treatment are not immediately removed from their prescriptions.

🟢 The policy uses the current ICD-11 classification, which places gender incongruence under conditions related to sexual health, not mental disorders.

Key: 🔴 Restrictive 🟠 Limited or conditional 🟢 Supportive

What This Policy Actually Proposes

NHS England’s draft proposition states clearly that feminising and masculinising (MAF) hormones are not recommended as a routine commissioning treatment option for children and young people under 18. The policy would supersede the current arrangements, which were themselves only introduced in 2024 in immediate response to the Cass Review, and which already restrict hormone prescribing to those aged 16 and 17 with persistent gender dysphoria, requiring national Multi-Disciplinary Team (MDT) endorsement for every single referral.

This new proposal goes considerably further. It would close access entirely to new prescriptions, regardless of a young person’s clinical presentation, the views of their treating clinician, or any individual assessment of their needs. The phrase used in the commissioning position is worth reading carefully: ‘Feminising and masculinising medicines are not available as a routine commissioning treatment option for treatment of children and young people under 18 years who have gender incongruence.’

There is a transition arrangement for young people who are already receiving treatment. Those aged 16 and 17 who have an existing NHS prescription may continue, but only if their lead clinician, the young person themselves, and their parent or guardian all agree in writing that continuation is in their best interests. This written agreement must follow a formal discussion about what the policy describes as the limited evidence about safety, benefits and risks, and a discussion about potential adverse outcomes. The framing of that requirement matters, and I will return to it.

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How the Evidence Was Reviewed

The policy rests on two independent evidence reviews, commissioned by NHS England and conducted by Solutions for Public Health in 2026. Both reviews used a PICO framework, which stands for Population, Intervention, Comparator, and Outcomes. This is a standard methodological tool in evidence-based medicine, and it is a reasonable approach when the criteria are set appropriately.

The concern here is that the PICO criteria were drawn very narrowly. Looking at the volume of papers excluded at the title and abstract screening stage alone gives a sense of how much of the international evidence base was set aside before any quality assessment took place. The reviews categorised the evidence across ten subcategories covering different combinations of medication, gender identity, and transition goal. In eight of those ten categories, the conclusion was that no evidence was returned within the PICO criteria. In the remaining two categories, covering oestrogen or testosterone for binary transition in adolescents, the conclusion was weak evidence of benefit.

It is important to be precise about what that means. An absence of evidence within a narrow methodological framework is not the same as evidence that the treatment is ineffective or unsafe. The global clinical consensus from the World Professional Association for Transgender Health (WPATH), the Endocrine Society, the American Academy of Pediatrics, and numerous other professional bodies continues to support gender-affirming hormones for adolescents as clinically appropriate care, based on decades of research and clinical experience. The evidence exists. The question is whether the framework used in these reviews was designed to find it.

The policy also cites the Cass Review, published in 2024, as the basis for the immediate interim restrictions that preceded this proposal. The Cass Review has been the subject of sustained and serious international scrutiny. A systematic re-analysis of its methodology and conclusions identified significant concerns about how the evidence was interpreted and which research was included. International clinical organisations have formally declined to adopt its recommendations. The Cass Review cannot be treated as a reliable or neutral foundation for a policy of this significance, and this review reflects that position clearly.

The Traffic Light Assessment in Detail

The table above provides an at-a-glance overview. Here is more detail on each area.

Under the red category, the most fundamental concern is that the policy removes access to treatment for all new patients under 18, without offering any alternative clinical pathway. A trans young person presenting to the NHS gender service who would previously have been considered for hormones now has no route to that care within the NHS. There is no individualised assessment process that could lead to a different outcome, no bridging arrangement, and no indication of when or whether that might change.

The evidence review methodology is a further serious concern. The PICO criteria were specific to the point of exclusivity, and the resulting evidence base does not reflect the full body of international research. The Taylor et al (2024) systematic review, which is cited in the policy’s own references, identified evidence of benefit in adolescents undergoing binary transition with oestrogen or testosterone. That finding is technically acknowledged in Category B of the evidence summary, but the overall policy conclusion does not reflect its significance.

The requirement for existing patients to engage in a formal discussion framed around limited evidence and potential adverse outcomes before they can continue their current prescription is also a red-category concern. These young people are already in clinical care. They and their families have made informed decisions with their treating clinicians. Imposing this requirement as a condition of continuation risks causing real psychological harm and may undermine the therapeutic relationship.

Under the amber category, the continuation arrangement for existing patients is a partial protection, but it comes with conditions that may not be easy to navigate. The 90-day consultation is a meaningful mechanism, but the fact that a policy working group has already reached its conclusions and that the policy has been published in draft form means the bar for reversal is high, and the process for weighing public responses against prior work is not explained.

The green category reflects some genuinely positive elements. The consultation exists, and that matters greatly. Existing patients are protected from immediate removal of their treatment. The policy’s use of the ICD-11 classification, which correctly categorises gender incongruence as a condition of sexual health rather than a mental disorder, is a small but important acknowledgement.

What Concerns Me Most

Reading this policy carefully, the thing that concerns me most is not what it says but what it does not say. There is a substantial and growing body of evidence on what happens to trans young people when access to gender-affirming care is delayed or denied. The research on mental health outcomes, including depression, anxiety, self-harm, and suicide risk, is not ambiguous. That evidence is not referenced anywhere in this policy document. The Equality and Health Inequalities Impact Assessment, published alongside the policy for consultation, needs to address this directly and in detail. I would urge everyone responding to the consultation to raise this as a priority.

I am also concerned about the young people who fall between the current policy and this new proposal: the 16 or 17-year-old who presents to the gender service now, who is not yet on treatment, who has been working towards a referral for hormones, and who will simply lose that possibility. They may seek private care if their family can afford it. They may access hormones through online sources without clinical oversight. This policy does not protect those young people. It removes their protection.

The absence of a fixed review date is troubling too. The policy states that it will be reviewed when information is received which indicates that the policy requires revision. That is not a commitment to review. It is a condition that may never be met if the standard of evidence required to trigger a review is set at the same level as the standard used to justify the original decision.

How to Respond to the Consultation

NHS England is asking three specific questions in this consultation, and each one offers a genuine opportunity to put important evidence on the record.

The first question asks whether all of the relevant evidence has been taken into account. This is where you can raise the limitations of the PICO framework, the exclusion of international research, the evidence from WPATH, the Endocrine Society, and others, and the findings of studies excluded at the screening stage.

The second question asks whether the Equality and Health Inequalities Impact Assessment reflects the potential impact of the proposed changes. This is where the evidence on psychological harm, suicide risk, and documented outcomes of care denial needs to be raised clearly and directly.

The third question asks whether there are any other issues NHS England should consider. This is open ground. You can speak to individual experience, to clinical practice, and to the situation of young people who will lose access with no alternative pathway.

The consultation closes on 7 June 2026. Please respond if you can, and please share this article with everyone who cares about the health and wellbeing of trans young people. Every response matters, and every voice needs to be heard.

Respond to the consultation here: NHS England MAF Hormones Consultation

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If this policy review has been helpful, please share it with anyone who needs to see it. Every response to this consultation matters, and every person who shares this article helps to ensure that the voices of trans young people and their families are heard by those making this decision.

Dr Helen Webberley | Gender Specialist and Medical Educator

www.helenwebberley.com

Please feel free to share your thoughts in the comments or as a Note, Article or Restack, or keep the conversation going on other platforms.

Resources and Links

• Dr Webberley Responds: Why the Cass Review Still Matters, And Why We Must Look Again

• Respond to the NHS England consultation (closes 7 June 2026)

• NHS England Public Consultation Guide

• Draft Policy Proposition (PDF)

• Draft Equality and Health Inequalities Impact Assessment (PDF)

• Evidence Reviews

• Consultation overview page

On 26 February 2026, North Hertfordshire District Council held a debate on a motion to formally support transgender rights. What was said in that room deserves to be heard more widely. These are the voices of the people who were there, in their own words, speaking plainly and from the heart about what they believe and why. Read them slowly. They are worth it.

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Cllr Sadie Billing, who proposed the motion

“Everyone in North Hertfordshire deserves to feel safe, respected and able to live as themselves. This motion makes it clear that discrimination and hostility have no place here and sets out practical steps to keep our policies and services inclusive.”

“Legal protections remain but the uncertainty has a real impact on people’s sense of safety and belonging.”

Cllr David Chalmers, who seconded the motion

Cllr Chalmers is a gay man who grew up in the 1960s. He drew a direct line between the treatment of his generation and what trans people face today.

“The hate and scars left on my generation of gay men turned many to alcohol, drugs, and even suicide. I have lost too many friends over the years, and now I am seeing that same diet of fear and shame destroying the lives of trans friends.”

Cllr Elizabeth Dennis, Labour

“When we fail to acknowledge and support gay rights, lesbian rights, trans rights, we also fail to acknowledge women’s rights.”

“It is an absolute nonsense to suggest that women’s rights suffer where we support trans people.”

Cllr Tamsin Thomas, Labour

Cllr Thomas described attending a women’s safety event in Hitchin attended by more than 100 women, where the question of trans women in bathrooms never came up.

“It wasn’t in their mind. It’s a manufactured fear.”

Cllr Joe Graziano, Conservative (voted for the motion)

“One of my best mates was a man and transitioned. In an idealistic world, we should be to a point where we shouldn’t be discussing this at all, where everybody is respected for who they are, end of.”

Cllr Ralph Muncer, Conservative (the sole vote against)

Included here for completeness and balance.

“I find it somewhat hypocritical that an administration who seeks to ensure that the protection of women and girls is very much at the forefront of policy, is content with allowing biological males to go into changing rooms, to go into toilets, that biological females and young girls frequent.”

What strikes me most about this debate is how straightforward it all sounds when you read the words back. One councillor who lived through the worst of what prejudice can do to a community spoke with the quiet authority of someone who has already seen this story play out. Others talked about what women actually said when asked what they were afraid of. And a Conservative councillor who voted with the majority simply spoke about his friend, and said that in a better world none of this would need to be debated at all.

This is just good sense. It is compassionate, it is legally sound, and it is the kind of thing that makes a real difference to real people who are watching to see whether the institutions around them are on their side.

Other councils can follow this lead. There is nothing complicated about it. You pass a motion. You write a letter. You mark Trans Day of Visibility. You say out loud that everyone in your area deserves to feel safe and respected. You put it on the record.

North Hertfordshire has shown it can be done. The question for every other council in the country is simply whether they are willing to do it too.

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With love and solidarity,

Dr Helen Webberley

Gender Specialist and Medical Educator

www.helenwebberley.com