On Wednesday, Wes Streeting announced that the Government will ban the private prescription of puberty blockers. With the NHS’s restriction on prescriptions, there is currently no way for trans children to access them other than through medical trials.
Stephanie Lynnette, 27, is the founder of Ask Awareness, a campaign which gives people a safe space to ask questions about trans experiences. She first sought out help from a gender identity clinic at age 12 and started on puberty blockers at 16.
Here, Stephanie tells The i Paper her experience of accessing puberty blockers. Her mother, Lynnette Stevens, 49, an end-of-life hospice care healthcare specialist, shares her experience as a parent helping her child through.
Stephanie: “I was prescribed puberty blockers shortly after I turned 16 but did not receive my prescription until just before my 17th birthday. This was only following a heated verbal battle between my GP and mother.
“Despite the advice of leading experts from two separate gender identity clinics and the UCLH paediatric endocrinology team that I should be prescribed puberty blockers, the GP refused to dispense the prescription on the grounds of their ‘personal beliefs and ethics’. As I sat in the GP’s office crying that I still wasn’t receiving my medication, my mother fought for my right to receive them.
“Puberty blockers are used to block the ongoing effects or delay the start of puberty to alleviate gender dysphoria and assist in a more seamless transition without the irreversible changes of biological puberty. This is why I sought them out. I knew, and my family knew, I was always supposed to be a woman, and the blockers were the first step in the medical transition pathway for myself.
“I was first referred to the Tavistock and Portman gender identity clinic [which closed in April after it was criticised in an independent review led by Dr Hilary Cass] at 12. This followed over a year of NHS counselling at local services and a letter I sent to my parents detailing my suicidal thoughts about being trapped in the wrong body. After what is now considered a relatively short 24-month waiting period, I had my first appointment at 14.
“From my initial referral at 12 to the moment I was first given the blockers, I went through five years of social transition during secondary education. I saw four independent psychologists, two industry-leading endocrinologists and three dietitians and made the commute from rural Cornwall to central London more than twenty times at an enormous cost to my family. It was not a quick process. I was also temporarily placed on artificial testosterone at the request of several specialists and my GP to ensure I ‘was sure’ – this was the most suicidal period of my life.
“I had waited five years for my medication. I’d been prodded, poked, scanned, examined and psycho-analysed from every conceivable angle and asked if I “was sure” more times than if I was the latest iPhone user agreement. As soon as the injection was over, I sat back on the bed and cried tears of joy as the nurse administering it congratulated me on my courage and bravery.
“I felt like I could breathe after I’d been holding my breath for five years, too afraid to exhale. There were almost no physical changes. I think a common misconception is that puberty blockers alter the body, they don’t. They press pause.
“The body only undergoes significant changes once hormone replacement therapy is introduced alongside puberty blockers, provided that a trans youth has been on blockers for a previously specified time. I myself had been prescribed blockers for two years before receiving HRT in adulthood.
“Over the next few months, my anger and distress subsided. My suicidality decreased as did my depression and anxiety. My social life improved, forming deeper connections with school friends I’d lost touch with out of envy, and my family relationships became stronger. I remained on puberty blockers well into my adulthood until receiving my gender affirmation lower feminising surgery in February 2020.”
Lynnette: “I noticed a difference, not physically but mentally, you seemed a lot happier. Because you’d already had to wait such a long time, I think you were so worried about your voice breaking and facial hair, and everything else that, for you and for us, it was just a huge relief.”
Stephanie: “My blockers saved me, not in the cliched, “Oh they saved my life!” – although they did – they saved me from myself, from my own mind. They saved me from the diagnosed gender dysphoria I had felt my entire life; they saved me from acts of self-harm, they helped preserve my sense of self, allowing me to build stronger relationships. They gave me a foundation of security in my identity as a young woman, arming me for the first time in my life with self-assurance to combat the weight of other people’s opinions and projections.
“Puberty blockers were, for me, like they are for many other young people, both trans and cisgender, a miraculous necessity. Set aside the minor discomfort of an injection in my bottom once every 11 weeks, the only negative experience I’ve ever experienced with blockers was entirely external.
“From refusal to prescribe to lectures on my fertility, the hardest part of being on blockers was the constant need to justify my intentions and the vilification of both my parents and me for seeking out my necessary care. Expressed to us from every angle, in every conceivable location from under qualified over-opinionated outsiders – ranging from school administrators to family friends who held no medical expertise.”
Lynnette: “For trans children and their parents, puberty feels like a ticking bomb. You know these things naturally happen. You don’t want to see your child go through these inevitable bad things when they’ve already got so much going on.”
Stephanie: “While I’ll leave the discussion of trans parentage to my lovely mother, as I’ve only ever been on one side of that coin, I will say this to my lived experience of socially transitioning from age 12.
“Puberty blockers cause an entirely reversible pause to the body of a young person; they are not robbing us of our childhood or our innocence. For years, they’ve been used in cisgender children to help with everything from early onset menstruation to delaying the onset of precocious puberty.
“They give young people the opportunity to breathe, to pause and reflect, and to make decisions without the pressure of the internalised nuclear bomb that is the irreversible change of puberty. They afford us a longer childhood and adolescence to discover ourselves.”
Lynnette: “I want people to know that puberty blockers are not just given out willy-nilly, they don’t just hand them over, they’re not sweets. There’s a rigorous process; I watched my daughter struggle through years of rigorous medical testing, the mental health implications of transitioning without help and worse. It was only after a long time down the line, after intensive counselling, that they finally helped her. No one is handing them out without a considered process.”
Stephanie: “The Government’s decision to ban puberty blockers means removing hope from thousands of trans youth who, like myself, see puberty blockers as the opportunity to give themselves space to breathe and think without the pressure of puberty.”
Lynnette: “Why do these people not speak to the people with these experiences, who’ve lived these lives?
“If you take that hope away, you’re going to cause huge amounts of mental anguish because trans youth are in a bad enough spot as it is. It’s adding to their mental anguish.”
The Department of Health and Social Care (DHSC) said the Commission on Human Medicines (CHM) had published independent expert advice that there is “currently an unacceptable safety risk in the continued prescription of puberty blockers to children”.
The department said the commission had recommended indefinite restrictions while work is done to ensure the safety of children and young people.
Announcing the ban, Streeting said: “In the past few months, I have met with young trans people who have either have been, may be or will be affected by the decisions I and my predecessor have taken. I have listened to their concerns, their fears and their anxieties, and I want to talk to them directly now.
“I know it’s not easy being a trans kid in our country today, the trans community is at the wrong end of all of the statistics for mental ill health, self-harm and suicide. I can’t pretend to know what that’s like, but I do know what it’s like to feel you have to bury a secret about yourself, to be afraid of who you are, to be bullied for it, and then to experience the liberating experience of coming out.
“I know it won’t feel like it based on the decisions I’m taking today, but I really do care about this and so does this Government. I am determined to improve the quality of care and access to healthcare for all trans people.
“I am convinced that the full implementation of the Cass review will deliver material improvements in the wellbeing, safety and dignity of trans people of all ages and this Government will work with them to help them live freely, equally, and with the dignity everyone in our country deserves.”
Anyone affected by any of the issues in this article can call the Samaritans for free at any time on 116 123, email them at jo@samaritans.org, or visit www.samaritans.org to find your nearest branch.
Liz Truss needs to take her own advice, and cease and desist