The mother says she was ‘let down’ by those who wanted to help her son’s experience at the Tavistock clinic

The referral of children to puberty blockers was not the only concern for some of the Tavistock staff. They were also concerned that sometimes assessments, if completed too quickly, would miss other factors that might be causing these children distress.

An audit published in 2002 of the first 124 patients seen by the service showed that only 2.5% of the referrals had no associated problems.

At that time, a quarter had spent some time in care, almost half had lost one or both parents to bereavement or separation (predominantly the latter), and about a quarter of those 12 and older had a history of self-harm and “inappropriate sexualization.” behavior’.

We don’t know how the thousands of most recently referred youth compare. In the Netherlands, the pioneers of the medical treatment of gender difficulties, young people must have experienced it since childhood and, most importantly, be psychologically stable, without other significant mental health problems.

GIDS (Gender Identity Development Service), according to almost every doctor I’ve talked to, referred young people to puberty blockers who simply didn’t meet those conditions.

And she did not rule out evaluating people for whom it was clear that gender issues were secondary, as in the case of Alex.

The teenager came home from school one afternoon in October 2013, as usual, but when his mother Diana asked him to pick something up off the floor, he said: ‘I can’t, I’m full of germs.’

It didn’t make much sense. She had been showering every day, but Diana thought that she had been blessed with a teenager with good hygiene habits. Her sister hadn’t thought anything out of the ordinary either. Neither of them realized that showering was part of worsening obsessive-compulsive disorder (OCD). “I felt like I was contaminated,” she says.

She made an appointment for him to see her local doctor, but he didn’t go. She couldn’t get out of the shower. At 6-foot-3 and wearing size 14 sneakers, 15-year-old Alex was a “gentle giant,” says Diana. He wasn’t effeminate, but he had always preferred female company and he didn’t like soccer. He had come out as gay a couple of years before and he was proud of it.

But after he told another boy at school that he had feelings for him, he was subjected to vile homophobic slurs, called “gay filth” and “paedo.” Some parents did not want him to associate with his children.

Soon enough, Alex’s OCD meant he could barely leave the house. Then one day, as Diana was trying to pick him up and out of bed, he yelled at her, ‘You don’t understand! I am transgender. You have misunderstood me since I was born. Then he accused her of being transphobic.

Diana didn’t know what he meant. She hadn’t really heard the word ‘transgender’. ‘I was in shock. And I just said, “You’re not very well,” because he wasn’t. Alex had had counseling sessions with the local adolescent mental health team and had told them that he was trans.

“I couldn’t believe what I was hearing: that she needed hormones, that she was born in the wrong body. I felt like a giant had hit me.

A referral to GIDS was made but there was an 18 week wait for care and during this period Alex became suicidal and threatened to stab himself in the jugular. There was talk that he would be sectioned. Alex was now confined to his house and not attending school, his OCD was so severe that he could not tolerate the outside world.

“I had to put a plastic sheet on the floor to get into her bedroom,” says Diana. She showered five times a day. developed severe IBS [irritable bowel syndrome].’

And meanwhile, the mental health team treated him like a woman and said that this would all be cured when he went to the Tavistock. His focus was not on how they could help Alex’s mental health issues, but on taking him to his first GIDS appointment.

It’s a significant journey from Diana’s home on the south coast of England to Tavistock in North London. Alex couldn’t touch anything without getting in the shower, Diana says, and yet here he was, trying to embark on a long journey across the country on crowded trains as a practice run.

Realizing how daunting this could be for a young man who couldn’t leave his home, a psychiatrist prescribed an antipsychotic drug for him to self-administer if he felt ‘panic’ while in London. Diana was surprised that a mental health professional would think this was a sensible plan.

The trip was a disaster. Alex managed to get home, where he passed out. As she slept, a distraught Diana looked at her phone and discovered that she was using the blogging and social networking website Tumblr. She was connected to hundreds of other young people, all of whom identified as trans. And, Diana says, he was being groomed by an older user who told his son that everything would be fine once he had all of his surgeries.

Alex was too sick to travel to his first GIDS appointment. Diana thought this could be taken as an indication that he was in too bad shape to consider transitioning. But a senior GIDS doctor said they would come to him instead.

And that’s what happened, despite Diana phoning Tavistock and saying it was “insane.”

The appointment took place at the local mental health clinic, where Diana claims the doctor welcomed her son with the words “many transgender people continue to live full and happy lives.”

“That just set the tone,” she says. She was immediately offered the offer of a meeting at some point with an endocrinologist.

Diana struggles to understand how any expanded NHS service would send a senior doctor several hours across the country to meet someone with such severe mental health issues that they couldn’t leave their home and still raise the possibility of a physical transition, possibly the most invasive option. – as a way forward.

Meanwhile, no one was dealing with Alex’s OCD, which was getting worse. Diane was furious. This was a boy who wanted to cut off his penis, she says, who saw things crawling on the walls. She believed that this could not be explained by saying that he was trans. Her son needed proper counseling and help for his OCD.

And so he acted, opting out of the treatment offered by the NHS and referring him to a private counselor instead.

Two years later, and three years after coming out as trans, Alex told Diana that he was “done with the gender.”

Diana had never been against the transition per se; she just thought it wasn’t safe to consider while Alex was in such a bad way. The fact that she now ‘gave up’ (to stop identifying as trans before beginning a medical transition) has shown, in her eyes, that she ‘didn’t need anything more than time’.

All along, she had believed that her son’s behavior was a reaction against being bullied for being gay. Diana believes that Alex’s identification as female was “an escape mechanism”, a “maladaptive reaction to hearing that your innate personality is that of a pedophile”.

Alex is now in his twenties. He is a gay man, with a boyfriend. He still has serious mental health problems, but he is sure he is a man.

Diana is desperately let down by those who were meant to help. She is a mother who loves her child and desperately wants her to be happy and healthy. She makes one thing clear: ‘I’m not anti-trans. I am pro my son. I am pro-health. And trans was the most unhealthy for him.