As parents and clinicians in the Clinical Advisory Network on Sex and Gender, we welcome the Department for Education’s draft guidance for schools and colleges to support children and young people who are questioning their gender (“Schools guidance on gender identity could help us move on from this toxic debate”, Editorial). While the guidance could be more robust, it is an excellent first step in protecting all children and young people. Girls should not be forced by schools to share toilets or changing rooms with the opposite sex, where they can be vulnerable to abuse.
Schools and colleges have, until now, been advised by unaccountable external agencies that have misrepresented the law and undermined child safeguarding. Schools and colleges must, through this guidance, reassert the primacy of child safeguarding and wellbeing, including parental involvement in important decisions about their children. Parents must hold schools to account.
One concern is that the guidance still permits schools to allow a child to “socially transition”. The interim Cass review described social transition as “not a neutral act”, but an active intervention that may have significant effects on psychological functioning. There is evidence that social transitioning can “fix” the young person’s beliefs about their gender and lead to irreversible medical interventions and surgery. If social affirmation is an intervention with clinical implications and risk of harm, how can it be right for schools to do so without clinical input?
Dr Sinead Helyar, nurse; Dr Juliet Singer, consultant child psychiatrist; Dr Louise Irvine, GP; Dr Stella Kingett, consultant psychiatrist; Dr Aileen O’Brien, consultant psychiatrist; Bob Withers, psychoanalyst; Dr Tessa Katz, GP; Stella O’Malley, psychotherapist; Dr Jane Martin, psychiatrist (retired); Dr Az Hakeem, consultant psychiatrist
Football’s original sin
The soft power in football and other events is a way for countries with too much money, no democracy, executions and misogyny to get a foot in the door of international affairs (“A culture of greed, riddled with inequality. Global football is a mirror of our age”, Comment). If there were ever an original sin, it has to be greed/gluttony.
Patricia Nolan
Paris, France
Starmer must dare to be bold
The truth that Keir Starmer needs to face is that if the only way he thinks he can get his brand of Labour into power is to out-Tory the Tories and to maintain the status quo, then he’s no different to them (“Caution might get Keir Starmer into No 10, but brave ideas will be needed to govern”, Comment). Or he can get his head out of the Westminster bubble and realise he has to change tack and be bold.
Vision is what people need. Hope. The promise of empathy in government. Starmer should identify some quick wins, and announce bold actions that he’s going to take in his first 100 days. I’d start with, day 1:
• non-dom status, gone. Money to the NHS;
• VAT on private schools, and an end to charitable status – and use that money for state education;
• higher rates of tax on those earning more than £250,000 a year;
• taxes on unearned wealth, above a threshold that excludes the bottom 95%;
• an end to homes bought through tax havens, with no stamp duty;
• end right to buy;
• look at rent caps;
• look at ways to stimulate growth in the economy that works for all, not just the 1-5%.
All these things he could do, straight away. It would give people clear water between him and Rishi Sunak. And it would give them the belief that things will get better. I don’t think he has it in him. And that is a tragedy.
Nicholas Makey
London E3
Loss of smell left me bereft
If I hadn’t had parosmia for four months following my first pre-vaccine bout of Covid, I am not sure I could have empathised with Rudi Zygadlo (“I lost my sense of smell after Covid. Here’s what I’ve learned about life without it”, Magazine). My family made fun of me as I almost cried when, on going for a walk in the forest, I realised I couldn’t smell it. The thought of never being able to smell my children’s hair again tipped me over the edge. It was astonishing how bereft I was without smell, and how others failed to understand just how awful it is. Fortunately, after six months my sense of smell returned. I’m never taking it for granted again.
Emma Hart
Ardmore, Pennsylvania, US
Assisted dying: get serious
Martha Gill bases her argument against assisted dying on recent events in Canada (“For many, the case for assisted dying is clear. But life – and death – is often not so simple”, Comment). She fails to mention that the Canadian law came from circumstances that could not arise in the UK. The Canadian supreme court instructed parliament there to introduce a law, something that could not happen here. Their law was based on intolerable suffering, not on terminal illness, which is why it has been able to be expanded.
The law proposed here is similar to the one that has been in place in Oregon for more than 25 years and on which most assisted dying laws are based. The criteria mean that it is available only to those who are terminally ill with a prognosis of less than six months, of sound mind and settled intention. The Oregon law has never been expanded and still accounts for fewer than 1% of deaths.
We need a serious debate about assisted dying but opponents must deal with the law that we would get here, and not on unfounded scare stories from a jurisdiction that is very different from ours.
Dr Jacky Davis, chair, Healthcare Professionals for Assisted Dying,
Board of Dignity in Dying
London NW5
Hobbies keep you young
Age reflects your time on the planet and the state of your mind and body (“Getting older is one thing, but growing up is another altogether”, Magazine).
My advice is to have at least two hobbies at any time, one that keeps you in good physical condition and one that works your mind. Too many people age early because of lifestyle choices that are unsustainable or simply harmful. Me? I’m 58 and enjoying a quiet Christmas Eve (still excited) cleaning my bike after a full day of hammering around jumps and climbs at my local mountain bike park. I’m just 12 on the inside.
Iolo Roberts
Bangor, Gwynedd
Forlorn hopes for 2024
Karen Pollock’s article on the rise of antisemitism concludes with a wish that 2024 could be the year to find a cure for it and Islamophobia (“Antisemitism and Holocaust denial are rife, just look at Stephen Fry’s X trolls”, Comment). This is surely a forlorn hope. Religious intolerance has been going on for hundreds of years, perhaps first with the treatment of the Jews by ancient Egypt, and followed by the Crusades and the expulsion of Jews from England and Spain. Currently, Muslims are persecuted in China and face antagonism by Hindus in India. It surely exacerbates these situations that many governments are defined by religion and that in many communities children are educated in religiously defined establishments.
Probably the best that can be expected in the future is that more religious adherents follow the teachings of their sects and encourage more understanding of others, but I fear that there are few grounds for optimism.
Graeme Mulcahy
Henley-on-Thames, Oxfordshire
If in doubt, delegate
The secret to a stress-free Christmas (“For a safe Christmas, break out the Baileys but put peckers away”, Comment) is the same as the secret to stress-free work: delegate and trust the person you delegate to. Not sure if that is going to work for peckers, though.
Paul Littlewood
Sheffield
