The ingredients for a safeguarding and medical scandal: A group who are ideologically committed to a treatment model irrespective of the evidence + A climate of fear in which concerns are not just dismissed but attract accusations of transphobia + Institutions & individuals focused on protecting their own reputation rather than admitting to mistakes Cases such as GIDS and now WellBN will continue to occur until these issues are addressed. And the problems in gender medicine extend far beyond paediatric services: adults deserve safe and effective care just as much as children.

It is worth reflecting further on the promised clarity 'about what the draft Bill does and doesn't do' because it reveals a fundamental problem with the conversion practices legislation as it applies to gender identity. Bridget Phillipson's key argument is that 'being T+' does not need fixing. But in reality, 'being T+' involves many thousands of children with a host of mental health issues and other vulnerabilities, who reject their healthy body, experience escalating distress and seek unevidenced medical interventions. That really does need fixing. When T+ is defined simply as 'who someone is' or people just being 'their true selves', any appreciation that the identity itself could be a maladaptive response to a range of external factors is dismissed. Even worse, the unremarkable understanding that not all identities bring health or happiness is misrepresented as an abusive effort to 'change who someone is'. This is the kind of activist language that led to the chronic safeguarding failings at GIDS and at WellBN. Under this framing, any denial of personal identity is seen as abhorrent: 'no one should be abused, shamed or threatened into denying who they are'. What is encouraged instead is affirmation of the 'true self' even if 'who they are' involves rejecting their own body. So this is what the bill would achieve: special protection for an identity linked to unhappiness about the body, and criminalisation of alternative understandings because these could be 'intended to change who someone is'.