trans youth

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What we have won

It was the largest trans protest in British history.

We travelled from across the country to central London. We were joined by allies, especially cis gay, lesbian, bisexual, and queer people who recognised the importance of solidarity, of standing together in this moment. Wielding bright flags and banners, we gathered in unprecedented numbers. We to were here to raise our voices against the institutionalisation of transphobic hate and abuse, to oppose calls for exclusionary policies and trans healthcare bans.

I couldn’t possibly miss this, so travelled down on the train from Leamington Spa with my home-made placard. Looking around after I arrived on that cold winter night, I marvelled at the sight. There were so many of us. Maybe as many as 150, or even 200! And my friend Jo even brought a home-made trans flag with them, which was an amazing thing to see outside of the internet.

Photo by Guido. I’m in this – can you spot me?

The year was 2008, and we assembled outside the Victoria and Albert Museum to protest the annual Stonewall Awards. The UK’s largest LGB charity had nominated the Guardian journalist Julie Bindel for an award, despite – or perhaps even because of – her notorious transphobia. The protest was called by the London Transfeminist Group, and supported by a range of other organisations, including Queer Youth Network, Trans Youth Network, and the National Union of Students (NUS) LGBT Campaign.

Afterwards, we gathered at a local pub and talked excitedly. The protest was a massive embarrassment to Stonewall, and through grassroots organising we had shown we could bring trans people and allies together on a scale that never before felt possible.

How could we build on this power, and what might the future bring?

***

It was the largest trans protest in British history.

Trans people travelled from across the country to central London. They were joined by allies, especially cis gay, lesbian, bisexual and queer people, plus parents and family members, trade unionists, and celebrities who recognised the importance of solidarity, of standing together in this moment. Wielding bright flags and banners, they gathered in unprecedented numbers. They were there to raise their voices against the institutionalisation of transphobic hate and abuse, and to oppose exclusionary policies and trans healthcare bans.

Photo by Aaron Chown/PA. Compare and contrast…

I wasn’t in London for Trans Pride 2026. I’m involved in plenty of protests and community events in Glasgow these days, from last year’s noise demonstrations outside the EHRC headquarters, to the incredible Solidarity Pride Hub, which filled the Pyramid at Anderston with amazing talks, workshops, and stalls led by trans and queer organisations. Nevertheless, watching online as the images came in was pretty incredible. A reported 150,000 people took to the streets, just one week after thousands more gathered for Trans Pride Brighton.

How can we build on this power – and what might the future bring?

***

For decades, the trans liberation movement has fought to change the world. We found new ways of being, and created language, art, and culture to name and explore these possibilities. We won new civil rights. We achieved incremental improvements in the provision of healthcare and education. We have made it a fair bit easier for many people to exist in the workplace, and to survive on benefits. We have built community: feeding each other, housing each other, and providing advocacy for each other, and partying together.

As the UK enters a new era of state-mandated segregation, I find myself asking: was it all worth it?

***

For all the achievements of the trans liberation movement, many of us have continued to struggle enormously in the face of interpersonal and institutional violence. This is especially the case for those more likely to be left behind by liberal trans activism, including disabled trans people, trans migrants, trans people of colour, and trans sex workers. Trans communities have also handily replicated the structural misogyny of the wider world. As a result, paid roles in advocacy, charity work, and the arts remain dominated by trans men and transmasculine people.

Meanwhile, through becoming more visible, we have become more vulnerable. Through being acknowledged within institutional frameworks, we have become more identifiable. Through asking for respect, we have become a problem. Through entering political conversations, we have become scapegoats.

Cis “centists” are often swift to blame trans people for our own problems. If we’d just been more polite, more accommodating, and less demanding.

Trans people also frequently assess our movement’s activist strategies. Sometimes this will be helpful. For example, there are lots of productive discussions happening right now about the respective merits of lobbying people in power vs building power in our communities from the ground up. Other times, certain trans people will say we have gone too far, demanded too much. If only we’d been more respectable. If only we’d laid off the pronouns. If only we could agree on a nice, clear definition of “trans”. If only we gave up on those confusing non-binary identities. If only we’d let children be children.

***

I came out to myself and my friends while in school, transitioning as a teenager in the early 2000s. I cannot emphasise enough how unusual this was – and consequently, how lonely and isolating my experiences were. We had so little information. Most out trans people at this time were middle-aged or older, and I didn’t have any opportunity to meet them. Being a trans teenager felt like a complete impossibility.

My transition had three key enablers. The first was my own sheer bloody-mindedness. The second was the support I did find and receive from others. And finally, I benefited from an enormous dose of luck.

After years of fruitless online searches for anything that would explain my feelings and my needs, I found a US web forum run by and for young trans people, providing invaluable advice and a sounding board. I wasn’t sure at the time whether I was a real transsexual, or just one of them fake cross-dressers. The broad, fluid language of transgender identity and experience meant that this artificial distinction didn’t actually matter. The important thing was solidarity: gender diverse people standing together in the name of our shared interests. This enabled me to explore what I might need and desire in an open-ended way with other people my own age, without feeling that I had to transition in any specific way or on any particular timescale.

In the offline world, none of my teen friends understood what I was going through. But they supported me unconditionally. My early romantic partners also had my back. One took me shopping, and helped me figure out my style. Another gave me my name.

I first went to see a doctor for help with medical transition aged 15, but I failed to receive a gender clinic appointment until I was an adult. This didn’t feel lucky at the time, but looking back, it was an enormous stroke of fortune. Through spending years on waiting lists, I avoided the conversion therapists who then – as again now – dominated child and adolescent services.

During these teen years, a schoolteacher – unable to provide me direct advice herself due to Section 28 – referred me to a free counselling service provided by a local charity. I remember my counsellor asking me, “do you think you are part of oppressed minority?” I wasn’t quite sure. Maybe? Probably?

Given the luck I had experienced, I did not understand how much I had already been let down. I did not fully comprehend the sheer void of information on trans existence. I did not realise that my self-hatred and self-denial was the fault of damaging social norms and expectations, rather than something broken in me. Nor did I understand how massively vulnerable I was as a result. The support of my peers meant that unlike many other young trans people, I was not subject to sexual predation: a topic later explored in my research, plus stories such as Paris Lees’ autobiographical book and TV series What It Feels Like For A Girl. I did not see how much my own internalised sexism had already warped my sense of what might be possible for me, leading me to take on a passive role in friendships with male friends who I watched play music and video games. And while I had already been beaten up or groped multiple times in the playground and the street, I was yet to experience much of the targeted transmisogyny that would accompany me into adulthood: the continued sexual assaults, the verbal abuse, the harassment, the stalking.

I didn’t know it at the time, but what I needed was trans community, and feminism.  

***

I became an activist in the mid-2000s, during my early 20s. Again, a few chance events spurred me along. But I also benefited from the care and energy of others who wished to change the world.

One of the first trans people I knowingly met in person was the professional speaker and advocate Rikki Arundel. A young gay man had booked them to speak for a student event at the University of Warwick, where I was studying for my undergraduate degree. Rikki took me to a café immediately after the talk. “So”, they asked, “you want to be a trans activist?” I hadn’t asked.

Rikki nevertheless spent some time outlining advice. Get to know people in your area: community members, local politicians, policymakers. Go to meetings and become known. Build a reputation as a helpful and reliable point of contact. At every possible opportunity, leverage this to demand change, positioning it as a sensible, reasonable course of action.

Rikki’s advice was invaluable for working within liberal systems. These days, I am wary of trans liberal approaches, as these can be individualising, and lead to concessions that leave many behind. But you do not need to believe in or support a system of power to work within and against it.

Around this time I also went to my first NUS conferences. Through the NUS LGBT Campaign and later also the NUS Women’s Campaign, I shared knowledge and skills with other young people, and went to my first protests. Through these campaigns I met other young, openly trans people in person for the first time, including Mallory Moore. I learned great deal from organisers such as Mallory. They appeared to have very different beliefs to Rikki, but were, in fundamental ways, doing very similar work. Get to know people. Build connections. Identify points of common interest. Figure out where and how to apply pressure to achieve change. Where Rikki spoke to the local council, Mallory worked with local feminist groups. I found myself doing both.

***

The isolation of my teen years continued into my early adulthood. Encounters with people like Rikki and Mallory were fleeting, one-off events. I would then go entire months without knowingly meeting another trans person.

To break this isolation, I began to travel. I took a day trip to Birmingham to hang out with a slightly older trans youth activist from Queer Youth Network, an internet community I’d recently joined. I travelled to Bradford and Manchester to speak at student union meetings, arguing for the introduction of all-gender toilets. I travelled down to London to attend an event hosted by a new organisation called Gendered Intelligence, and marvelled at being in a room with over a dozen other young trans people. This event wasn’t actually very good: it only happened because it had been funded by cis academics who wanted to do some boring research. But I left to sit in the corridor and chat with other trans girls, who would become lifelong friends.

There were so few of us out because there was still so little information available, and so little in the way of community support for those who did try to come out or transition. Most trans people were spending years, decades, lifetimes stuck in the closet. But this was beginning to change.

Trans communities in the UK were benefiting from a virtuous cycle of coming out. The internet helped a great deal with this, as new resources and information spread online. But the real change came with trans people simply being a visible part of public life. Transphobes like to call this “social contagion”. I prefer Laverne Cox’s term, “possibility model”. You see a trans person getting on with their life, and realise that sex change is possible for you, too.

In so many spaces, I was patient zero for the viral spread of trans possibility. I cracked eggs everywhere I went. Every time I spoke at an event, or attended a conference, or hung out with other queers at the pub, I showed that another world was possible. Young trans people came out all around me, and in turn they became visible to others.

But coming out is just the first step. For trans lives to be liveable, we need support from other people. We need to share resources and information. We need community.

***

I remember speaking in the late 2000s or early 2010s with an older trans woman at an event in Wolverhampton. Following the repeal of Section 28 some years before, she was keen to work with schools to ensure that young trans people were never as isolated and confused as I once was. “We need education at an early age”, she said.

We did this. It was not the action of any one person or group at any moment in time, but the action of a movement across many years. Organisations like Schools OUT produced material and information for schools. Groups like Gendered Intelligence helped support the development of a knowledge base to evidence change. Individuals like myself spoke with our local councils about how they could change their policies. Thousands of teachers across the country quietly changed their curricula, introduced new approaches, and created clubs for trans and queer kids.

Meanwhile, others created blogs, youtube videos, social media posts that circumvented schools entirely, speaking directly to young people. Importantly, much of this material sought to break away from the old binaries that used to divide trans communities: male-to-female vs female-to-male, transsexual vs transvestite. With “trans” we were imagining solidarities across difference, a context in which those who did not seek medical transition sought commonality with those who did, and vice-versa. We were collectively imagining a world in which sex norms and gender stereotypes no longer governed our lives, and in which we might work together to achieve our varying desires and needs.  

It is interesting to think about this former progress at a time when the UK government has produced incredibly transphobic new legal guidance for English schools, and when NHS England is actively pushing conversion practices. Trans kids now face an incredibly hostile policy environment: one that refuses to even name their existence even as it demands that they be segregated and abused.  

Yet, young trans people continue to come out, to seek support and support one another, in numbers that would have been inconceivable to the protesters gathered in London on that cold night in November 2008.

***

The strange irony of trans life in the 2020s is that there are still more of us than ever. Even as external conditions become more and more hostile, the virtuous cycle continues.

Some of this is about possibility models. You can see this in Trans Pride London 2026. We are talking 150,000 possibility models on the streets in central London in one day alone. Every single one of these people sends a message to those thinking about coming out. That message says: you are valued, you are loved, and support is available. You are not alone.

Some of this is about trans-led support. While the NHS, crisis services, shelters, housing services (etc etc) have variously got better and worse over the years, they have always let many of us down. In light of this, trans people have built mutual aid networks to get vulnerable people out of dangerous accommodation, house those in need, produce and share medication, and disseminate harm reduction resources. In this context, trans diversity is vital: we need strong communities that are more interested in how we might bring our myriad of skills and experiences to bear in caring for one another, rather than obsessing over how our language and identities might differ.

Some of this is about trans art and culture. You can turn on the TV and see trans actors, comedians, politicians, and experts, on shows written or produced by other trans people. You can turn on the radio and hear trans people playing music or speaking about their experiences. In some towns and cities, you can even can go to your local gallery and see work by trans artists, visit your local pub or club or DIY venue and see trans performers, and they might even give out handy little flyers telling you where you can get your hands on HRT.

Some of this is about solidarity work from cis people. All that endless work of education over the past decades has not been in vain, however much the politicians and hateful people of this world would like it to be. Through incessantly speaking out and demanding change, and in joining with others to support their struggles, trans people have made allies everywhere. Teachers and lecturers, doctors and nurses, administrators, hospitality workers, lawyers, and many more are more likely to have access to information through their family or friends or trade unions, which help them in turn to support trans people in a hundred thousand little ways every day.

***

In 2008 we found hope in the possibility of community connection, solidarity, collaboration, and friendship. In 2026, we see what was successfully built from that hope and that possibility.

Over the last two decades and beyond, we have won trans community and connectivity on a scale that was once unthinkable. We have made allies across every part of public life. We have helped hundreds of thousands people to improve their lives. This is a historic achievement.

Today, the trans liberation movement faces off against vicious foes and their allies in the Labour government, who would see us eliminated altogether. Trans people of all ages and backgrounds are forced to navigate laws and policies designed to make our lives more difficult and more dangerous.

It is all too easy to think that the trans activism of the past has failed, that every gain has been reversed in an orgy of hate and bigotry. Yet this is simply not true.

The achievements of the past have helped prepare us collectively for the demands of this moment. There are more of us than ever, and we have successes as well as failures to learn from.

Let’s see what we can do with that.

Some relevant resources:

Trans Actual: Know Your Rights

Trans Actual: Segregation in Practice Report

Trans Learning Partnership: Stronger Voices: Trans Housing, Community, & Livelihood

Good Law Project: We’re supporting a legal challenge against the code of practice

Good Wee Place: EHRC Sex Segregation. Staying safe and responding well. (guidance for venues and individuals)

Gendered Intelligence: EHRC Code of Practice Guidance (guides for Young People, and for Adults)

Good Night Out Campaign: Pee In Peace

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New article: Pathologising Legacy Measures and over-assessment

I have a new peer-reviewed academic article out in the International Journal of Transgender Health, co-authored with my colleagues Cal Horton, Jaimie Veale, Lou Kerley, and Ken Pang.

Pathologising Legacy Measures and over-assessment:
reconceptualising ethical assessment and data collection practices in trans children’s healthcare

The article looks at a range of questionnaires which are in common use internationally in trans youth healthcare. These are designed as a type of data collection tool known as “Patient Recorded Outcome Measures”, or PROMs, in which patients are asked direct questions about their feelings and experiences, to track the outcome of specific treatments.

PROMs are common across healthcare and mental health interventions more generally. You may have experienced this yourself if you have ever seen a therapist, for instance. A widely-used example is GAD-7. This invites patients or clients to use a numerical scale to rate how often they have felt bothered by particular problems, such as “feeling nervous, anxious or on edge”, or “feeling afraid as if something awful might happen”.

If a patient or client fills out a questionnaire such as GAD-7 both before and after receiving a treatment or therapeutic intervention, the care provider can – in theory – test how successful their intervention has been.

In trans healthcare, PROMs have historically been used by clinicians for research purposes, as well as for tracking individual outcomes. This has often been problematic, especially when patients are presented with a great many questions, or where these questions are experienced as pathologising or intrusive. For example, in the mid-2010s the Nottingham Centre for Transgender Health notoriously subjected new patients to 27 pages of apparently mandatory questions, including about seemingly random topics such gaming. This caused a great deal of stress and confusion for people seeking care at the clinic.

However, with specialist trans healthcare provision increasingly facing political threats, many clinics currently present PROMs as necessary to demonstrate the benefits of the care they provide. With this in mind, Cal Horton set out to examine 36 PROMs used in trans youth healthcare, assessing them according to four aspects of pathologisation (authenticating transness, intrusion, delegitimisation, and transnormativity) as well as over-assessment. They then brought their findings to our research team, and we wrote them up collectively. We found that both pathologisation and over-assessment were widespread across a majority of these PROMs. For example:

“Tool BI2 asks children to rate how happy they are with 26 body parts, asking which body parts they would like to surgically change, including body parts that cannot be changed through medical intervention (e.g. hands). These questions do not adopt a trauma-informed approach, and many may be experienced as abusive. Tool BI1, for example, asks how children like to pee and how they feel about looking at their body naked, questions which are clinically unnecessary and likely to be experienced as a significant intrusion of privacy by service users.“

The central argument of our article is that numerous commonly-used PROMs are impacted by a wider legacy of pathologisation in trans health, in which young people especially were treated as objects of clinical curiousity, rather than subjects of care. Since these PROMs are well-established and scientifically “validated”, they continue to be used in clinics which profess to practice forms of affirmative care. We therefore named these “pathologising legacy measures”, and caution against their continued use.

We do recognise that many clinics continue to use pathologising legacy measures out of a genuine desire to evidence necessary, life-saving care in an increasingly hostile political environment. Our ultimately question to these clinics is: at what cost?

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Open letter to NHS Director for Specialised Services on trans youth hormone ban

I am one of the 85 signatories to an open letter to James Palmer, NHS England’s National Medical Director for Specialised Services. We are raising serious concerns about the recent NHS evidence reviews of hormone therapy for trans youth, and subsequent prescribing policy and public consultation.

The letter has been published and sent to Palmer by Trans Actual – you can read more about it on their site here. In my signature, I note that I was a 2023 recipient of the NHS England LGBT+ Advisor Award. Unfortunately, in subsequent years, NHS policy on LGBT+ healthcare seems increasingly shaped by ideology and political pressure, rather than patient experience, expert advice, and evidence. In meetings I attended with Palmer in the early 2020s, I personally heard him share various forms of disinformation about young trans people, such as the factually inaccurate claim that recent cohorts of adolescents presenting with gender dysphoria represent a distinct population from young people referred to the same clinics in earlier years.

For a longer and more detailed critique of the NHS evidence reviews, see this excellent analysis by Kim Hipwell: A Medical Mess: An Analysis Of The NHS’s Proposal To Ban Hormone Therapy For Trans Youth.

The public consultation is open until 7 June, and you can submit a response here.

Dear James Palmer,

We are a group of clinicians, researchers, and academics working in gender care, paediatrics, and related fields of healthcare, medicine, and science.

We are writing to lay out our serious concerns with NHS England’s recently-published evidence reviews into the use of gender-affirming hormone therapy (GAHT) by children and adolescents.


1. Lack of Clear Rationale

The Cass Independent Review previously commissioned a systematic evidence review into GAHT for under-18s.

Based on this peer-reviewed and published analysis, Dr. Cass recommended that “NHS England should review the policy on masculinising/feminising hormones. The option to provide masculinising/feminising hormones from age 16 is available, but the Review would recommend extreme caution.”

In 2024, NHS England reviewed and updated their GAHT policy accordingly.

A “living systematic review” – also recommended by Dr. Cass – is now underway, to consolidate the evidence base and keep it up-to-date. This work is being conducted by EPPI-Centre and others, funded by the National Health and Care Research Institute (NIHR), and includes an ongoing review of evidence for GAHT for under-18s.

Therefore, it remains entirely unclear why – having previously wholeheartedly accepted the Cass Report – NHS England has now launched a separate evidence review that was never recommended by Dr. Cass and which duplicates other research already commissioned and underway.


2. Lack of Peer Review

None of the NHS England evidence reviews have been peer reviewed or written to meet publication standards. Instead, NHS England released the reviews only as part of a public consultation process and has asked the general public to “check that draft policies are well evidenced” and to determine whether “all of the relevant evidence [has] been taken into account”.

Consultation is not a substitute for formal academic review, and risks conflating technical evaluation with public opinion.


3. Methodological Limitations and Risk of Bias

Rather than address a single, clinically meaningful research question, NHS England subdivided the GAHT for under-18s evidence review into 10 separate and extremely narrow PICOs (population, intervention, comparison and outcome search parameters).

We have confirmed that this methodological decision was made by NHS England’s “Policy Working Group”, prior to instructing the “independent” researchers, Solutions for Public Health (SPH).

This methodological approach explicitly goes against the gold-standard guidance outlined in the Cochrane Handbook, which cautions that fragmentation of PICOs is likely to result in “sparse” evidence and “could be chosen by review authors to produce a desired result.”

As a result of these overly-narrow search parameters, the researchers had to exclude some of the most significant studies on gender-affirming care for young people, such as Chen et al., 2023, the largest NIH-funded prospective study of trans youth ever conducted.

Ultimately, the researchers could find only 11 eligible studies across all 10 PICOs, with 0 (zero) studies found for 6 of the 10 reviews. In contrast, the University of York evidence review commissioned by Dr Cass found 53 studies, 34 of which were assessed as moderate- or high-quality.

As an example, studies were deemed “out of scope” if participants had received GnRH analogues in the context of puberty suppression prior to receiving gender-affirming hormones (despite the fact that this was the standard treatment protocol internationally for many years, including in the UK).

According to the published reviews, as a result of this methodological decision alone at least 38 studies were excluded that would otherwise have been eligible (and potentially many more at title/abstract stage). These studies could, at the very least, have provided information on the risk profile of GAHT, a factor which NHS England claims to be central to their policy decision making.

NHS England has published no rationale at all for this – and other– methodological decisions. In response to an FOI request, NHS England indicated that studies involving GnRHa puberty suppression “cannot be included” in the PICOs because of “legal issues”, an “ongoing research trial in this area” and “lack of new evidence” – reasons that we find scientifically unsound.

Additionally, in contexts where limited evidence is available for a paediatric intervention, it would be typical for researchers to consider extrapolating data from research into adults, something that NHS England again chose not to do.

In effect, NHS England has adopted a methodological approach that predictably minimises the available evidence base, then cites this manufactured scarcity as a justification for restrictive policy conclusions.


4. Misreporting and Misapplication of Findings

Especially in paediatrics, clinical policy and decision-making is commonly based on evidence considered limited and/or “low-quality” as recognised under the GRADE system. There is therefore no reason why the purported lack of evidence reported in these reviews should automatically lead to the policy position that gender-affirming hormones are so unsafe and/or ineffective for 16- and 17 year olds that they must be immediately withdrawn.

Even when looking only at the 11 studies included in this NHS England evidence review, we believe the overall pattern of evidence suggests that the benefits of GAHT for under-18s outweigh any harms. We believe this is also the case in the University of York review.

We have also found that at least one of the studies included in the SPH reviews that apparently found evidence of “harm” (Grannis et al., 2003) was entirely misreported. The evidence review states that those taking oestrogen had significantly higher depression, suicidality and social anxiety scores than those not on hormones. In fact, Grannis et al. found no statistically-significant differences on these measures.


5. Impacts of Treatment Withdrawal

As far as we are aware, NHS England has no plan to monitor the impact of this withdrawal of gender-affirming healthcare on patient outcomes. This is despite evidence that removal of gender-affirming care is associated with adverse mental health outcomes, including increased suicidality among trans youth.

A decision to withdraw a treatment must consider what alternatives will be provided. Psychotherapy or psychosocial support alone – all that is currently available via the NHS – has not been demonstrated to be an effective treatment for those with a diagnosis of gender dysphoria. Nonetheless, as far as we know, NHS England has no plans to conduct a similar evidence review of
this intervention.


6. Conclusion

In summary, a drastic and potentially devastating policy change that runs counter to international standards of care has been advanced:

  • without any clear rationale,
  • on the basis of a methodologically-flawed process,
  • in the absence of peer review,
  • and without plans for monitoring impact or mitigating harm.

We therefore urge NHS England to:

  1. pause and reverse implementation of any policy changes arising from this flawed review process,
  2. publicly acknowledge and take into consideration the existing University of York systematic review into gender-affirming hormones and the existing EPPI-Centre study,
  3. ensure any clinical commissioning policy on gender affirming hormones for under-18s reflects established international best practice,
  4. and incorporate patient and clinician consensus and testimony into any decision about transgender healthcare.

A full list of signatories can be found here.

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Crowdfunder: help a Black trans kid afford care

I’m currently helping to raise money for Isaac, a young trans man I know, and his family.* In the face of enormous NHS failings, they need your help to afford trans healthcare.

Share or donate:
Help a Black trans kid afford care


There is of course already a lot of fundraising for healthcare within trans communities. This is inherently unfair for several reasons. Firstly and most importantly, it’s wrong that people struggle to receive the care they need from state-funded providers, and pretty much all trans people across the world are discriminated against in this regard (whether or not we are talking about medical transition).

Secondly, research shows that crowfunding tends to favour individuals with more existing social capital. People trying to raise money for their care benefit from factors such as being older, transmasculine, white, and/or well-connected on social media.

For these reasons, I try to support collective fundraising where possible. Some examples of this include the Glasgow Transfem Electrolysis Project, and the gig I was DJing at just this week for Trans Healthcare Access Glasgow.

However, there are cases where we simply don’t have the infrastructure or resources in place (yet?!) to support collective fundraising. A good example of this is all minors: young trans people who are more likely to face heightened discrimination and legal barriers both to accessing care in the first place, and in attempting to circumnavigate these barriers.

I do not have the capacity to make a habit of running fundraisers. In this instance, I have known both Isaac and his family for a long time. I know that they are systemically disadvantaged due to economic factors, an inability to go public and put a face to their crowdfunder, and the intersection of transphobia, racism, and various other forms of structural oppression.

Here’s some of the blurb from the crowdfunder page about why you should support Isaac:

Isaac’s story

Isaac is a Black trans kid living in England. He is an expert baker of chocolate chip cookies, loves painting and drawing sharks, and has a budding rock collection. He’s obsessed with highland cows, and knows all the words to Hamilton.

Isaac has a very supportive family who want to help him access healthcare. However, they are in low income work, and are on universal credit.

They therefore need your help to afford care for Isaac.

Stylised drawing of a young man, with white and pink chalk on black paper.

NHS failings

Isaac received a diagnosis of gender dysphoria from the NHS England Gender Identity and Development Service (GIDS). However, the clinical timelines were so slow at GIDs that this diagnosis came too late for him to access any medical treatment before the clinic closed in 2024.

Like many of young people, Isaac has found the new NHS trans healthcare clinic for under-18s – the Children and Young People’s Gender Service  – to be traumatic and abusive. He also has no hope of being prescribed medication there.

For more information on young trans people’s terrible experiences at NHS clinics, see Dr Cal Horton’s article, “The worst thing I ever experienced”

How much money does Isaac’s family need?

We are aiming to raise up to £8000. This is to cover the cost of the following for up to three years:

  • Diagnostic appointments
  • Subscription to a private clinic
  • Medication costs
  • Blood tests

Isaac’s family may save on some of these costs if they can find a GP who will provide shared care and blood tests. However, this is not guaranteed.

If Isaac’s treatment costs less than the money raised, any remaining donations will go towards a top surgery fund for when he is an adult.

If there is still remaining money not spent on Isaac’s healthcare, the family will donate this to fundraisers for other trans kids and/or other trans people of colour.



*Isaac, of course, is not his real name. However, the image for this campaign is a self-portrait of his future self that he drew when much younger. Isn’t it amazing?

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Trans children’s rights and the UNCRC – new article and interview

I have a new article out, co-authored with Dr Cal Horton. It’s about the incorporation of UN convention rights into Scottish law, and what this should (in theory) mean for trans children in Scotland and beyond. The article is totally open access so anyone can read, download, and share it anywhere. You can peruse a copy right here:

The United National Convention on the Rights of the Child and the Rights of Trans Children in Scotland
The International Journal of Children’s Rights

In recent years I’ve felt increasingly critical of human rights as an artificial framework for behaviour, which is frequently ignored or manipulated by those in power. As Nat Raha and Mijke van der Drift put it, these are “human rights for human resources”. Nevertheless, the UN Convention on the Rights of the Child (UNCRC) is now part of Scottish law, and Scottish children and policymakers alike are being informed that this conveys certain expectations for how young people are to be treated.

Cal and I believe it is important to reflect on what this all means for people seeking to work in a humane way with trans children, in Scotland and beyond. In particular, we emphasise the importance of directly involving young people in conversations and decision-making about their own lives. We draw on the demands of young people themselves in doing so, including groups such as Trans Kids Deserve Better Scotland, who note that policymakers have actively ignored young trans people by “by shutting trans bodies and voices out of every room that matters [and] pretending we don’t exist.”

This weekend also sees the publication of an interview I did for the Herald about the UNCRC article. In this, I discuss the findings of my research with Cal. I also reflect more generally on the situation faced by trans studies researchers, in which it is increasingly hard to conduct trans-positive research even as the UK government and funding bodies throw millions of pounds at anti-trans researchers.

Screenshot of the Herald newspaper website. The article header reads: Expert says trans children's rights are not being respected. Exclusive by James McEnaney. There is a photograph of Ruth Pearce, a smiling white woman with shoulder-length brown hair who is wearing an Against Me t-shirt. Below the image is a quote from Ruth: "It is a difficult time to be doing any kind of research on trans or queer or even feminist topics, so I'm finding that I need to be quite cautious about media coverage.


We end the interview with key three takeaways regarding what can be done to protect the rights of trans children, in Scotland and beyond:

“Number one would be to genuinely consult with young trans people and ask what they want and need. They deserve real and meaningful consultation.

“Number two is that there is a huge amount of knowledge that already exists, both on young trans people’s experiences and on how to consult with young people. Draw on the knowledge that already exists.

“And number three is to acknowledge that there is a trans-eliminationist movement. Acknowledge that there is an active attempt to stop anyone from doing the first two things.

“There’s an active attempt to stop any anyone taking seriously what young trans people have to say about their own lives, and an active attempt to stop any accessing of existing knowledge, and that comes from a place of prejudice.

“One of your starting points has to be acknowledging that that exists.”

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Puberty blocker consultation: my response

In early September I recieved an email from the Department for Health and Social Care, inviting me to participate in a closed consultation on the Labour government’s proposed extension of the Tory ban on puberty blockers. The deadline was 1st October 2024.

September was already extremely busy. I started the month at the International Trans Studies Conference in Chicago, and ended it at the WPATH Symposium in Lisbon. In the meantime I was faced with various writing deadlines, administrative tasks, and the start of a new teaching semester. The small number of other academic experts and voluntary organisations who were also invited to respond no doubt faced very similar challenges with the short notice and unforgiving deadline.

Nevertheless, I scrambled to respond. Like Cal Horton, I regard government consultations on trans healthcare to be inherently abusive at this stage; as I wrote to the Nuffield Council on Bioethics in 2018, “we respond not with hope or optimism, but in fear. This is the power you wield over us”. Given the turgid vibes found in recent political discourse, I also held little hope of a long-term ban being prevented. However, it seemed worth using what little prestige I have as an academic to at least try to encourage the government to listen to actual evidence.

Trans Writes are now reporting that an extension of the ban until 2027 is on the cards for Britain, following a unanimous vote on the same by the Northern Ireland Assembly. With this in mind, I am now publicly sharing the evidence I provided in the closed consultation, plus slides from an oral presentation to the Commission on Human Medicines, who advised the Government.

I don’t think for a moment that sharing these materials will change anything in the short term. However, I feel it is important to put them in the public realm now for the sake of transparency.

[PDF] Puberty blocker consultation – response from Ruth PearceDownload

[SLIDES] Commission on Human Medicines – Pearce presentationDownload

Going forward, I hope the work that many of us have done in building and sharing an ethical base for the ethical provision of trans healthcare will make a difference. In the meantime, there is an important lesson here about relying on existing, unequal systems of power and control. As Nat Raha and Mijke van der Drift argue in their new book Trans Femme Futures, making demands of institutions leaves the power in their hands. It is more important than ever for trans people to build power and knowledge within our own communities, in collaboration with others.

We have survived worse in the past by sharing information, ideas, and life-changing medication between us, and we will do so again.

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Out now in Scientific American: “The U.K.’s Cass Review Badly Fails Trans Children”

I have co-authored an article with Cal Horton for the science magazine Scientific American. We take a concise look at what the Cass Review is, what it found, why the methods used were troubling, and how it is being used to harm young people.

You can read the article here. I hope it will be helpful as a basic explainer for why trans community groups, academic experts, and clinical specialists are so concerned about the Cass Review.

Screenshot of Scientific American website.

Writing for Scientific American was a really interesting experience. It was of course radically different to publishing in a peer-reviewed journal: we put the piece together in a matter of weeks, and it was not scrutinised by academic experts from our specific field of study. At the same time, there was an extremely rigorous editorial, fact-checking, and copyediting process that also made it very different to publishing in most magazines or newspapers.

I was deeply impressed with the sheer amount of time and care the Sci Am editors put into this piece. On one hand, their contributions ensured the piece is written in accessible language, with an international (and especially US-based) readership in mind. On the other hand, we had extensive discussions to ensure that all points made in the article could be rigorously evidenced, including some very detailed exchanges about the specifics of UK law, and what exactly the Cass Review document does and does not have to say about exponential growth over different periods of time. We had to be able to strongly back up any even slightly contentious point.

It was a challenging experience, but one I felt very held by as an author committed to consciencious research practice. Publishing this piece in Sci Am definitely ensured that it was as good as it could possibly be.

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New article: Trans Birth Parents’ Experiences of Domestic Violence

Through 2018 and 2019, I travelled across the UK and Germany to speak with trans men and non-binary people about their experiences of pregnancy and childbirth.

These research interviews for the Trans Pregnancy Project took place in kitchens, living rooms, and cafes, next to canals and rivers. We covered topics ranging from conception to pregnancy loss, taking in questions of masculinity and the body, relationships with family, friends, workplaces and social groups, interactions with medical practitioners, and people’s journeys through perinatal services.

I remain deeply honoured to have been trusted by participants to share and analyse their stories. The questions planned by our project team touched on deeply intimate and sometimes traumatic experiences, as well as joyful accounts of kinship and bringing new life into the world. These were by design long, deep discussions, covering a great range of issues that have been rarely discussed in academic literature to date.

And sometimes, an unexpected conversation would happen.

We – the research team – did not plan to study domestic violence. Instead, this topic was introduced by research participants. I will never forget the first time this happened, silently putting aside my planned questions as the man in front of me quietly, carefully disclosed what had happened to him, and how it intimately shaped his experience of pregnancy.

As others shared their stories in turn, I began to realise just how important these narratives are, and the need for peer-reviewed work that explored them in detail. The resulting article is now available following a long gestation period (pun intentional). I hope it will useful to a range of practitioners – educators, crisis workers, midwives, obstetricians, doulas, family doctors – as well as to academics and, most importantly, community members.

Read now for free:
Trans Birth Parents’ Experiences of Domestic Violence
Conditional Affirmation, Cisgenderist Coercion, and the Transformative Potential of Perinatal Care
by Ruth Pearce, Carla Pfeffer, Damien W Riggs, Francis Ray White, and Sally Hines


I am also really pleased that we have published in the “platinum open access” journal Bulletin of Applied Transgender Studies. Launched in 2022 and hosted by Northwestern University Libraries, the journal is free to publish in and free to read, with articles shared under a creative commons license. We found this publication route offered an extremely rigorous double-anonymous peer review that really challenged us, and ultimately strengthened our arguments and use of evidence. Given the exploitation and profiteering that is rife in the academic publishing industry, supporting new journals such as the Bulletin feels like an important political move as well as the right scholarly decision.

Journal logo

Please do share this article in any context you feel it will be helpful to others. Remember, under the license anyone can distribute it as-is for non-commercial reasons: so download, print, and pass it around to your heart’s content.

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Trans Kids Deserve Better – protest at NHS HQ

Young trans people have been leading an incredible protest at Wellington House, the London headquarters of NHS England. They have been holding space on a ledge of the front facade since London Pride on Saturday 29 June.

The protesters will be coming down today (Tuesday 2 July) and have called for supporters in London to join them at a rally from 4pm.

Photo of a group of people sitting on a ledge of a building, with towering pillars and glass windows behind them. They are holding a large banner which reads "We are not pawns for your politics". They have decorated with the windows of the building with trans flags, placards, and the words "trans kids deserve better".


The action powerfully highlights the repeated failure of UK politicians, the mainstream media, and NHS bodies to truly listen to young trans people about their experiences and needs. This is perhaps most powerfully seen in the Cass Review, which has systematically excluded expertise and evidence from trans people in formulating its recommendations, and in trans healthcare bans implemented for under-18s in England in Scotland. Meanwhile, the Labour party are promising to uphold these bans and implement a range of deeply transphobic policies should they win the election on 4 July.

These concerns are powerfully highlights by the protesters themselves. In Diva, a 17 year old activist explains:

“Decisions are being taken that affect our lives without any trans people in the room, let alone trans young people. Too often trans kids are portrayed as a monolith of confused, depressed teenagers. We are denied choice and robbed of our autonomy. But we should be trusted to make the same decisions about our healthcare that all people are. 

In every other way I am trusted when I tell people what I want to do with my life. But not now. There is so much real anger out there and we hope our actions will encourage others to fight for a voice, and the healthcare and dignity that we are currently denied.”

Another protester explained to Pink News:

“We are staging this protest to remind politicians and voters that we’re real kids, not just political talking points. We may not have a vote, but it is our lives that are at stake. Gender-affirming healthcare is a matter of life and death for us and we hope our actions will bring awareness to this fact and encourage others to fight for the healthcare and dignity we are so shamefully denied.”

As a former youth activist working in this field for almost two years now, I am hugely heartened and inspired by this powerful protest. In the face of institutionalised violence and silencing, young trans people are seizing the narrative. It is up to us adults to listen, learn, and fight alongside them.

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Podcast: Reviewing the Cass Review

I am featured in the most recent episode of Red Medicine, a podcast about the politics of health, medicine, and the body.

The interview features a deep dive into the Cass Review, including the contexts of trans healthcare and the anti-trans moral panic, as well as the underlying assumptions and methodological shortcomings of Review’s final report on healthcare for trans and gender-questioning young people. We explore how the Review is constructed as credible in spite of its flaws, plus how and why that is dangerous both for young trans people and for good science.

You can listen to the report through the Simplecast link above, or alternatively through Apple Podcasts or Spotify.

More information on the topic is available in my post What’s wrong with the Cass Review?