First Do No Harm

An Open Letter to the publishing industry

In the light of the welcome news that Wes Streeting has confirmed the ban on puberty blockers following the Cass Review, our member Looby-Lou has written this powerful piece reminding the publishing industry of their responsibility in this area. We do not advocate banning books, but we also do not advocate the publishing of books for children and young adult that spread disinformation, fail to give two sides of an argument and contain inappropriate content. This is basic safeguarding and should be the standard to which we all adhere.

In light of the damaging revelations in the final report of the Cass Review, we call on all in publishing to stop the publication and promotion of children’s books that indoctrinate young minds into believing that it is possible and desirable to change sex.

Over the last decade, there has been a huge surge in books aimed at children and adolescents promoting the ‘transgender’ child. We will not name and shame these books, but there are high profile examples which promote puberty blockers and cross-sex hormones as being safe and effective, normalise surgical interventions such as mastectomies, and normalise the social transitioning of children and the use of pronouns. A significant number of these books are targeted at children in nursery school.

The very thing that these books are promoting and normalising are, as the Cass Review makes abundantly clear, ‘built on shaky foundations’. As the review also makes clear, these surgical interventions are not proved safe or effective. Indeed, NHS England has banned puberty blockers outside of clinical research, and the Review has recommended that no-one under the age of 18 be prescribed cross-sex hormones unless in exceptional circumstances. Not only is the evidence for putting children on a life-altering medical pathway ‘remarkably weak’ but the harms in relation to fertility, bone density and brain development amongst others are becoming more apparent.

The review  also  strongly warned of the long-ranging dangers of socially transitioning young children and how it may ‘profoundly alter a child’s developmental trajectory’.

By publishing these books, our industry has normalised these surgical interventions, and normalised the idea of the transgender child to impressionable children and vulnerable adolescents. The industry contributed to great harm.

We must no longer bury our heads in the sand on this matter or ignore the voices that have been shouting for years about the dangers. Many of those voices have been bullied out of the industry or cowed into silence. It is an issue that has torn children’s publishing – indeed, the whole industry – apart.

As the review said: ‘Childhood, adolescence and young adulthood are dynamic developmental periods for gender expression, cognitive development and overall brain maturation’. In other words, gender expression in a variety of forms is a perfectly normal part of growing up.

It is now time for the publishing industry to tackle the part we have played in normalising what has now proven to be harmful. It is time too, to learn to say a firm ‘no’ to those who still, through a refusal to admit the truth that’s staring them in the face, still wish to promote this harm. It is time for everyone in publishing to stand up for children and remember the importance of both safeguarding and the fact that just as in medicine, our first principle should be: Do No Harm.