I was advised not to listen to Keira’s harrowing story but I overruled that: ministers must overcome obstacles to find the truth
Government ministers have difficult decisions to make, often between options where the best course of action is unclear. Some decisions, however, are simple. They are about right and wrong. Last week’s decision to shut the Tavistock’s gender identity service (GIDS) clinic is one such example.
When I became equalities minister in early 2020, the NHS clinic for young people was presented to me by government officials as a positive medical provision to support children. I was assured that was there “nothing to see here”, if anything, the Tavistock was getting unfair press. This was despite whistleblowers like Dr David Bell already raising concerns about practices at the clinic.
Children and their welfare should be a priority of any government. After receiving correspondence on the matter I decided to listen to every perspective on the issue of those experiencing gender distress to prepare future policy. I noticed officials seemed to be consulting the same people and previous ministers had created an LGBT advisory panel that was clearly suffering from groupthink.
I insisted on meeting campaigners on both sides of the debate: not just Stonewall but, to the horror of some officials, the LGB Alliance. I met clinicians and, most importantly, I asked to meet young people who had used the Tavistock’s services.
One such young person was Keira Bell. To my surprise, I was advised strongly and repeatedly by civil servants in the department that it would be “inappropriate” to speak to her. I overruled the advice. Along with other advisers across government I met Keira and listened to what she had to say. Her testimony was harrowing and brought many on the Zoom call to tears. Keira described how, after being put on puberty blockers at the age of 16, she was given testosterone shots at 17, before her breasts were cut off at 20. Worse was the casual indifference she described from the GIDS service to her continued post-surgery wellbeing.
There are two types of ministers — those who assume that officials know best and follow their advice unquestioningly, becoming spokespeople rather than decision-makers — and those who don’t.
The government machine wants to be comfortable and consensual and campaigners and activists know how to take advantage of this. A minister asking tricky questions can be stopped in their tracks by accusations of stoking “culture wars”. Minutes of private meetings with whistleblowers and concerned citizens can be selectively leaked or become the subject of numerous innocent-looking freedom of information requests, designed to identify targets for harassment on social media, as I discovered in one unfortunate case.
Whitehall has solutions for ministers wishing to dodge difficult decisions: issue another call for evidence for information you already have; publish a consultation that is captured by campaigners or form a new working group of “stakeholders”. However, the work of government is all about making difficult decisions, even if it makes us unpopular.
I write not to take credit for this result — my part in it was very minor — but to give an insight into the numerous obstacles that slow down even the most determined minister from finding out the truth and making the right decisions.
Others were more influential. I could not have done anything without being empowered by my senior minister, Liz Truss, to challenge advice, meet whoever was relevant and do my job as I saw fit. Not everyone is that lucky.
Even more credit should go to health secretaries such as Matt Hancock who in the midst of the pandemic pushed for the commissioning of the review by Dr Hilary Cass that led to the closing of the Tavistock and also his successor, Sajid Javid, who provided support when I raised numerous concerns that the Department of Health refused to prioritise.
It would be wrong to portray the entirety of the civil service as hostile on these issues. Far from it. A small minority of activist officials are the tail wagging the dog, often to the dismay of their colleagues and the hand-wringing of far more senior officials. This includes some permanent secretaries who are too scared to challenge their own staff and instead see ministers as obstreperous.
A lot of the hard work was done by gender-critical journalists and a feminist grassroots movement informing the public of what was going on at great personal cost.
I was astonished that in trying to help mostly gay children whose childhoods were being destroyed by experimental treatment, I was misrepresented by mischief-makers and their friends in certain media outlets as being anti-LGBT with slurs gleefully retweeted by Labour politicians such as Angela Rayner and Chris Bryant.
But it was clear that many women in today’s workplace were paying a much bigger price for telling the truth while doing their job. Journalist Lucy Bannerman exposed the Tavistock’s ideology and practices only to have a mob picket her workplace with placards labelling her work “transphobic”. Online trolls routinely sent her death threats. Professor Kathleen Stock was hounded out of Sussex University by students. Maya Forstater and Allison Bailey are two heroic women who have been vindicated through our legal system. But their struggle for justice came with unimaginable hardship simply for asserting that biological sex was real.
Where was the furore in parliament as these women suffered? A healthy opposition would have pushed government to solve the problem sooner. Instead Labour, the Liberal Democrats and the SNP were on the wrong side of the debate, captured by gender-identity ideologues. Notable exceptions, such as MPs Rosie Duffield and Joanna Cherry, were ostracised by their party leadership who refused to look at the evidence, preferring to posture on social media and chant slogans in parliament.
The reason it took this long for the Tavistock clinic to be shut down is that activists succeeded in creating an environment in which critics and journalists felt unable to interrogate the dogma that youngsters should be able to medically transition in the way overseen by Tavistock. The treatment of these women showed the heavy price to pay and many people including MPs on all sides of the house simply didn’t want to get involved.
There is a wider problem of campaigning groups making life difficult for those who have to make tough decisions by creating a toxic atmosphere on social media where many MPs engage with their constituents. A Conservative MP in a marginal seat told me she was not confident discussing the matter publicly for fear of being branded a bigot by her Liberal Democrat opponent. A Labour MP told me in private she was grateful her party was not in power because they would not be able to face down the large number of activists online that Labour relies on to push its message.
The country owes so much to Dr Cass and her impartial and evidence-based work. Being external to the Whitehall machine partly explains her success in getting it completed.
Many people ask why I am speaking only now. To do so earlier could have politicised an independent report. Second, there were vigorous debates in Downing Street and no settled view on how to tackle the matter without upsetting one group of stakeholders or another. Collective government responsibility often means keeping your personal opinions to yourself. To be as frank as I can be now, I would have had to resign my position and risk a more compliant person taking on the role.
There is still much to do. Many find the question “What is a woman?” baffling and silly. It is really a proxy for working out what side of the debate a politician is on as we make policy.
Some proposals I saw on our conversion therapy plans would have inadvertently criminalised the very clinicians who blew the whistle at the Tavistock. Earlier this year, the decision to pause these legislative proposals was portrayed as being anti-transgender people at a time when government was doing everything it could to ensure they received the most appropriate care.
Even now, the SNP-led Scottish government is pushing forward controversial legislation that will reopen the issue of self-identification and create confusion between different jurisdictions in the UK on how we define who is and who isn’t a man or a woman.
Contentious issues such as these need firm direction from a prime minister and I am confident that we will finally see this in the coming year, whichever candidate wins the leadership contest.
The Whitehall machine often becomes the voice of interest groups in government rather than government’s voice to interest groups. This stems from a sincere, yet naive, belief that you can appease special interests with platitudes and “lines to take”. The truth is some battles have to be fought and won.
This requires strengthening a civil service that is terrified of controversy and recalibrating it towards policy and away from posturing on issues it believes as too “contentious”.
To win these battles, ministers must see through the courage of their convictions, ignore Twitter storms and face down vested interests who are profiting from scandals such as the Tavistock that ruined so many lives.
First published online by The Times, 30 July 2022
