(2 years, 8 months ago)
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I appreciate that the hon. Lady was not here for the bulk of the debate, but I am very conscious that some Members have trans children and trans siblings. I know from my own experience in the debate about equal marriage that what changed the whole tone of that debate was MPs standing up in the main Chamber and talking about their personal experiences as a gay man or as a lesbian woman, unable to get married. However, it is a very personal decision for a Member to stand up and talk about their personal life; some people are comfortable doing it and some people are not.
So although I firmly recognise that many Members, many members of staff and many House officials will have trans siblings and trans children, it must be the individual’s decision whether they come forward to help change the debate. I urge them to do so; I would love them to do so, because it changes the whole tone of a debate when people can visualise and personalise, rather than hearing some abstract policy about what a trans person might be. However, that is a very personal decision.
I accept all the criticisms that I have heard today that we have not always got the tone right. That is absolutely true. I am sorry if I get a thick ear from some of my ministerial colleagues for saying so, but it is true that we have not always got the tone right. This is sometimes an emotive issue where we sometimes get it wrong. However, I can tell Members that the Secretary of State is absolutely committed to ensuring that trans rights are firmly embedded in our programme. That is why I and Lord Herbert of South Downs have joined the team, and it is also why we have Iain Anderson as the LGBT+ business adviser.
An amazing addition to our team and the work we do is Dr Michael Brady, as national adviser for LGBT health. If anyone has in any doubt as to what we need to do, they should spend time with Dr Brady and go to the clinics that he works in, because the work that he and his team do is truly amazing. If anyone has any doubts, any fears or any worries about what the trans community are, they should go and see for themselves, and talk to Dr Brady and his team.
I will bring the Minister back to a point he made earlier, when he said the Government would remove the gender dysphoria language. Can he give a bit more explanation, based on the advice that he is getting from Dr Brady and others, about what they will replace that language with concretely? Will it just be a different word, or will there be a slightly different process that trans people will need to go through with their doctors? Will those doctors only be specialists, or will there be an ability for people to go to general practitioners and so on? Answering those questions might provide some movement that would be welcome.
The hon. Gentleman asks quite a complex question, so, as he would expect, I do not have the answer now, but I will write to him. I can say that the word “disorder” will be removed; regarding exactly what it will be replaced with and how that will be implemented, I will write to him to give a full answer.
I will just mention the issue about some of the processes we have talked about. On trans health, progress is being made on adult gender identity services. Five pilots in a variety of settings have been developed, and these will be evaluated to give an insight on improving delivery. As I said at the outset, the fact that people have to wait three to five years to access services is simply unacceptable, and we are committed to ensuring that the whole client/patient—whatever term we want to use— process is streamlined and made faster, more effective and client-led.
I am in the enviable position of being able to promise lots because I do not actually have to deliver it—I am not the Health Minister. I can commit to having conversations with colleagues across Government to deliver all the changes in the bits of Government and processes that impact LGBT people. That issue is firmly on my agenda, and I will take away that specific request and discuss it with my colleagues in the Department of Health and Social Care.
The issue of under-18s is often where people have the most concern, but I want to stress that it is the Government’s view that the under-18s are properly supported in line with their age and decision-making capabilities. That is why Dr Hilary Cass is leading an independent review into gender identity services for children and young people. We will receive the interim recommendations soon. I have met Dr Cass and her team to discuss their work, which is rightly independent of Government. I believe that many concerns that Members and the public have about services for under-18s, which are firmly an NHS responsibility, will be addressed by the interim report by Dr Cass.
I wonder if it is the Minister’s opinion that older teenagers under the age of 18 have the capacity to guide their own pathways—just as with the Gillick responsibility.
The decision-making rules on under-18s will remain as they are. That decision making has to be informed by the client, clinician and the wider support framework, and all parties must have a voice.
To conclude, discussion around the previous consultation has been, rightly, intense, and issues raised today are fraught. The shadow Minister called it a Gordian knot, and I think we will struggle to address some of the issues. However, I share her view that we actually agree on many issues. With a lot of good will, we can address many of the issues that have been raised today. We have to remember who we are doing this for. It is to ensure that the trans community are supported with kindness, which is a word that I hate, because it sounds patronising, but the trans community must be supported as they go through what is an incredibly difficult process.