From claims that Jesus was trans to demands for puppies for snowflake students, outrage and offence keep people like me in pocket. Indeed, anyone worth their column inches will have faced calls for “cancellation” or “no platforming”. But under such headlines there are people who bear real scars from the culture wars. Those caught in the crossfire are most often children and young people in need of support; they have been failed by the adults and institutions that should have their best interests at heart.

The policies that led to the medicalisation of young women like Bell were formed in the dark

That’s why voices like Keira Bell’s are uniquely powerful; reasoned and calm, on 7 April Bell told her story of how she came to believe that her problems would be solved by transitioning to become male. In a moving and personal account of her experience for Persuasion she explained: “I had so many issues that it was comforting to think I really had only one that needed solving: I was a male in a female body. But it was the job of the professionals to consider all my co-morbidities, not just to affirm my naïve hope that everything could be solved with hormones and surgery.”

Keira Bell is the 24-year-old young “detransitioned” woman at the centre of the case which has become ground zero in the culture wars. In December 2020 three hight court judges ruled in her favour and against the Tavistock and Portman NHS Foundation Trust, effectively preventing the prescription of puberty-suppressing medication to children. The unanimous judgement expressed concern about “the experimental nature of the treatment and the profound impact that it has”.

The treatment Bell was offered at the Tavistock was based on the “affirmative” model whereby a person’s perception of themselves as the opposite sex is affirmed. Bell was 16 when she was referred for puberty blocking medication. Until July 2020 the NHS claimed the effects of puberty blockers are “fully reversible”. But they recently changed their guidance, acknowledging that little is known about the long-term side-effects on a teenager’s body or brain.

The policies that led to the medicalisation of young women like Bell were formed in the dark, with little political or journalistic scrutiny. Some have suggested this is no accident; in 2019 a report produced by the LGBT pressure group IGLYO (with assistance from staff at the international law firm Dentons) advised those lobbying for “legal gender recognition for youth” to “intervene early in the legislative process and ideally before it has even started” and to “avoid excessive press coverage and exposure”.

The ferocity of the debate online is a reflection of the stifling of debate in our civic institutions

Thirteen years ago, Susan Evans was the first person to resign from the Tavistock and Portman NHS Foundation Trust over concerns about the treatment pathway of children with gender dysphoria. She first blew the whistle in 2004, when Bell would’ve been around seven years old. Since Evans’ departure scores more clinicians have followed suit with many expressing misgivings about the influence of transgender lobby groups on clinical practice. As clinical confidence in the affirmation model declined, the numbers referred increased; in less than a decade UK gender identity services have seen a 1,460 per cent increase in referrals of boys and a 5,337 per cent increase in girls.

Rather than reflecting on the evidence brought to the surface by Bell’s case, MPs across the political spectrum have doubled down on their stance and criticised those urging caution about the affirmation model. When, in 2018, a meeting was held in the House of Lords to discuss the issue MPs and peers were reportedly threatened with the withdrawal of the whip if they attended. Lord Moonie who chaired the event recalls “a direct attempt to coerce me into cancelling the meeting which I had sponsored, and when I refused, they said they were suspending my membership”. Moonie, who had been a member of the Labour Party for 40 years, quit. To date just a handful of MPs, notably David TC Davies, Rosie Duffield and Joanna Cherry, have questioned the affirmation model.

One of the first parliamentarians to champion the concept of “transgender children” was Maria Miller MP. In an interview for The Independent in 2016 Miller said: “I would prefer it if these trans people didn’t face dark and twisty childhoods. If there is anything I can do to stop that, then I will — even if it rubs a few people up the wrong way.” Miller was at the forefront of driving “reform” of the Gender Recognition Act (2004). The proposals she championed included a recommendation that “16- and 17-year-olds, with appropriate support, to apply for gender recognition, on the basis of selfdeclaration [sic].”

The ferocity of the debate online is arguably a reflection of the stifling of debate in our civic institutions and parliament. The posturing of politicians has forced young people like Bell into the no-man’s land of the culture wars, their bodies have become collateral damage. Bell’s childhood was “dark and twisty”, and her way of coping was to pass as a man.

The scars on Bell’s body were not just caused by surgeons; they mark the cowardice of our political class

In 2017, at around the same time Keira Bell was having her healthy breasts removed, I received an email from an employee at The Independent asking for approval for a post-publication edit to a controversial line in an article. The piece was one of the first in the mainstream British media about treatments for children with gender dysphoria. The offending sentence read: “There is no one approved way to respond to a child who declares themselves to be transgender.” This assertion had offended those who considered “affirmation” of a child’s identity to be the only correct approach; I was asked to reference guidance from World Professional Association for Transgender Health (I refused).

Bell’s voice of reason and calm cuts through the perpetual outrage machine that is social media and the braying of politicians. Her experience shows the vulnerability of British institutions from parliament to the mainstream press and NHS. She is a brave young woman; but suffering and the scars on her body were not just caused by surgeons, they are marks of the cowardice of our political class.