Time to stop, think and learn
Biology in Medicine proposes an urgent and necessary Significant Event Analysis on the NHS approach to gender dysphoria to stop unsafe medical practice.
The NHS loves to use aviation as a role model for safety and accountability. An example in general practice is the Significant Event Analysis (SEA) which is used to improve clinical governance and patient safety. SEA’s are a way to analyse critical incidents, near misses or unusual outcomes with the goal of improving systems and preventing future errors. They can involve clinical, administrative and management processes and staff.
As a group of doctors and colleagues, Biology in Medicine proposes the following Significant Event Analysis.
Step 1. What happened?
The NHS has been taken in by the ideological belief system of gender identity. What this means is that the NHS allowed policies and clinical practices to be influenced by activists to adopt a wholly gender affirming model without evidence or safeguards. This is seen in the following:
- Blurring of data due to the replacement of data on sex by ‘gender’ on health records.
- Focusing Equality, Diversity and Inclusion (EDI) policies on trans rights (often under the guise of LGBTQ+) at the expense of other protected characteristic rights.
- Diluting of evidence base due to activists leading and influencing the authorship and development of clinical policies
- Bias in consultations and reviews conducted by the Department of Health and professional regulatory bodies towards supporting gender ideology.
- Allowing Gender Identity Clinics (GICs) to be run from a wholly gender affirmation model endorsing demonstrably unsafe guidelines from discredited organisations such as WPATH (World Professional Association for Transgender Health).
- Promoting mistruths and unsafe guidelines to GPs regarding prescribing and affirmation.
- Avoiding the full implementation of The Cass Review
Step 2. Why did it happen?
- The NHS, professional bodies including the GMC and society in general has put a novel concept about gender identity before biology and the best available evidence. Unlike any other health condition, the NHS has ignored its usual rigorous standards of evidence when it comes to gender dysphoria.
- The NHS has been blindsided by the mantra to ‘be kind and inclusive’, also now in the GMC guidelines, wrongly using this to require the acceptance of the demands of people who say they need medicalisation when their body doesn’t match what they would like it to be.
- The gender affirmation model has promoted ‘no debate’ which has led to a culture of fear and silence within the NHS, preventing challenges from within and outside.
- Clinical governance procedures have failed to deploy.
Step 3. What was learned?
- Patient safety and accountability are eroded when an inflated idea trumps science and evidence
- Safeguarding measures have not worked
- Patients who question their gender are at high risk of harm:
a. Direct harm from gender affirmation which incorrectly states that they can change sex and from harmful interventions.
b. Indirect harm from inaccurate data leading to missed sex-based screening and incorrect diagnosis and treatment.
- Loss of accurate information when gender has replaced sex such as GMC.
- Policies are inaccurate and propagate risk across the whole organisation.
- Clinicians and staff are at high risk of moral injury from being required to offer treatments they know are harmful.
- Staff are forced to work in organisations that do not respect single sex spaces.
Step 4. What changes are needed?
Stop unsafe medical practice. This means:
Remove the influence of activists
Withdraw policies and guidelines that promote gender affirmation
Stop promoting gender affirmation to children and young people in all spaces
Stop the medicalisation of gender dysphoria. This means:
GPs stop prescribing cross sex hormones to people with gender dysphoria and stop referring patients to GICs.
GICs are closed in their current form (see below).
Start safe practice. This means:
NHS consults all stakeholders without bias
NHS updates all policies regarding gender dysphoria to incorporate the findings of the Cass Review (2024), the Sullivan Review (2025) and the Equality Act 2010.
NHS develops clarity regarding the accountability of organisations and professional regulatory bodies to ensure approaches are aligned with best available medical evidence
NHS investigates the clinical governance of GICs in terms of informed consent, the provision of psychological interventions as first line treatments, the long term follow up of patient outcomes and the provision of full support for any patients who choose to detransition. All evidence and potential harms should be clearly explained to patients and families with a detailed consent form for each harm
NHS ensures that all mental health services are able to offer people with gender dysphoria appropriate psychological treatments based on exploratory therapy, including assessment for behaviours, conditions and experiences that increase the chance that a person feels uncomfortable in their sexed body.
NHS and education sector help children and young people to understand the following:
Gender non-conformity is welcomed and needs space to be
Gender and sexuality questioning is normal: time helps
Gender distress (dysphoria) is a symptom that might require supportive psychological or talking therapy; sometimes medication helps
Sex cannot be changed, just as age cannot be changed
Evidence based medicine and biology should be the pilot of healthcare. Let’s fly people safely rather than let passengers and their feelings take command of the cockpit.
Superb and easy to follow analysis. I have restacked.
With biology in medicine, admit that humans share behaviors with animals, incuding negative social behaviors.
A key shared behavior is sexual mimicry, so males can avoid male social competition and take advantage of female cooperativeness to access female groups for unwanted social and sexual gratification. In females it exhibits as male mimicry to avoid male contact and use male hierarchy imitation to gain resources for offspring.
The behavior is present wherever there is sexual competition and strong sexual dimorphism which can be imitated. It is a way of “cheating” the system.
Every major animal group has members who have evolved sexual mimicry behavior, from cephalopods and mammals to lizard and birds.
In humans the primary manifestation is “trans” male behaviors, which protect males from male social violence, and which is used to gain male-competition-free sexual access to female groups such as in prisons, to lesbian social groups and other social institutions to coerce females into sex. It is also used to bypass male competition in dominance hierarchies politically, socially (in sports), and to deny autonomous female assemblies.
We should strive to ensure that sex mimicry is understood as a natural behavior evolving occasionally in response to sexual competition.
Once begun the mimicry creates intense anxiety that it not be detected though it is usually quite obvious. It doesn’t need to be perfect only sufficient to establish patterns of needed responses in other humans.
The patterns it elicits are temporary male unawareness of the mimic (unattractive female and not a competitive male) and temporary female protective impulse (as a disadvantaged female and but not of a male threat).
As the deception fails mimics develop ally’s to insist on the realty of deception which always escalates into both erasing sexual distinctions (gender instead of sex), and claims that any sexual uncertainty (adolescent coming of age, andro- and menopausal changes) are signs of mimicry.
Sexual mimicry leads to self-harm to amplify the effect (self-mutilation) and to categorical effacement (women don’t exist) to remove competition to the deception.
Sexual mimics are convicted of sexual offenses three times the rate of ordinary males. They use mimicry to compete with women and replace them in politics, sports, and other social roles where they seek to avoid competition as a male at the cost of female representations.
Learning of this biological phenomenon is important to our society in the future. It can’t be eliminated (a natural phenomenon) but it can be managed by learning in school, in medicine, and in legal systems to undersrand the presentation of the behavior in men and protecting women from predatory sexual mimics, and protecting female institutions from incursions by males and female autonomy from incursions by males.
For social institutions which have succumbed to the incursions and have been groomed and recruited to support male mimics, we need to report on the degree to which they believe in male sexual mimicry, and reward them for positive direction in recognizing the behavior and taking actions to re-establishing productive male/female boundaries.
A simple scorecard of male/female boundary maintenance can be managed with organizations where a 100% score means all important male/female institutional boundaries are maintained and no special deference is given to males imitating females.
This means in practice no celebration of cross-sex mimicry, no change of institutional language to establish tolerance of mimicry, no mimic use of female/male segregated spaces allowed, no inclusion of males in designated female roles, no institutional external financial support for males imitating and supplanting female roles, no alteration of sex statistics into “gender” statistics, compliance with all appropriate laws (EEOC) on the basis of sex, not gender, compliance with title IX laws on the basis of sex, not gender.
In educational institutions it means that all language about sex is about sex, not gender, that sexual mimicry is discussed as a topic along with negative (female abuse) and positive (avoidance of male violence), its persistence in the animal kingdom, and evolutionary paths to select for “cheating” behavior as a reproductive strategy - in biology, where we began.