Confronting Transgender Issues in Sri Lanka

Michael Patrick O’Leary, in The Island, 12 March 2023, where the title reads  “Time to Think Part One”

Transgender Issues in Sri Lanka:

Sri Lanka’s first president, JR Jayewardene, famously boasted that the newly-created executive presidency gave him the power, “to do anything, except make a man a woman, or a woman a man”. Today, there is much conflict in many countries about making a man a woman or a woman a man. The issue recently contributed to the downfall of Scotland’s First Minister, Nicola Sturgeon, who had seemed unassailable. In Ireland, the government is under attack because the Equalities Minister, Roderic O’Gorman, has been siphoning money off to trans activist groups that had been earmarked for the Traveller and Roma communities, migrant integration and redress for children who had been abused by the state and the church. There are some who believe that if a man says he is woman – “self-identifies” as a woman – then he is, indeed, a woman. Wishing makes it so. Those who dispute this are labeled “transphobic” and are brutally attacked in the trans wars. JK Rowling has been vilified simply for saying a man cannot be a woman.

Sunday Island readers might consider that this a first world issue and not relevant in Sri Lanka. The trans wars raise issues of free speech which are widely relevant in any country, even Sri Lanka. According to a December 2019 report by Equal Ground, a non-profit group that advocates for LGBTQ rights in Sri Lanka, there are some 122,000 people in Sri Lanka aged 18-65 that identify as transgender. Some of them gather at night in our neighbourhood. National Transgender Network Sri Lanka has a Facebook account. Dimuthu Attanayake wrote about trans people in Sri Lanka who have resorted to sex work to make a living because of the economic crisis. RoarMedia (to which I have contributed) published a balanced and compassionate article back in 2016. Ceylon Today published a series of articles by my good self in 2021. The Sunday Morning newspaper has published regular features on trans issues. HiruNews reported a 12 hour gender reassignment operation at Jaffna Hospital on a person from Batticaloa. There are advertisements on the internet for sex reassignment surgery in Sri Lanka.


On February 23, 2023, A Time to Think by Hannah Barnes was published. I preordered the book so I could quickly read it for you and report back as soon as possible. Barnes regards her work as an investigation into flawed healthcare – not an attack on Trans rights. The subject of the book is GIDS (Gender and Identity Development Service) run by the Tavistock and Portman NHS Foundation Trust. Hannah Barnes had previously investigated the clinic for the BBC’s Newsnight programme.

The NHS has ordered the clinic to be closed. The Hippocratic Oath requires a physician to swear upon the healing gods to, “first, do no harm”. The treatment promoted by GIDS did a lot of harm. Barnes spoke to over 60 clinicians, psychologists, psychotherapists, nurses, social workers as well as clients and their parents.

The clinic was launched in 1989 by Domenico Di Ceglie to help people aged 17 and under struggling with their gender identity. They “ended up with three or four cases” in its first year. True gender dysphoria is very rare. The term describes a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity. This sense of unease or dissatisfaction may be so intense it can lead to depression and anxiety and have a harmful impact on daily life. Barnes quotes Di Ceglie, “And then somebody said to me, ‘But is it that you, [by] creating a service, you are creating the problem?’” The number of people seeking the clinic’s help is 20 times higher than it was a decade ago. Something strange is going on.

Cass Report

Dr Hilary Cass, a leading paediatrician, was commissioned to review and report on the service provided by GIDS. Cass said the Tavistock clinic needed to be transformed. She said the current model of care was leaving young people “at considerable risk” of poor mental health and distress.

Cass reported that:

The service was struggling to deal with spiralling waiting lists

It was not keeping “routine and consistent” data on its patients

Health staff felt under pressure to adopt an “unquestioning affirmative approach”

Once patients are identified as having gender-related distress, other healthcare issues they had, such as being neurodivergent, “can sometimes be overlooked.”

Affirmative Approach

In the acrimonious debates about transgender issues, one has to carefully unpick the meaning of words. When Cass says, “affirmative approach”, she means that very young children who were confused about whether they were male or female were put on a fast track to receive puberty blockers. There is very little research about the side effects of these medications but there are well-founded fears that they cause deficiencies of bone density. There are also well-founded fears of blood clots and cardiovascular disease. There is little doubt that puberty blockers cause infertility and difficulties in achieving orgasm. It is unlikely that anyone who opts for this treatment will have a happy sexual life.

“Neurodivergent” means that most of the children that GIDS dealt with had a lot of problems apart from gender. This means that issues about whether they identified as male or female were, in reality, secondary to other issues including “non-suicidal self-harm, suicidal ideation, suicide attempts, autism spectrum conditions (ASCs), attention deficit hyperactivity disorder (ADHD), symptoms of anxiety, psychosis, eating difficulties, bullying and abuse”. Many of the children would have developed into a reasonably happy life as homosexuals if GIDS had not fast tracked medical intervention to alter their gender. Over 90% were lesbian. Some of the patients interviewed by Barnes thought they might be happy as neither male or female. There is much evidence of homophobia surrounding the issue of gender reassignment. Was GIDS promoting a form of gay conversion?

Early Intervention

“Early intervention” is another term bandied about. It means doing nasty things to children below the age of consent. What it means is that pre-adolescent children have been chemically castrated with drugs designed to be used on sex offenders. Claims are routinely made that puberty blockers are reversible. There is no data to support this view. Decisions are made by parents which can have a disastrous effect on children’s lives. The lower age limit of 12 was removed as the GIDS clinic moved to a “stage” not “age” approach, allowing younger children to be referred for puberty blockers.


There are many mentions in Hannah Barnes’s book of a charity called Mermaids. This was founded in 1995 to provide support for transgender youths up to 20 years of age. The influence of Mermaids and Susie Green on GIDS’s practice and policy seems egregious, nay, sinister. Susie Green was the chief executive of Mermaids from January 2016 until 25 November 2022. Her son Jack became a girl called Jackie. She took him to Boston when he was 12 for a course of puberty blockers. On his 16th birthday he had “gender reassignment surgery” in Thailand. In plain English this means orchiectomy, castration, which would be illegal in Britain for a 16-year-old. Green promoted the wider use of puberty blockers and tried to persuade GIDS to support her.

Domenico Di Ceglie and his successor, Polly Carmichael, would regularly attend meetings of Mermaids and subsequently encourage staff to change practice. According to GIDS staff that Barnes interviewed, “Mermaids became more political and harder to work with. Their position appeared to be that there was only one outcome for these children and young people – medical transition.” Clinical psychologist Kirsty Entwistle, on the GIDS staff from 2017, said: “Those who’d connected with Mermaids were terrified, because they’d been told that their child was going to kill themselves if they didn’t get blockers.” Entwistle was shocked when her clinical partner cited a female patient’s early love of Thomas the Tank Engine as evidence she should be referred for puberty blockers.

No Talking Cure

The Tavistock was, for many years, seen as a centre of excellence for psychoanalysis within the NHS. The Tavistock’s reputation was based on psychotherapy – the talking cure. Distinguished people who passed through the Tavistock’s portals include Freud, Jung, John Bowlby, Lily Pincus, RD Laing, HG Wells and Samuel Beckett. I had dealings with the Tavistock in 1994 when one of their psychotherapists, Valerie Sinason, was spreading disinformation about “ritual satanic child abuse.” I will deal with that in my next article. There was little therapy of any kind available at GIDS. “The ‘fundamental problem’ was that the team could only ever carry out ‘limited’ psychological work with young people and families.” New staff could not be trained quickly enough and patients were disorientated by seeing new people at every appointment. Children were referred for drugs sometimes after only two sessions.

I Had not Thought Delusion Had Undone so Many.

Part of the madness was that children were turning up identifying as other ethnicities such as Japanese. Why is there an epidemic of young people with gender dysphoria? Most cases used to be boys wanting to be girls. Why are most of them girls today who want to become men?” The number of teenage girls claiming to have gender dysphoria had risen by 5,000% in seven years.

Dr Anna Hutchinson, a senior clinical psychologist at GIDS, joined the clinic at the start of 2013 with significant experience from a number of London’s leading hospitals, including Great Ormond Street Hospital. By late 2014, GIDS’s activity was “increasing faster than staffing”. Barnes quotes Hutchinson, one of the many whistleblowers to have gone on the record: “Self-diagnosed adolescent trans boys — natal females — started to fill up GIDS’s waiting room with similar stories, haircuts, even names – ‘one after another after another’. They’d talk about their favourite trans YouTubers, many having adopted the same name, and how they aspired to be like them in the future.” I will look at mass hysteria in my next article.

Cancel Culture

Barnes had submitted a detailed book proposal to 22 publishers. None of them wanted to publish the book. Barnes recalls: “Of the 12 who responded, all via email, not one publisher said anything negative about the proposal. In fact, several praised it, saying that it was an important story that should be told – but not by them. Some mentioned that other authors they published would be ‘sensitive’ to the material, others hinted that it would be difficult to get it past junior members of staff.” She said, “Ten other publishers did not respond to my proposal, something my agent tells me is very unusual.” Mark Richards and Diana Broccardo, the owners of the small, independent publisher Swift Press agreed to publish the book. The book received uniformly positive reviews and is selling very well. There is strong anecdotal evidence that staff at London branches of Waterstones and Foyles (Foyles is now owned by Waterstones) are actively preventing people from buying the book.

In my next article, I will deal with the issue of moral panic and mass delusion.


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