Should there be an age restriction on something which shouldn’t be happening at all? It’s a question prompted by news that the NHS may be backing down on a proposal to set a minimum age of seven for referrals to its gender clinics.

The proposed threshold had been part of draft guidance published in 2023, which stated that “showing an interest in clothes or toys of the opposite sex – or displaying behaviours more commonly associated with the opposite sex – is reasonably common behaviour in childhood and is usually not indicative of gender incongruence”. Seven was suggested as a minimum age for intervention on the basis that children would, by then, be more capable of articulating their needs and engaging with healthcare professionals.

The current backtracking would appear to be the result of pressure from trans activists during the consultation process. Just what impact this will have on very young children — those at an age where many still believe if you change your clothes, you literally change your sex — remains to be seen. Stephanie Davies-Arai of Transgender Trend has suggested it may have some benefits, enabling families to access professional advice as early as possible rather than be misdirected by trans lobbyists. At the same time, as long as such advice is delivered in the context of  “gender medicine” — as long as there is a perceived need for “gender clinics” and “paediatric gender care” — misdirection seems unavoidable. This will be the case whether the patient is four years old or 10.

Of course, “burn it all to the ground” is not considered a rational or nuanced response to an issue. Nonetheless, following the Cass Review, the Tavistock closure and numerous court cases highlighting the sheer madness of trans ideology, one can’t help feeling that any discussion of when a child is “ready” to be diagnosed as trans avoids getting to the heart of the issue.  After many years of outright denial that there was any problem with socially and (eventually) medically transitioning children, it feels as though we have entered a prolonged period of tinkering. There’s a willingness to admit that some things need to change, but no one who has been complicit in this scandal is yet prepared to question the entire concept of “the trans child”.

It’s a concept rooted entirely in stereotypes, regressive beliefs about masculinity and femininity and, at its worst, male fantasies. Re-reading the 2023 draft guidance, one is struck by how bizarre it is for any supposedly progressive institution to be delivering judgements on how “normal” — or not — it is for a child to be interested in “clothes or toys of the opposite sex”, even if the conclusion is that it is “reasonably common”. It’s a reminder that gender identity, as an idea, comes from a time when gender roles were deeply ingrained, homosexuality was illegal, and “unmasculine” men and “unfeminine” women were considered aberrant. It is insane, years later, to think that a child’s relationship to masculinity or femininity should ever, in and of itself, be subject to medicalisation.

If the ugly aftermath of the Supreme Court’s ruling on the definition of “woman” has highlighted anything, it is the need to stop pretending that adult male transitioners have anything in common with the traumatised children they hide behind. Some men are attracted to the idea of feminine subjugation, but a child’s rejection of gender norms and/or hatred of their sexed body should not be used to validate misogynistic fantasies. As long as there is a belief that some — even a tiny minority, perhaps only identifiable in late childhood — are born in the wrong body, their very real needs will be reframed in order to pander to the desires of more powerful others.

There should be no age threshold when it comes to children accessing meaningful psychological support. But in a progressive, open-minded society, isn’t it time to stop referring those with varied needs — some abuse survivors, some autistic, some who might grow up to be gay — to “gender clinics”? If the practice sounds like something from the Fifties, that’s because it is. It’s not the age limit that’s the problem — it’s the whole thing.

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Victoria Smith is a writer and creator of the Glosswitch newsletter.

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