On Saturday I walked past the scores of masked, chanting protestors who were barricading the RCGP main entrance. I was ushered in through a discreet side door, in order to attend the First Do No Harm conference: an event whose main focus was the management of adolescent gender dysphoria.
The conference embodied the way in which health professionals should approach all new areas of practice: a meticulous scrutiny of evidence presented by leading academics in the field, a thoughtful consideration of the conditions under which doctors might unwittingly cause harm, a deep concern for ethics, and a central focus on child safeguarding.
The history of our profession is littered with examples of interventions advocated by well-meaning enthusiasts which have ultimately been found to cause great harm. The medicalisation of adolescent gender dysphoria seems likely to have secured its place on that list.
The call for a return to “ordinary best practice” is also a call to be appropriately sceptical of the pleading of special interest groups. More than that, we should view exceptionalism as a colossal red flag: when a group argues that somehow the usual standards of evidence-based practice and professional ethics don’t apply to their case, we need to be extra vigilant. As doctors, we have a shared responsibility for the actions of our profession, and a duty to learn the lessons when things go wrong on our watch.
The RCGP should be commended for hosting a conference dealing with an area of medical practice that warrants particular scrutiny, precisely because it is contentious and has escaped many of the usual checks and balances. The protestors outside the college have the right to protest, but not to override the academic systems and ethical frameworks that assure public safety and ultimately maintain trust in our profession.
Rapid Response:
Exceptionalism is a colossal red flag
Dear Editor
On Saturday I walked past the scores of masked, chanting protestors who were barricading the RCGP main entrance. I was ushered in through a discreet side door, in order to attend the First Do No Harm conference: an event whose main focus was the management of adolescent gender dysphoria.
The conference embodied the way in which health professionals should approach all new areas of practice: a meticulous scrutiny of evidence presented by leading academics in the field, a thoughtful consideration of the conditions under which doctors might unwittingly cause harm, a deep concern for ethics, and a central focus on child safeguarding.
The history of our profession is littered with examples of interventions advocated by well-meaning enthusiasts which have ultimately been found to cause great harm. The medicalisation of adolescent gender dysphoria seems likely to have secured its place on that list.
The call for a return to “ordinary best practice” is also a call to be appropriately sceptical of the pleading of special interest groups. More than that, we should view exceptionalism as a colossal red flag: when a group argues that somehow the usual standards of evidence-based practice and professional ethics don’t apply to their case, we need to be extra vigilant. As doctors, we have a shared responsibility for the actions of our profession, and a duty to learn the lessons when things go wrong on our watch.
The RCGP should be commended for hosting a conference dealing with an area of medical practice that warrants particular scrutiny, precisely because it is contentious and has escaped many of the usual checks and balances. The protestors outside the college have the right to protest, but not to override the academic systems and ethical frameworks that assure public safety and ultimately maintain trust in our profession.
Yours faithfully
Dr Jim Boddington
General Practitioner
Competing interests: No competing interests