Time to Think
by Michael Patrick O'Leary
Part One
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. 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 labelled “transphobic.”
GIDS Gone
On February 23, 2023, A Time to Think by Hannah Barnes was published.
Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children by Hannah Barnes is published by Swift Press (£20). I got mine from Kindle.
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 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.

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. Words sometimes lose the meaning to which we have common-sensically become accustomed. 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. The most commonly used puberty blockers are gonadotropin-releasing hormone agonists, which suppress the production of sex hormones, including testosterone and estrogen. 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”. 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.
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. Alan Turing was technically a sex offender because homosexual acts were illegal in 1952. Turing is widely considered to be the father of theoretical computer science and artificial intelligence. He accepted hormone treatment with a non-steroidal oestregen medication as an alternative to prison. He developed breasts and became overweight. He committed suicide. His image appears on the current Bank of England £50 note.

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.
Mermaids
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. Would Jack have been happy as an adult gay man? Who can say? Homophobia is a recurrent theme in all of this. After taking her child to Boston in 2007 to receive puberty blockers, Susie Green worked to make them available in Britain from GIDS. In response, GIDS began prescribing blockers from 2011 onwards, making them widely available in response to demand from families.

In 2017 Susie Green gave a TED Talk in which she admitted that her now ex-husband had disciplined her son for playing with feminine toys as a child, and that the boy began identifying as a “girl” after those toys were taken away from him. Green and her husband appeared to be more comfortable having a “trans kid” who was “really” a girl than having a feminine boy who was probably gay. Irish Comic genius Graham Linehan, creator of those wonderful TV comedies Father Ted and Black Books, has long battled with Green and Mermaids. When he voiced concerns about Mermaids in 2019, he was viciously attacked and YouTuber HBomberGuy raised £125,000 for Mermaids in retaliation. This was made possible by a large number of famous people who proudly contributed to the Mermaids cause. On February 21, 2023, Graham reported that Susie Green’s TED Talk had been removed from TED and YouTube. Graham wrote: “Susie’s talk can be summarised thusly: ‘Kid seemed a bit gay, Dad didn’t like it, so we cut his penis off and told him he was a girl’”

According to the Daily Telegraph, Green was forced out of Mermaids because of a staff backlash over her “incapable” leadership. An internal audit, launched earlier this year by the Social Justice Collective (SJC), a diversity group, is understood to be highly critical of Ms Green’s handling of complaints of racism, safeguarding, the vetting of trustees and her “shoving her head in the sand”.
Domenico Di Ceglie and his successor, Polly Carmichael, would regularly attend meetings of Mermaids and upon their return 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.
Child Abuse
Mermaids appointed Dr Jacob Breslow to their board, regardless of the fact that he is a known advocate of paedophilia. Breslow appeared at the B4U-Act conference. B4U-Act is an organisation founded in 2003 by convicted child abuser Michael Melsheimer. An undercover investigation by the Daily Telegraph found Mermaids were sending breast binders to teenage girls without parental knowledge or consent.

Kellie-Jay Keen-Minshull (who blogs as Posey Parker) was reported to the police by Susie Green for referring to male to female trans surgery as castration on Twitter. There is no doubt that the procedure involves chopping off of the ould gonads. Kellie-Jay, mother of four said, “I am not part of a grooming gang or paedophile ring, I haven’t hurt anyone or abused anyone. I am a woman with an opinion.” West Yorkshire police underwent a training session on transgenderism led by Mermaids. Graham Linehan reported on February 23, 2023, that Kellie-Jay has again been summoned by the police and had to pay £ 3,000 in legal fees. British police have given up any pretence of investigating burglaries and other crimes but have time to waste scolding people about their use of pronouns. GIDS was strongly influenced by someone who castrated her own son and bullied people who criticised her.
Under the influence of Mermaids, GIDS was “routinely offering an extreme medical intervention as the first-line treatment to hundreds of distressed young people who may or may not turn out to be ‘trans’”. The normal rules of medicine and children’s healthcare did not seem to apply. Puberty blockers are touted as a means of giving young people “time to think” as in the title of Barnes’s book. In reality, in excess of 95% of young people who start on puberty blockers opt to take cross-sex hormones. Puberty blockers are just the start of the conveyor belt.
No Talking Cure
The Tavistock was, for many years, seen as a centre of excellence for psychoanalysis and psychotherapy within the NHS since being included at its founding in 1948. 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? Why are so many of them girls who want to become men?” The number of teenage girls with gender dysphoria had risen by 5,000% in seven years.
Dr Anna Hutchinson, a senior clinical psychologist at Gids and part of the senior team, 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.”
Cancel Culture
Barnes had submitted a detailed 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, essentially, 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.


I do not think I have ever seen a positive book review in Private Eye, the UK’s biggest-selling magazine (to which I have often contributed). The reviewer (he is anonymous but I believe him to be Marcus Berkman) generally chooses a book he knows he is going to hate and proceeds to pour scorn. He has nothing but praise for Barnes’s investigations. In the light of the overwhelmingly positive reaction to the book it is surprising to learn that it was rejected by 22 publishers, many no doubt wary of the potential backlash involved in covering a story with the potential to inflame culture warriors on all sides.
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. Dimuthu Attanayake wrote about trans people in Sri Lanka suffering because of the economic crisis and resorting to sex work to make a living. This issue has been covered in the Sri Lankan media. RoarMedia (to which I have contributed) published a balanced article back in 2016.
Ceylon Today published a series of articles by my good self in 2021.
In my next article, I will deal with the issue of moral panic and mass delusion.
Great stuff again, Michael. You would probably enjoy Trans by Helen Joyce which I recently finished.
Covers similar ground, available on Kindle too.
Alastair (in Tokyo)
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Read it ages ago, smart arse that I am. I met her brother Ed when I was invited to a reception at the Galadari Hotel for the Irish cricket team. At the same event I met Sri Lanka’s ambassador to the UN and Ireland’s ambassador to India. I’m not just anybody, you know!
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Hi Michael,
Not surprised at all that you’d read ‘Trans’. If you’ve got time for more on this general topic can I recommend a podcast in four parts called ‘The Witch Trials of J.K. Rowling’. It goes into a lot of the background to the ‘TERF wars’. Most illuminating. I got it through Amazon music or check out http://www.thefp.com
Best,
Alastair
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I just read an article on Graham Linehan’s blog which cites the podcast you mention. The article is by Jonathan Haidt whose book The Coddling of America I have read.
https://jonathanhaidt.substack.com/p/mental-health-liberal-girls?utm_source=substack&publication_id=1221094&post_id=107274500&utm_medium=email&triggerSave=true
Also worth a read is Kathleen Stock’s Material Girls.
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