The following is an interview with Keira Bell for Spanish feminist platform Tribuna Feminista.
Keira was interviewed by Raquel Rosario Sánchez.
As a 14-year-old, Keira Bell started experiencing severe discomfort with her body. She did not fit into stereotypes about femininity and thought that the problem was her body. She hated the idea of growing into a woman and thought that maybe hating pink dresses and make up meant that she was not female. What if her discomfort meant that she was boy?
Instead of questioning the underlying problems, such as depression, self-hatred and low self-esteem, with compassion and care, the NHS’s gender clinic for children advised this teenage girl that she was indeed male, and that the best treatment for her dysphoria was to immediately begin blockers which would stop her puberty development.
Following three separate, one-hour appointments, GIDS put Keira Bell on a pathway that began with puberty blockers at 16, cross-sex hormones at 17, and resulted in a double mastectomy by the age of 20. We do not know enough about the long-term impact of puberty blockers and cross-sex hormones, or their effect on children’s cognitive and reproductive development, but Keira knows that this medical treatment did not resolve the dysphoria she was experiencing.
Today, as a 23-year-old, Keira is pursuing a Judicial Review of the Tavistock and Portman NHS Trust which managed her treatment. The Tavistock GIDS clinic continues to diagnose hundreds of minors. Most of these children are girls who are as confused as Keira was during her teenage years. Keira now argues that children with gender dysphoria who approach the clinic need better support, not an ‘affirmation model’ which automatically sets them on a path towards puberty blockers and cross-sex hormones.
Interview with Keira Bell
Raquel Rosario Sánchez: You are an ex-patient of the Tavistock’s Gender Identity Development Service (GIDS) for under 18-year-olds. What led you to walk through the doors of the Tavistock as a 16-year-old?
Keira Bell: The couple of years leading up to that point, I was stuck in severe depression and anxiety. I felt extremely out of place in the world. I was really struggling with puberty and my sexuality and I had no one to talk these things through with. I identified most with butch lesbians and I initially felt like I had found my tribe.
However, the women that I saw through the internet still seemed to be comfortable with their bodies and having sexual relationships. So, I think that I began to doubt myself and I began to think that there must be more to it. When I stumbled upon transsexualism, that was me – I was meant to be a boy. It made absolute sense to me and I related so strongly to those women [online] that had started to undergo medical transition. I felt that I needed to start with medical transition as soon as possible in order to achieve my happiness.
RRS: Do you think the internet, particularly social media and online forums, are fuelling the rise of teen girls seeking gender transitioning treatments? How do you think adults can challenge the messages spread on these websites?
KB: Absolutely, and this rise has been increasing exponentially in the past decade. From what I have seen, social media is more often than not really harmful to girls and young women. When I was a teenager, I was virtually using social media and online forums as a way of discovering myself and learning about the world.
I know that must only be getting more and more common, and the messages more extreme as time goes on. It is extremely unhealthy. The messages being given can be challenged by raising awareness. I would say to adults to spread the word, speak out, resist the propaganda that is being pushed.
RRS: A 16-year-old is not legally old enough to drive a car or get a tattoo. According to the Children Act 1989, a minor is considered someone who is under eighteen years old. Yet we are witnessing a worldwide push to consider children and teenagers “adult enough” to consent to life-altering treatments. What do you think lies behind this global push?
KB: Follow the money!
RRS: What was your initial experience and reaction to puberty blockers as 16-year-old, and to cross-sex hormones and surgery, later on?
KB: Hormone blockers were viewed as a means to an end and I did not like being on them at all. I was very happy and excited to start cross-sex hormones, as I thought that I could finally start to live my life how I was supposed to.
When surgery came around, I thought of it as more of a practicality situation. I was sick of wearing my binder. It was painful and an annoyance. I was unhappy with how my breasts looked, even more so at that point than before.
RRS: Looking back now, how do you reflect on those years of your life?
KB: I look back with a lot of sadness. There was nothing wrong with my body, I was just lost and without proper support. Transition gave me the facility to hide from myself even more than before. It was a temporary fix, if that.
RRS: How can society address gender dysphoria in children and teenagers, without resorting to experimental, and oftentimes unnecessary, medical practices?
KB: It has to start with how we look at gender non-conformity, and non-conformity in general. Almost every girl (if not all) that wants to or has transitioned has felt like they are wrong because they do not conform to something that this society deems as important or necessary.
Gender nonconformity needs to be accepted. Role models are really important. Young lesbians or bisexual women, especially those of us who are black or brown, don’t have many role models. We need better mental health support, and I think that speaks for most countries. Mental health support is a great preventative measure.
RRS: Over the years, a lot of adults, particularly medical professionals, were involved in your treatment. Did any of them express doubts or challenge you against making these life-altering decisions?
KB: In my experience, when professionals outside of the gender identity clinic saw me, they were hesitant about dealing with me much, because (at least back then) gender dysphoria or the desire to change sex was a rare occurrence in patients. They would direct you to the Gender Identity Development Service as they were under the impression that the GIDS gave specialist support and therapy in a neutral environment. This of course wasn’t the case. Once I arrived there, I was not challenged in any sense and I was affirmed [as a boy] from the beginning.
RRS: After realising that medical transition would not help alleviate your dysphoria, you took the brave step of taking legal action against the Tavistock. What galvanised you to take legal action?
KB: I was and am so desperate to see positive change. I felt that I was in the perfect position to do so – it is my story and I have come out the other side. I clearly see how damaging this issue is, especially because now it has turned into a movement. There are so many girls out there who are just like I was and their true needs for support and care are being ignored. I want justice.
RRS: What would you say to a girl or young woman who is questioning her sex and feels that going down a path of medicalisation might be the only solution to her dysphoria?
KB: I would feel wrong to do anything but discourage it. The environment over the past 10 years has changed so drastically. Nowadays, everyone is being asked left, right and centre “what are your pronouns?” or “what’s your gender?”.
I would encourage that girl or that young woman to really limit her time on social media, to go out into nature and most importantly: think for yourself! In my opinion, the further you can get away from self-centredness, the better.
RRS: Today, you are an inspiration to many people, particularly to young women who also struggle with the imposition of femininity. Where do you see your advocacy taking you next?
KB: I haven’t made any solid plans as I like to move freely. But for now, I want to continue raising awareness and help some way in getting better mental health support for gender dysphoria.
Thanks to Keira for granting me this interview. I am grateful for her courageous campaigning for the rights of girls to stereotype-free lives and for better protection for children with gender dysphoria. I look forward to Keira’s continuous leadership and advocacy on this matter in the years ahead.
Raquel Rosario Sánchez
30 November 2020
Additional resources for young people affected by these issues:
Update 02 December 2020:
Keira Bell won!
For detailed information on the case put before the court, the landmark judgment and the far-reaching impact this will have, please see: