a man in blue crew neck t shirt holding a poster

Gender Expansive Care and Human Rights in the UK: A Catechism for the Already Converted?

A group of therapists and support workers at an Adult Sexual Health Clinic run by the NHS have presented their case for gender expansive healthcare to be firmly placed under the banner of human rights work (Lawson et al, 2023). In order to achieve their aim, they call upon practitioners to adopt an allyship role, and to become scientist-advocates-practitioners in advancing what is clearly an overtly political practice. The prospect of marching under the banner of human rights, or at least the trans variant of human rights, might have a seductive appeal for many. After all, who (apart from a reactionary bigot) could possibly doubt the importance of supporting this cause?

There are two major problems with their argument, however. One relates to their decidedly partisan interpretation of human rights and the second concerns what counts as evidence in support of their case.

Human rights

The claim that ‘trans rights are human rights’ is a central plank of the case for the social acceptance of people identifying as trans, and according them entitlement to certain standards of care. Rights can be categorised in various ways, in terms of negative rights, such as protection from discrimination, and positive rights, namely entitlement to enhanced access to healthcare. Human rights have acquired a powerful cachet in the post-war world, driven in part by international agencies like the United Nations and articulated via influential documents, such as the UN Declaration of Human Rights. The movement for promoting trans rights seeks to attach itself in a seamless manner to this tradition, perhaps hoping to avoid close scrutiny in the process. However, there are serious problems with this attempt to subvert the established tradition of human rights and use it for a new purpose. These problems arise because each set of human rights should require careful justification as to whether it fully deserves our support; human rights claimed by some can usually be expected to conflict in some way with the human rights held by others; and human rights claims in general may well offer much less than first meets the eye.

To start with, making the claim for human rights is not necessarily aligned with progressive or humanitarian policies, although it is perhaps tempting to assume that this is always the case. The case for defending the human rights of oppressed national minorities was a key propaganda theme of the far-right in the 1930’s, such as those claimed for the Sudeten, Czech and Polish Germans. Rights can be in sharp conflict, as in the case made in the US, where the rights in law of the unborn are held to conflict with the rights of women to obtain an abortion. Rights can also be framed in a highly selective manner, so the rights of trans men identifying as women can take priority over those of women in prison settings, or in rape crisis centres, while the rights of apparently less deserving groups, such as detransitioners, are systematically undervalued. The proposed model of trans human rights is deeply invested with the advancement of trans interests, with each part of the framework interlocking closely with other sections, in order to provide a self-supporting and self-justifying model (see Figure 1: Trans Human Rights as a Self-Validating Framework)

Figure 1: Trans Human Rights as a Self-Validating Framework

Hence the human rights of people identifying as trans are held in the Lawson paper as being universal, indivisible, inalienable and requiring of collective consideration – an impressive, if unwieldy list. However, seen from outside rather than inside the tent, trans rights appear to be absolute in nature, non-negotiable (so not open to any form of concession or compromise) and non-reciprocal, ie rights for trans men identifying as women to access women’s protected spaces do not entail a parallel right for women to access trans spaces. The Lawson paper makes a token effort to square the circle on the notion of balancing rights with other groups (for which, read women and children) but denies that trans rights represent any form of threat to others and gives up even this modest line of argument after a hundred words or so.

What counts as evidence?

The second problem with the paper concerns the nature of evidence to support the case made. The very concept of gender identity lacks defining criteria or objective proof of its existence. However, it plays an absolutely central part within gender ideology as a belief system, akin to a religion or set of cultural beliefs, which cannot be disproved either by argument, or by evidence. The evidence claimed for transgender expansive rights constituting a new set of human rights requires prior acceptance of the key building blocks of belief, such as the existence of an innate gender identity, minority stress and systematic discrimination against trans people, all requiring exceptional levels of protection in law in the form of human rights.

The Lawson paper relies firmly on the use of the established language of gender ideology, using questionable terms such as cis-normative, with a particular virulence reserved for the role of therapists as gatekeeper, deep hostility towards exploratory therapy, and an unwarranted respect for the now somewhat shaky guidance provided by World Professional Association for Transgender Health (WPATH). Once again, detransitioners are claimed to constitute a mere 1% of those undergoing medical transition, and thus far below the standard rates of regret for most forms of surgery. Gender identity is not to be confused or conflated with other factors, such as social contagion, homophobia, autism or sexual trauma, but needs to be fully acknowledged and respected on its own terms. And so it goes.

This seems increasingly like a largely self-referential trans universe, which has no apparent need to take account of policy or legal changes in the external world of reality, such as the Cass Review (2022), or growing concerns over evidence of the iatrogenic harms caused by medicalising gender distress. The claims made here do read, however, more and more as if it were a form of catechism of revealed and incontestable semi-religious truths, now made slightly shop-soiled and threadbare through their constant retelling, but still eagerly consumed by those already converted to the faith.


The Cass Review (2022) Independent review of gender identity services for children and young people: Interim report. https://cass.independent-review.uk/publications/interim-report/

Lawson, Z. et al,(2023)A human rights based approach to transgender and gender expansive health” Clinical Psychology Forum, 369. October, 92-106. https://explore.bps.org.uk/content/bpscpf/1/369/91

By Peter Jenkins, a member of Thoughtful Therapists, whose scoping survey for the UK government consultation on conversion therapy can be found here: https://thoughtfultherapists.org/scoping-survey-pdf/

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