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Looked after children

Updated: Nov 7, 2023

Gender ideology: A risk of additional harm to Looked After Children.

With the launch of The Promise in 2020, (click on link) Scotland made a commitment to care-experienced children, in recognition that system change was essential to ensure that some of the most vulnerable children within our society are safe, cared for, and that family relationships are supported and nurtured. This pledge was in recognition of the need for change that emerged from the Scottish Independent Care Review, which identified the historic harms that were endured by children, purportedly ‘cared for’ by the State, overseen by regulatory bodies, and involving many statutory and charity organisations.

In considering the needs of care-experienced children, what becomes evident is the amount of trauma, distress, and turmoil that has been part of their lives, and whose impact can have a lasting effect on their identity, self-esteem, emotional wellbeing, and development. In this context, therefore, it is very understandable that their emotional wounds make them susceptible to solutions that seem to offer an alternative sense of self. Such solutions act as a protective defence, with the hope of a new beginning, a feeling of belonging, or a narrative to explain their distress.

This is where the recent phenomenon of transgender or gender identity, and the beliefs that surrounds this ideology, carry a psychological allure to traumatised children. The proposal that we can opt out of the biological reality of our sexed bodies, and reject core parts of ourselves and our life experience is seductive, especially when it relates to aspects of ourselves which might be associated with trauma, abuse, and feeling profoundly unsafe. This appears to be the case for many vulnerable children, where identifying as trans may seem like the cause, and a solution, for psychological distress. This coping response appears to be particularly evident in the context of girls and young women, in whom there has been an exponential rise in the adoption of trans or non-binary identities. It is an area where we also see a worrying over-representation of looked-after girls in the emerging trans population. This cohort of girls and young women have life experiences that lead them to reject the biological reality of being female.

This is all set within a context where it is evident that profound risks are being taken by systems and organisations who have a core duty, and objective, to protect the rights of looked after Scottish children. These risks stem from the activist-influenced guidance that has been produced by the Scottish Care Inspectorate, and from transgender lobbying groups seeking to influence legislation and public policy in relation to parental responsibilities and family life. They are also present in an adherence to a gender-affirmative approach in schools and in the NHS, and a culture of silencing in 3rd sector organisations, who are largely dependent on Scottish Government funding.

The cumulative result is that we now find ourselves in a situation where Scottish children, especially those who are ‘looked after’ and who have fewer protective life factors, are being exposed to, and impacted by, a new type of social and systemic harm, and a failure of professional safeguarding duty.

It is within this landscape that guidance from the Scottish Care Inspectorate presents the mastectomy of a care-experienced young woman as ‘gender affirming care’. Further ‘guidance’ consists of signposting to the discredited, and activist organisations, such as Stonewall and LGBTYS, and indicates referral pathways to the Sandyford Clinic, where access to puberty blockers and cross sex hormones are available, and where an affirmative clinical model is privileged. These recommendations are outlined as examples of good and desirable professional practice.

Throughout the Care Inspectorate document, scant regard is taken for looked- after children’s need for single sex spaces in residential settings, or the right to access wholistic, exploratory, evidence based therapeutic interventions. Indeed, any awareness of the risks of possible social contagion within care settings is ignored. In taking this ideologically influenced stance, this guidance undermines fundamental principles of prevention of further harm, or indeed the recovery from the underlying trauma that has impacted many trans-identified children in care. No alternative to the affirmation-only approach is offered, and any reference to the recommendations made by Dr Hillary Cass in her Interim Report, is absent. Crucially, the document makes no mention of any of the data that has emerged from England, with regard to the over-representation of care experienced children who were referred to GIDS, and the high prevalence of trauma amongst this cohort of children.

Without a much-needed critical analysis, robust data, practice guidance drawing on evidence-based research, and the use of established child development theories, we see an approach being promoted for which there is no beneficial evidence base. By affirming the child’s discomfort and distress as linked to their biological sex, a sense of ‘wrongness’, shame, and hatred about themselves and their body, is made concrete, rather than supporting the child to a place of self-compassion and acceptance.

Whether through ideological motivation, activist influence, professional cowardice, or a sense of misguided well-meaning and lack of knowledge, we have strayed into a situation where a new type of harm to looked-after children is being perpetuated. When clear risks and impacts of gender ideology are being minimised or ignored, and professional curiosity curtailed, safeguarding and therapeutic best practice is sidelined. The overall result means that the fundamental principles and intentions of The Promise are being undermined and, as a consequence, Scottish looked-after children are being harmed.

Authored by a Family Therapist who is a child safeguarding professional


Barnes, H (2023) “Time to Think” Swift Press

Shrier, A (2021) “Irreversible Damage” Swift Press

Cass Review: Independent review of gender identity services for children and young people: Interim Report (Feb. 2022)

H. Devor (1994). “Transsexualism, Dissociation, and Child Abuse: An Initial Discussion Based on Nonclinical Data.” Journal of Psychology and Human Sexuality, 6(3), 49-72. | Aaron H. Devor (

Web sources

The Promise

Independent Care Review – The root and branch review of Scotland's care system.

Guidance for CYP services on the inclusion of transgender including non-binary young people.pdf (

Expert Advisory Group on Ending Conversion Practices Report and Recommendations (

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