Hazel McHaffie

gender identity

Future possibilities

There will never be a shortage of subjects for me to write about! I lose tracks of scientific breakthroughs and medical marvels. And today, given the breadth and range of material available, I’m not going to even attempt to link everything I mention to scientific papers – Google the key words and you’ll get the information if you’re interested.

When HIV/AIDS first came to our attention in the 80s there were doomsday predictions of biblical plague proportions and real-life devastating statistics. I was a researcher at the time and saw it, wrote about it, first hand. Then came huge public awareness campaigns … followed by the development of anti-retroviral wonder drugs … then combination therapies, that could hold the disease at bay. Now here we are, with stories of stem cell donations from people with ‘natural immunity’ rendering patients free from the virus. You could weave a pretty complex plot with that one! And in 2019 my file marked HIV/AIDS looks completely different from the slim wallet of 30 years ago.

Inside of Me coverThen there’s the transgender issue. Wow! So many dimensions. About young children wanting to transition. About people wanting to reverse the process; the irreversibility of some therapies. About misleading statistics. Eebie jeebie – how crazily tortuous a plot could you construct in that area. The imagination goes into overdrive. Makes my little sally into that world in Inside of Me, pale into banality.

It’s 41 years since the first test-tube baby, Louise Brown, was created, and infertility was very much top of my pile when it came to choosing subjects for my set of novels. Now despite widespread opposition, criticism, vilification, stigma, as many as 8 million babies have been born by IVF. And the endless thirst for knowledge and understanding, coupled with a bottomless pit of compassion, drives researchers and clinicians in this area to seek more and more solutions to the problems couples have in conceiving, or avoiding perpetuating deadly genetic diseases. There’s mileage for several more books to follow on from Paternity, Double Trouble and Saving Sebastian. Did you know, for example, that the success rate for assisted fertility is way way higher (50%) than for natural conception (25%) … plenty of scope to work up a story-line there, huh? Imagine a gang of 35-year-old career girls going to the freezer to select artificially-created sperm … or genetically screened/modified embryos … ticking selection boxes along the way for green eyes, athletic ability, fiery temperament …? Endless possibilities!

The statistics on abortion reflect changes in society’s mores and values; programmes like Call the Midwife have increased public awareness of how things have developed in a generation. Add in dating apps, modern career paths, cohabitation, social expectation, fertility statistics … I feel an historical reflective story coming on! I well remember, in the 70s/80s soon after the 1967 Abortion Act was introduced, women coming in for a second, perhaps even third, abortion were looked upon askance. Recent Government figures have highlighted that of almost 68000 abortions carried out in 2017, 1049 were undergoing their fifth abortion and 72 their ninth! And there’s a story behind every one.

Then there’s the horrific topic of female genital mutation … don’t get me started! The recent story of the first person to be convicted in Britain briefly reported in the national press was shocking enough – the little girl was three years old; the mother cut the child herself in her London home; indecent images and animal pornography were involved. I absolutely couldn’t go there with fiction. But … should our collective conscience be prodded?

Resources, caps on the cost of medical and social care … I’m somewhat allergic to numbers, but reading about the human consequences of budgetary restrictions brings out the indignant in me. And might just compel me to write about it if I’m around long enough to get to that file.

Even the topic of assisted dying – a recurring hot potato – has subtly changed since I published my novel on the subject, Right to Die, eleven years ago. The issue’s been described by lawyers for the Royal College of Physicians as ‘one of the most controversial and morally contentious issues in medicine’, but ongoing polls of both medical and public opinion show a definite move towards accepting the need for some change. This might be simply taking a neutral professional stand as against opposing it; or a swing towards legalising some form of assisted suicide in the UK. A novel today could look very different.

Yep, I’m endlessly adding to the possibilities in my files as medicine and science reveal more and more, and society’s tolerances and expectations change. This is just a superficial skim. Anyone out there keen to pick up the gauntlet?

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Modern medical challenges: What do you think?

I’ve just had another filing morning – yawn, yawn. (For new visitors to my blog, that means tucking an accumulation of snippets and ideas into files on different medical ethical topics which might or might not become novels one day.) So I thought I’d share some of the news items with you and throw out a few thoughts for you to ponder or not as you feel so inclined. I’ve supplied links for extra information if you’re interested. No pressure.

Gender issues

An 8 month old Canadian baby has been issued with a health card that doesn’t specify the child’s gender. Single parent Kori Doty is a non-binary transgender person who wants baby Searyl to decide for *themself how *they wish to be recognised.
(*parent’s chosen pronouns)

Over here, the number of children under 10 being referred to gender identity clinics has quadrupled  in the past five years – figures showed that of the 2,016 referrals for children between the ages of 3 and 18, no less than 165 were under 10. (stats from the Gender Identity Development Service – the NHS’s only such facility)

Two young British men (Hayden Cross and Scott Parker – one 21, one 23) have gone public about putting their gender reassignment on hold until they’ve given birth. Both were born female, both have been living as men for a number of years.

And now there’s talk of transgender women receiving donated wombs. It’s a complicated enough process in biologically female patients, with significant risks to mother and fetus during pregnancy. But those who are born male have other issues to contend with such as an inadequate pelvis for giving birth naturally.

A hotter topic seems to be the growing number of transgender people who are seeking reversals, quoting crippling levels of depression and suicidal thoughts, but this development is being kept very quiet according to Prof Miroslav Djordjevic who runs a clinic in Belgrade. Some specialists fear that money plays a part in this with patients accepted for reassignment as long as they can supply the requisite cheque without adequate psychological evaluation and counselling.

Q. What do you feel about
the move to have non-gender specific loos and forms and facilities?
– a lower age limit for reassignment?
– young people who’ve started to transition wanting to call a halt to have babies while they still can?
those subsequently wanting to reverse the process?
transgender women having a womb transplant and giving birth?

Genes and inheritance

The Chief Medical Officer has advocated DNA gene sequencing for every cancer patient in Britain to prevent misdiagnosis, needless hospital visits and ineffective chemotherapy. Testing can correctly identify not just the actual illness but also specific mutations which play a significant role in the success of treatments. On the face of it it’s a big ask: more than 350,000 people are diagnosed with cancer annually and at the moment each DNA test costs around £600. But centralising the testing would reduce the individual costs and personalising the drugs used should speed up treatment and save the NHS a lot of money.

Charlotte Raven was unaware that there was Huntington’s Disease in her family until her father – newly officially diagnosed himself – told her when she was 36 and already had one child. Now aged 48, she’s had symptoms for 7 years and estimates she has at best 10 years to live. She has two children both of whom have a 50% chance of inheriting the illness.

Q. What do you feel about
– the proposal to gene sequence every cancer patient?
the potential discrimination in favour of cancer patients when other disciplines are seriously strapped for cash?
– having the definitive test for a crippling inherited disease yourself?
– the optimal age to tell a child they have a 50% chance of inheriting a degenerative condition?

Fertility

According to research led by a Hebrew university which tracked over 40,000 men, since 1970s sperm counts have fallen by almost 60%. These findings have been likened to the canary in the coalmine – indicative of changes in society and the environment that are damaging health far beyond fertility. Just what should we be doing about chemical pollution, stress, obesity, tight underpants?

A British-born Sikh couple, Sandeep and Reena Mander, whose parents came to this country from Punjab, have launched legal action against the adoption service in their county, Berkshire, after being refused permission to adopt a white child because of their ‘cultural heritage’. The council have only white babies on their register. This professional couple are in their early thirties and have already undergone 6 years of fertility treatment (privately financed to the tune of c£150,000) unsuccessfully. And they have the backing of their local MP – the prime minister, no less! They have now been cleared to adopt in the USA – another extremely expensive procedure.

The senior council of the Royal College of Obstetricians and Gynaecologists – without balloting its members – has voted by a majority to decriminalise abortion at any stage of a pregnancy on the grounds that it has a responsibility to protect women’s health by ensuring access to key services. It isn’t, however, advocating changing the current 24-week cut off period for abortions; rather it seeks to have the restrictions governed by professional regulations not the criminal law.

Scotland has introduced two new changes this month:  women from Northern Ireland can now get free abortions here, and women are allowed to take the abortion bill at home instead of having to be admitted to a clinical setting. i

Q. What do you feel about
– the implications of falling fertility? Should society be being more proactive in your view?  If so, how?
– i
nfertile couples incurring massive expense trying to have a baby?
adoption agencies discriminating in terms of ethnicity, faith, geography, etc?
the availability and legality of abortion?
– the risks to women of inducing abortions at home?
– medical tourism?

Not to mention all sorts of stories and news and stats on NHS resources, performance targets, shortage of health care professionals … never any shortage of material to fire the grey cells and indignation, and get the creative juices flowing. What if …? Supposing …? Imagine if …

 

PS. I’ve done my best to check various sources but please do post a comment if you have more information that runs counter to the brief synopsis I’ve offered.

 

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