Are NHS Workers Bringing Trump-Style Anti-Trans Ideology to the UK?

Six leading gender clinicians including ones associated with a controversial NHS review of transgender healthcare spoke at the conference of a designated anti-trans hate group that shares funding with key pro-Trump outfits, Novara Media can reveal.

The news has prompted “grave concern” from a leading UK trans rights charity, as well as several senior NHS clinicians who currently work or have previously worked in NHS gender services.

Clinical psychologists Trilby (Tilly) Langton and Anna Hutchinson presented a co-authored paper at the Society for Evidence-Based Gender Medicine’s (SEGM) conference in Athens in early October.

Langton was instrumental in Hilary Cass’s review of child and adolescent gender services and holds a senior position within NHS gender services. Langton designed the methodology of the evidence review that was critiqued across the medical profession for deeming 98% of existing research on gender-affirming hormone therapies to be not of a high quality, and discarding around 40% of the studies. Hutchinson works with the NHS as a contractor delivering training to NHS gender clinicians.

Hutchinson and Langton spoke on ‘Cass Review aligned teaching and training in the UK’ with their third co-author, psychotherapist Anastassis Spiliadis, who is cited in the Cass Review and sits on the board of SEGM.

SEGM was founded in 2019 by a group of primarily US clinicians resistant to gender-affirming approaches to gender care, and is based in Idaho. One SEGM founder, Stephen B Levine, has argued that trans people are pathologically narcissistic. The group’s work has been used to support findings that medical treatment of gender dysphoric children constitutes abuse. In an email to Novara Media, Spiliadis strongly rejected the characterisation of SEGM as a hate group.

Also speaking at the conference were adolescent psychiatrist Riitakerttu Kaltiala, another advisor to Cass who practises in Finland, where until last year trans people had to undergo forced sterilisation to legally change their gender; psychologist Julie Alderson, head of the new southern ​​NHS children’s gender service, and Michael Absoud, the deputy chief investigator in the puberty blocker trial currently being established as one of the recommendations of the Cass Review.

Of the six clinicians, Spiliadis and Hutchinson responded to Novara Media’s request for comment.

“That senior NHS gender clinicians attended a conference organised by a designated anti-trans hate group further erodes trans young people’s trust in the NHS,” Tammy Hymas, head of communications and Advocacy for the trans youth charity Mermaids, said in a statement to Novara Media. Hymas added that the charity is “gravely concerned that the NHS is at risk of alienating trans young people from accessing vital healthcare.”

Ideological confluences.

For many, the SEGM conference points to deep ideological confluences between gender-critical clinicians in the US and UK, one mirrored in politics.

For while then-equalities minister Kemi Badenoch floated the idea of a “lavatory tsar” inspired by US bathroom bills, US gender-critical clinicians were taking inspiration from their UK counterparts. SEGM hailed the Cass Review “the single most notable event in the history of youth gender medicine of the last decade” – its conference programme begins with a quotation from the review.

In June this year, the Southern Poverty Law Centre (SPLC), a leading US civil rights organisation whose civil lawsuits famously bankrupted the Ku Klux Klan, designated SEGM an anti-trans hate group. According to the centre’s research, SEGM is one of the “key hubs of anti-LGBTQ+ pseudoscience”.

The SPLC has undertaken extensive research to identify the funding sources of anti-trans groups and found that many share backers with key Trump enablers. SEGM, for example, takes money (via the Edward Charles Foundation) from the Charles Koch Institute, a conservative political network that also funds the Heritage Foundation. The Heritage Foundation is the group behind Project 2025, a 900-page “wish list” to centralise presidential power and normalise religious conservatism, including by tightly restricting abortion access and expanding political appointees.

Asked about the designation of SEGM as an anti-trans hate group, Spiliadis said: “My personal and professional view is that SEGM is focused on advancing evidence-based care for young people with gender dysphoria.” He added that he “unequivocally reject[ed]” claims that SEGM is an anti-trans hate group, adding that this has been “refuted by investigative reporting”, citing a highly ambivalent profile of the organisation in a US magazine.

On the links between SEGM and the Heritage Foundation, Spiliadis said “I think you might have to contact SEGM directly if you are interested in asking questions about their funding. From my end, I can only share [that] I do not support far-right approaches as these would be against my personal, professional and ethical stance and against my psychotherapy training. I believe women should have appropriate access to safe and legal abortion rights and processes.”

Langton, Hutchinson and Spiliadis are due to present their SEGM paper as a workshop in January at an event organised by the Association of Clinical Psychologists. Along with two other clinicians, the three run a consultancy that specialises in providing training to NHS gender services. Central to their training is promoting a “gender exploratory” approach to gender dysphoria (a term Spiliadis coined in 2018) as an alternative therapeutic model to gender-affirming therapy. The US LGBTQ+ charity Glaad has described gender exploratory therapy as a euphemism for conversion therapy.

In an email to Novara Media, Spiliadis rejected this characterisation, saying that gender exploratory therapy aims “to challenge both conversion therapy practices and immediate medical affirmation without thinking holistically, ethically and in a developmentally-informed [way] about children’s and adolescents’ physical and mental health needs. … I am, of course, against any form of conversion therapy for people’s self-identification.”

Hutchinson also strongly rejected this characterisation of her work in an email to Novara Media. She said: “Seeking to develop compassionate and evidence based therapies for questioning or trans identified children is an attempt to improve standards of care in the field. Trans and questioning children and adolescents have the same right to receive safe, developmentally informed, evidence based care as anyone else. Supporting this is in no way equivalent to supporting conversion therapy.”

Other presenters at the SEGM conference are more openly proponents of conversion therapy, including Canadian psychologist Kenneth Zucker, who promoted conversion therapy for gay people in the 90s and has been accused of doing the same for trans young people (accusations he denies).

Also represented were members of allegedly anti-trans parent groups. Richard Stephens was formerly on the committee of Bayswater, a peer support group for parents of transgender children. A report on the group published by the Bureau for Investigative Journalism in July found that members have discussed destroying their trans children’s belongings, blocking their access to the Childline helpline and that the group promotes the book Desist, Detrans & Detox – Getting Your Child Out of the Gender Cult (In an email to Novara Media, Stephens said he was not aware that the group had promoted this book).

“I told [them] to go and get [their] phone, laptop and tablet,” one Bayswater parent wrote in a post published between April 2022 and April 2023, after Stephens had left the group, “and that [they weren’t] getting them back until [they] would give up [their] binder.” 

A controversial review.

The news that NHS clinicians were presenting at the conference of a designated US anti-trans hate group came as little surprise to several of their colleagues who spoke to Novara Media. For months now, clinicians working for the UK state have been sharing best practices with US politicians on how best to stem the tide of gender-affirming healthcare in both countries.

This has created unlikely bedfellows between Christian conservatives in the US, many with pro-Trump and anti-abortion views, and UK clinicians, including Hilary Cass herself. During her review, Cass and her team met with Patrick Hunter, a member of the Catholic Medical Association and advisor to Florida governor and bathroom bill spearheader Ron DeSantis. When briefly a Republican presidential nominee last year, DeSantis attacked Trump, who in his first term as president banned trans people from the US military, for being too soft on transgender rights.

“There is a gap” between gender-criticial clinicians such as Langton and Hutchinson and Spiliadis, one senior for the health service told Novara Media, “but it is not as big as the people as expressing those views think it is.”

The Cass Review has been treated with scepticism by much of the medical profession, with many – including the European Professional Association for Transgender Health and the British Association of Gender Identity Specialists – pointing to its self-selecting evidence base and deliberate exclusion of trans people, including clinical experts.

In late July, the British Medical Association, the trade union and professional body representing over 190,000 medics in the UK, announced it would conduct an independent evaluation of the review, citing “concern about weaknesses in the methodologies used”. The BMA originally rejected the findings of the report, though now takes a neutral position.​​

Despite the controversy it has provoked, the review has been welcomed by Labour, forming the basis of Wes Streeting’s decision to make permanent an emergency ban introduced by the Conservatives on puberty blockers for under-18s, the main group to whom the drugs are useful (some have suggested that such a ban is a necessary preliminary step to Dr Absoud’s trial, without which there would be no incentive for prospective participants). An unsuccessful challenge was recently launched against the puberty blockers ban in the high court.

In October, Cass was rewarded for her service with a cross-party peerage, a move that delighted Kemi Badenoch. Badenoch, who briefly floated the idea of a “lavatories tsar”, was equalities minister at the time of Cass’s appointment and has since said the review would have been impossible under a Labour government, a statement widely interpreted as suggesting Cass was a political appointee. “What I have come to realize is that this report, for all its claims of impartiality, is fundamentally a subjective, political document,” wrote an opinion columnist for the New York Times in August. Cass maintains her impartiality.

Scarcely had all of the votes been counted in the American election when Labour ministers began loudly courting president-elect Donald Trump. While such public displays of affection may be a calculated attempt to preserve the two countries’ special relationship despite the apparent gap between the Labour and Republican leadership – Trump has reportedly described Keir Starmer as “very leftwing” – fears that Trump-style anti-trans ideology is being imported to the UK appear increasingly well-founded.

Correction 22 November: This article has been updated to clarify Anna Hutchinson’s role and include a comment of hers.

Correction 13 November: This piece previously listed Richard Stephens as a proponent of conversion therapy and reported that he is currently a member of Bayswater. Stephens left the group’s committee in 2021 and says he is “not a proponent of conversion therapy, openly or in any way”.

Correction, 13 November: A previous version of this article suggested that Hilary Cass’s evidence review, whose methodology was designed by Trilby Langton, discarded 98% of the available evidence on gender-affirming hormone treatments. In fact it designated 98% of the studies to be not of a high quality and ignored around 40% of them.