The final part of ITV drama Butterfly airs [this evening], marking not so much the conclusion of a TV show but the climax of a social justice event, at least if you believe the show’s makers and the largely rapturous notices. Starring Anna Friel as the mother of Max, an 11-year-old who’s born male but identifies as a girl, and broadcast in the last weeks of the government consultation on reforming the Gender Recognition Act, it’s clearly been conceived as an intervention on the side of the angels. Or rather Mermaids: Susie Green, CEO of the charity for families of trans children, was a consultant on the programme.

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Butterfly, though, is storytelling. It’s emotionally appealing. It’s accessible. It’s simple. In fact, it’s very simple indeed, which is why it’s quite boring, and also why it’s dangerous.

That’s a strong word to use of a primetime drama, but consider what Butterfly is telling its audience. It offers a starkly segregated version of childhood: boys do active, sporty things and girls are decorative and pretty. Max’s parents first of all try to “fix” him into having the appropriate interests – his dad with corporal punishment, his mum by treating the “girly” things as a shameful secret to be kept to the bedroom – and, when that fails, they solve the problem instead by recategorising him as a girl. The possibility that Max, like 60-90% of children with gender dysphoria, might simply turn out to be a boy who likes pink, isn’t given house room here.

Then there’s that jaunt to America for treatment. In the show, it’s a high-stakes decision for Max’s mother to make, but one that we’re never supposed to doubt is in Max’s best interests. The Ferrybank, with their advocacy of “watchful waiting” rather than filling out a shopping list of prescriptions, act as the story’s primary antagonists. After all, viewers have already been told unequivocally that Max really is “a girl in a boy’s body”. In the context of the show, any resistance to that isn’t sensible clinical caution, it’s just cruel. The lesson for distressed children and their anxious parents watching the show is: don’t trust the experts who won’t give you what you want.

In the real world, though, things aren’t so easy to call. Gender dysphoria has complex, multiple causes, and in children that usually involves the family dynamic. NHS clinicians, trying to address these delicate cases, increasingly find that anything they want to explore has been pre-empted by the pressure on parents to “affirm gender”: parents have often socially transitioned their child long before they reach the consulting room. Sometimes, parents have even started the medical course privately, via clinicians such as Helen Webberley – convicted this month of running an unregistered clinic, but still linked to by the Mermaids website.

The argument for rushing to treatment, as put forward by Mermaids and repeated by Max’s mum in Butterfly, is “better a happy daughter than a dead son”. In other words, children with gender identity issues are supposedly so prone to suicide that the only option is to stall puberty immediately, starting cross-sex hormones as early as possible. (This maximises the child’s chances of eventually passing as the chosen sex; it also costs them their adult fertility and sexual function.) In the first episode of Butterfly, Max follows this script by making a graphically portrayed suicide attempt.

But the script is false. The startling figures offered by Mermaids for suicidality in trans children are taken from self-selecting surveys that don’t control for comorbidity of mental health conditions. The NHS gender identity development service reports that less than 1% of its patients have attempted suicide; meanwhile, Swedish research has found that transitioning doesn’t remove trans people higher risk for suicide. In other words, the Mermaids version overstates the risk and then demands a cure that doesn’t work.

This isn’t just inaccurate. It’s damaging. In Max’s story, a child questioning their gender will see that suicide gets results: not just medical treatment, but ultimately the reconciliation of Max’s parents (the final scene of the last episode sees Max getting the longed-for blocker injection as his parents hold hands in the foreground, everything as it should be in the straightest of all possible worlds, the violent man back in the family fold). This presentation of suicide goes directly against the Samaritans guidelines for preventing the spread of suicide. Reckless politicising of self-harm is what endangers young people’s lives, not delaying irreversible medical treatments.

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As one gender identity specialist who watched the programme points out, Max is told persistently, insistently and consistently by his parents that he’s “wrong” as a boy. “This is not acceptance,” she says. “In fact, this is rejection.” Under the lipstick smile, Butterfly is a charter for something very regressive, and very cruel: the credo that children who can’t perform the “correct” sex stereotypes must change their bodies, or die.

Sarah Ditum, read the full article here