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Twelve months ago this week I reported in detail from a special conference at Imperial College in London. Clinicians from Britain, Holland and the United States came together to discuss their different views about the best way to treat adolescents with persistent gender identity issues, and a strong desire to permanently change sex.

The central issue is about how to deal with Puberty. If clinicians don’t do something to prevent normal puberty occurring then a trans child will undergo changes that are impossible – or at least painful and expensive to reverse in adulthood.Some children say they would rather commit suicide and their parents are understandably frantic.

Puberty can be blocked in a way that’s completely reversible. So this is what doctors in several parts of the world are now doing. If the child should change their mind, you stop the drugs and puberty kicks in as though nothing had happened. It buys enough time till the child is older and their course in life is certain.

British clinicians have been ultra cautious and conservative though. They fear factors which might be as yet unknown if you meddle with puberty’s course. Paradoxically they weight this more highly than the certain negative outcomes of an unwanted puberty and the results of foreign studies.

That was twelve months ago. And on the face of it nothing seems to have changed much today. Clinicians at the UK’s only specialist centre for child and adolescent gender identity patients say they will still only prescribe blocking therapy once puberty has largely completed at the age of 16 – by which time irreversible changes have occurred.

What has altered, however, is that the advocates for change – mostly parents of trans children – are getting more of a hearing for their case.

In this show we feature a recent interview from BBC Radio Four’s flagship “Today” programme and afterwards I reflect on what mature media coverage does for the debate.

You can also listen to my full original interview with Nicky's mother, "Gender Dysphoria, A Mother's Tale", first released in April 2008

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