Butterfly – a great TV drama

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Butterfly – a great TV drama

“Butterfly” has been a terrific drama. There were three episodes each shown on a Sunday evening at 9 pm on ITV. If you’ve missed it, do watch it on the ITV hub – it’s well worth it!

At the centre of the drama is an eleven-year-old child named Max, who was assigned male at birth on the basis of his anatomy. Max, though, feels that he is a girl, and has felt like this for years. He suffers from a condition known as gender dysphoria. The drama is about the efforts made to resolve this and their consequences.

Before I go any further, I feel I ought to say that although this article is about “Butterfly”, it isn’t a review. It’s my personal response, as a transgender woman, to a powerful drama about the transgender experience.

At the start of the drama we are shown how Max’s gender dysphoria has split the family, with the father, Stephen, living away from his wife and two children. He has access to the children, though, and Max attempts to please him by feigning enthusiasm for football.

But Max must be Maxine. The drama follows the journey made by the whole family as he/she seeks to achieve this. The drama shows us that a sufferer from gender dysphoria experiences acute distress as a result of a mismatch between the gender they feel themselves to be, and the gender suggested by their anatomy. It’s a serious condition. Sufferers, including children, have a high rate of self-harm and suicide.

Max, being eleven, is going to enter puberty soon, possibly within months. His voice will break and he will grow facial hair; his whole body will become, irreversibly, that of an adult male. This will bring two big problems; firstly, Max will suffer great distress at the physical changes; secondly, those changes will make it harder for him to live in his chosen gender role when he’s an adult. What’s to be done?

Well, certain drugs block the hormonal onset of puberty and delay the development of adult secondary sexual characteristics. So, Max’s voice won’t break, and his body won’t develop the characteristics of an adult man. This will allow time for him to mature before any irrevocable decisions about gender role are made.

This is the heart of “Butterfly”; the struggle by Max/Maxine, championed by her mother Vicky, to obtain puberty blockers. We see the family at an NHS clinic, and at a private clinic; we see Maxine start to live full-time as a girl, with the inevitable bullying at school; we see her feeling so unloved that she self-harms, with almost fatal consequences; we see the family pulled this way and that by their response to the situation. The biggest problem is that before anyone will prescribe puberty blockers both parents have to give consent – and Stephen simply will not do this.

Vicky resorts to desperate measures. The courts become involved. The Local Authority child protection team become involved. There is a real risk that Maxine will be taken into care, and then what would happen to her?

I won’t give any spoilers, except to say that the drama is tense, nail-biting, and has a believable finale.

Is it true to life? Yes, very much so. The common theme in all the responses to Max’s gender dysphoria is a personal agenda – I’d call it a moral agenda, except that prejudice is hardly a moral stance. Nobody was actually neutral, even the professionals who really ought to be even-handed. And that is completely true-to-life.

Even more poignantly, and powerfully, the drama captures little details like Max’s difficulties with the school toilets. He couldn’t bring himself to use the urinals, and clearly found the whole masculine environment overwhelmingly hostile. How well I remember that!

So “Butterfly” is both powerful and authentic. It’s worthwhile, therefore, to consider its implications in the real world.

In recent years there has been controversy about intervention where children feel themselves to be transgender, and “Butterfly” contributes to that debate. Watching it, and thinking about it, has crystallised my thinking on the matter (yes, the drama really is that good). In brief, the effective treatment of gender dysphoria requires irreversible changes. One viewpoint is that we should not give such treatment to children, “because they might be mistaken”; the other viewpoint is that where there is a clear and strong diagnosis of gender dysphoria we should intervene as early as possible, before puberty if possible.

Drugs to block puberty blur the lines of the debate a little by allowing time for the child to mature. They seem to be safe, but some people have questioned the reversibility of their effects if administered over a long period.

The current treatment of gender dysphoria is for the sufferer to live in the gender role that they feel is appropriate, supported by whatever surgical and hormonal treatment is necessary. Gender confirmation in this way has a good record of success.

If you don’t treat gender dysphoria, the afflicted individual goes on suffering. Because the suffering is intense, the individual is at a (much) higher risk of suicide. In fact, there’s only one thing worse than not treating the condition and that is treating gender dysphoria as a mental illness. This has a dismal record, especially where it is linked to condemnation of the transgender feelings, and has led to many suicides.

And yet, despite these facts, people persist in wanting to treat gender dysphoria as ‘special’, ‘different’ or just plain ‘morally wrong’. This inevitably finds its way into the treatment of transgender children. People say that they must be protected from these strange urges until they’re old enough to make a mature choice (of course, by that time puberty has well and truly done its worst…).

What would I like to be available for everybody who suffers from gender dysphoria?

Prompt referral to clinical specialists (the current waiting time is far too long).

Where gender dysphoria is diagnosed, prompt availability of treatment (currently once you have your diagnosis it’s at least an eighteen month wait before you can even discuss the options with a surgeon, and many months more before surgery takes place)

Treatment of everybody with a confirmed diagnosis of gender dysphoria. Age should not be a factor (subject to NHS guidelines for consent). Gender confirmation is a life-saving treatment, and this applies to young people as well as adults.

It’s worth looking at the NHS Guidelines for Treatment of Children and Young People

These set out the following criteria for consent.

“Children under the age of 16 can consent to their own treatment if they’re believed to have enough intelligence, competence and understanding to fully appreciate what’s involved in their treatment. This is known as being Gillick competent.

Otherwise, someone with parental responsibility can consent for them.

This could be:

  • the child’s mother or father
  • the child’s legally appointed guardian
  • a person with a residence order concerning the child
  • a local authority designated to care for the child
  • a local authority or person with an emergency protection order for the child

The person with parental responsibility must have the capacity to give consent.

If a parent refuses to give consent to a particular treatment, this decision can be overruled by the courts if treatment is thought to be in the best interests of the child.

If one person with parental responsibility gives consent and another doesn’t, the healthcare professionals can choose to accept the consent and perform the treatment in most cases.

If the people with parental responsibility disagree about what’s in the child’s best interests, the courts can make a decision.

In an emergency, where treatment is vital and waiting to obtain parental consent would place the child at risk, treatment can proceed without consent.”

These guidelines seem to me to be all that is needed to safeguard young people. There is no need to treat intervention for gender dysphoria as something special; it’s just another medical procedure that will improve the lives of most of those who receive treatment.

“Butterfly” has done a great job of highlighting these issues, and I hope it helps to improve society’s treatment of young trans people. And, whatever your stance on the issues, do watch “Butterfly” – it’s a cracking good drama!


Book review – “The Memory Stones” by Caroline Brothers, published by Bloomsbury

The memory stones, from CB

BUENOS AIRES, 1976. Osvaldo Ferrero and his wife Yolanda escape the city’s heat with their daughters, Julieta and Graciela, who is madly in love. On their return, the military junta stages a coup, and Osvaldo is forced to flee. Graciela is abducted and becomes one of the ‘disappeared’. Yolanda fights on the ground for some trace of their beloved daughter, while Osvaldo can only witness the disintegration of his family from afar.

Soon Yolanda and Osvaldo realise that Graciela was expecting a baby when she was snatched; perhaps they are fighting for an unknown grandchild as well.

This is a great novel, in the sense that ‘The Grapes of Wrath’ by Steinbeck is a great novel. It is driven by passionate indignation that men should do such wicked deeds, it tells the story through believable characters, and it is written with quiet words that nevertheless sing.

Caroline writes beautifully, and uses some vivid metaphors. There is, for example, a three page story of the travails of a letter through the streets of Buenos Aires. It tells the reader of the appalling crime that has been committed against Graciela with a forcefulness that description could never achieve on its own.

It’s difficult to bear the sadness and loss of the central characters. There were times when, despite the enthralling writing, I picked up the book with reluctance because it hurt so much. In reading the novel, I learned that the regime’s rule of terror took more than the lives of most of those who disappeared; it also took fulfilment from the lives of those whose families and friends were taken.

I was glad that I persisted in reading. Osvaldo and Yolanda are people of integrity, determination, and, above all, love. By the end of the story, love has won some victories to set against the evil of wicked men, and those victories are important. When you read this book – and you really should, for it is a deeply enriching experience – summon up your own integrity, determination and love, summon up your courage, and immerse yourself. It’s well worth it!

You can read more about the novel at https://www.facebook.com/MemoryStones1/

Review – My Husband Next Door

Author: Catherine Alliott
Enjoyment rating: 6/10
This is a literary novel; I think. It’s a love story (definitely a love story) but not a romantic love story (on the whole). You may by now have noticed that I find it difficult to categorise…
As the plot is important, and there’s something of a twist at the end, I shan’t provide any spoilers. Without giving away anything essential, I can say that the story is about Eleanor (Ella) who lives in a ramshackle farmhouse with her two teenage children. Her husband is a famous artist, Sebastian Montclair, who is now struggling to finish any paintings at all. He lives in a converted outhouse of the farm. Ella’s parents have a dysfunctional marriage, which reaches a critical point at the start of the novel. The story explores how the combination of circumstances affects Ella.
Ella is written in the first person. She is a maelstrom of disorderly emotions and the writing evokes this very well. In fact, at times I had to stop reading for several hours to calm down. She is by a long way the most believable character in the book.
Her husband, Sebastian, doesn’t feature very much in the action, but he’s very much at the heart of the story. The author uses great skill in showing how all the characters are aware of his presence, and how they respond to it.
The other characters are to a certain extent caricatures, although they permit some entertaining comedy. I particularly enjoyed one scene where Ella is receiving acupuncture treatment from her best friend (Acupuncture? What could possibly go wrong…?). Not all the comedy is successful, unless you like the ‘cringe with embarrassment’ school of comedy (which, personally, I don’t).
The reason I describe this as a literary novel is that it attempts a psychological rationale for the characters’ fates; it’s not simply about the outcome, but the way the outcome is achieved. There is a sense of negative actions and attitudes prompting further negativity in a downward spiral, and positive actions and attitudes similarly prompting a virtuous upward spiral. I’m not sure I found it convincing for these particular characters in their specific situation.
Even more importantly, I wasn’t convinced by the psychology of the painting, and the inability to finish. Never mind, it doesn’t spoil the read. This is definitely worth borrowing from the library!

Review – The year I met you

Author: Cecelia Ahern
Enjoyment score 7/10
This book is about Jasmine, a young woman who is (unwittingly) on a journey of self-discovery. She travels from a place where she’s falling apart but doesn’t realise it, towards a destination where she is once more enjoying life. During this period, her struggles affect the lives of those close to her, principally the man who lives opposite her (Matt Marshall, the ‘you’ of the title), her older sister, Heather, (who has Down’s Syndrome) and an über-sexy recruitment consultant.
The story is told by Jasmine in the first person, and it’s told powerfully. It has the same effect in places as someone shouting in the reader’s ear, which can be off-putting, but we go on listening because we want to know what happens next. And there is a twist. The narrator consistently refers to the man who lives opposite as ‘You’, very rarely mentioning his name. So, even as the reader is busy living the turmoil that is the narrator’s emotional life, we are also being urged to identify with the neighbour – for who is the narrator addressing if not the reader?
Jasmine’s character is well drawn. The author has used her actions to demonstrate who she is. Just to make sure that we don’t miss the way Jasmine is harming herself, the author describes the coping strategies used by Jasmine’s sister, Heather, to live a fulfilling life despite her disability. We are given a clear feeling for Jasmine’s inner life. It’s well worked out, and has a depth that repays exploration.
The characters of Heather and Matt Marshall are adequately described; the other ‘characters’ are plot devices.
I must confess that this book rather baffles me. When I started reading I was irritated by the central character, who is self-destructive in an erratic, hyper-emotional fashion. By the time I finished, I was wondering just how many of her characteristics I shared…