Susan Bewley vs. transgender people

Susan Bewley is a British obstetrician and anti-transgender activist. Bewley was an invited speaker at a 2023 anti-trans conference organized by Society for Evidence-Based Gender Medicine, an anti-LGBTQ hate group. Bewley has collaborated with other anti-trans activists on academic publications and other initiatives, including Clinical Advisory Network on Sex and Gender, and FAIR in Medicine.

Background

Susan Jane Bewley was born in July 1958 in Dublin, Ireland, the eldest of five siblings born to psychiatrist Thomas Bewley (1926 – 2022) and physician Dame Beulah Rosemary (Knox) Bewley (1929 – 2018).

Susan Bewley earned a bachelor’s degree from the University of Oxford in 1979 and qualified as a doctor in 1982. Bewley’s research focused on severe maternal diseases and violence in pregnancy.

Bewley co-founded Women In Medicine in the early 1980s as a radical counterpart to the Medical Women’s Federation. The organization known as GLADD [The Association of LGBTQ+ Doctors & Dentists] formed in 1994 and was formally constituted in 1995. Its more inclusive approach is reflected in the name (which includes lesbians and dentists) and in the appointment of Bewley and David Harvey as co-chairs.

Bewley was a Trustee and Chair of the charity HealthSense UK (formerly HealthWatch) before stepping down in 2022.

Bewley identifies as lesbian.

Trans-skeptical research

In 2018 The BMJ published a feature by Ingrid Torjesen titled “Trans health needs more and better services: increasing capacity, expertise, and integration.” Bewley coauthored a critical response with Richard Byng, Damian Clifford, and Margaret McCartney, citing Jesse Singal, Anne Lawrence, Denise Chew, and Lisa Littman. The authors have a rigid and prescriptivist view of evolving scientific terminology around sex, gender, and sexuality:

Proposed ‘terminology’ may mislead and fudges the reality of biological sexual dimorphism. Sex is not “assigned”, but determined at conception and in early embryonic life. Biological characteristics of male and female have “historically” been observed at birth and likely this will continue. Sex should not be confused with gender – a social construct. Although internal subjective identity, legal status and external appearance can change or be re-aligned, a person’s underlying biological sex cannot. (Byng 2018)

In 2021 Bewley co-authored a paper critical of describing non-affirming models of care as “conversion therapy”:

The concept of conversion therapy with reference to alternative gender identities is examined critically and with reference to psychiatry’s historical relationship with conversion therapy for homosexuality. The authors consider the uncertainties that clinicians face when dealing with something that is no longer a disorder nor a mental condition and yet for which medical interventions are frequently sought and in which mental health comorbidities are common. (Dahlen 2021)

In 2022 Bewley co-authored a paper critical of healthcare protocols for trans and gender diverse patients in the UK:

No appropriate primary care audit standard was found. There was inconsistency between multiple UK gender identity clinics’ (GIC) individual recommended schedules of care and between specialty guidelines. Using an international, secondary care, evidence-informed guideline, it appeared that up to two-thirds of patients did not receive all recommended monitoring standards, largely due to inconsistencies between GIC and international guidance. (Boyd 2022)

The “evidence-based medicine” movement has been seized upon by anti-trans activists as a way to restrict or ban gender affirming healthcare, especially for minors. While skepticism plays a critical role in the development of medical technologies and protocols, systematic reviews and collection of best available evidence can hide author biases and dogmatism behind an authoritative aura, as seen in the 2024 Cass Review. Evidence-based medicine is just one part of developing best practices. Clinical wisdom and patient values must also be factored in, but “evidence-based” dogmatists often prioritize their beliefs to the detriment of clinician and patient experiences. Nationalized healthcare is notoriously inadequate for minorities, especially sex and gender minorities, and centralized “gender clinics” have often led to to poor experiences and outcomes for trans and gender diverse people, typically due to long wait times, cookie-cutter approaches, and rigid gatekeeping developed based on the ideology of the clinic staff and management.

In 2024, Bewley appeared with anti-trans activists Carrie Mendoza, Jamie Reed, and Stella O’Malley in a video for anti-trans group FAIR in Medicine to criticize guidelines being developed by the World Health Organization. This was part of the WHO Decides campaign to remove trans people, their allies, and affirming experts from the guideline development committee.

References

Bewley, S. (2022). Regret after Gender-affirmation Surgery: A Systematic Review and Meta-analysis of Prevalence. In Plastic and Reconstructive Surgery – Global Open (Vol. 10, Issue 9, p. e4512). Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/gox.0000000000004512

Boyd I, Hackett T, Bewley S (2022). Care of Transgender Patients: A General Practice Quality Improvement Approach. In Healthcare (Vol. 10, Issue 1, p. 121). MDPI AG. https://doi.org/10.3390/healthcare10010121

Gribble KD, Bewley S, Bartick MC, Mathisen R, Walker S, Gamble J, Bergman NJ, Gupta A, Hocking JJ and Dahlen HG (2022). Effective Communication About Pregnancy, Birth, Lactation, Breastfeeding and Newborn Care: The Importance of Sexed Language. Front. Glob. Womens Health 3:818856. https://doi.org/10.3389/fgwh.2022.818856

Dahlen S, Connolly D, Arif I, Junejo MH, Bewley S, Meads C (2021). International clinical practice guidelines for gender minority/trans people: systematic review and quality assessment. In BMJ Open (Vol. 11, Issue 4, p. e048943). BMJ Open https://doi.org/10.1136/bmjopen-2021-048943

Bewley S, Dahlen D, Connolly D, Arif I, Junejo M, Meads C (2021). International Clinical Practice Guidelines for Gender Minority/Trans People: Systematic Review & Quality Assessment. How Does the Endocrine Society Fare? Journal of the Endocrine Society, Volume 5, Issue Supplement_1, April-May 2021, Page A791, https://doi.org/10.1210/jendso/bvab048.1609

Griffin, L., Clyde, K., Byng, R., & Bewley, S. (2021). “The article ‘Sex, gender and gender identity’ fails to adequately engage with the extant scientific literature”: Reply. BJPsych Bulletin, 45(5), 310–311. https://doi.org/10.1192/bjb.2021.79

Bewley S, McCartney M, Meads C, Rogers A (2021). Editorial: Sex, gender, and medical data. BMJ 2021; 372 https://doi.org/10.1136/bmj.n735

Griffin L, Clyde K, Byng R, Bewley S (2020). Sex, gender and gender identity: a re-evaluation of the evidence. BJPsych Bulletin (Vol. 45, Issue 5, pp. 291–299). Royal College of Psychiatrists. https://doi.org/10.1192/bjb.2020.73

Arif I, Dahlen S, Connolly D, Junejo MH, Bewley S, Meads, C (2021). 2090: Obstetrics & Gynaecology in International Clinical Practice Guidelines for gender minority/trans people. In Category – Women’s Health and Policies. BJOG: An International Journal of Obstetrics & Gynaecology (Vol. 128, Issue S2, pp. 271–281). Wiley. https://doi.org/10.1111/1471-0528.23_16715 [PDF]

Bewley S, Clifford D, McCartney M, Byng R (2019). Gender incongruence in children, adolescents, and adults. British Journal of General Practice (Vol. 69, Issue 681, pp. 170–171). Royal College of General Practitioners. https://doi.org/10.3399/bjgp19x701909

Byng R, Bewley S, Clifford D, McCartney M (2018). Response to Torjesen, I. (2018). Trans health needs more and better services: increasing capacity, expertise, and integration. https://www.bmj.com/content/362/bmj.k3371/rapid-responses Original Torjesen article: https://doi.org/10.1136/bmj.k3371

Subotsky F, Bewley S, Crowe M [Eds.] (2018). Abuse of the doctor-patient relationship. Cambridge, England: Cambridge University Press. ISBN 9781108677288

Luisa Orza L, Welbourn A, Bewley S, Crone ET, Vazquez M (2014). Building a safe house on firm ground: Key findings from a global values and preferences survey regarding the sexual and reproductive health and human rights of women living with HIV. https://salamandertrust.net/wp-content/uploads/2014/05/BuildingASafeHouseOnFirmGroundFINALreport190115.pdf

This page previously misstated the name of one of Bewley’s parents and has been corrected to Thomas Bewley.