I fought the PayPal and I won

You might disagree with this point of view, but that doesn't make it unreasonable.

As Wright notes in https://www.realityslaststand.com/p/sex-is-not-a-spectrum, this view of sex as a binary system is based on the concept of male and female being the two discrete halves of the reproductive system in humans (and other anisogamous species):

"Biological sex [...] is connected to the distinct type of gametes (sex cells) that an organism produces. As a broad concept, males are the sex that produce small gametes (sperm) and females produce large gametes (ova). There are no intermediate gametes, which is why there is no spectrum of sex. Biological sex in humans is a binary system."

Surely this is not an unreasonable starting point for an evolutionary biologist to extrapolate from?

> If someone thinks biological sex is binary, that shows they're uninformed. Like gender, it is essentially a point cloud in n-dimensional space - largely bimodal, but with a few other notable clusters.

Not really though - if someone has carefully considered this topic and still regards the sex binary as the most appropriate model to apply, it's more likely to indicate they are considering function over form in their reasoning. In particular, reproductive function - i.e. why we all have sexed bodies in the first place.

With this model, sex isn't just an assortment of bodily features, but is based on the reproductive function around which several related aspects of our bodies have evolved, with male and female being the two types of anatomical pattern appropriate to each reproductive role.

However, I do understand that to those who want to believe that sex can be changed through pharmaceutical and surgical interventions, this view of sex as a functional biological system isn't as compelling as the 'point cloud' model, which comes with the implication that if these points can be changed somehow, then sex is too.

...This still ignores examples where sexual characteristics don't actually fit a binary, though. These are edge cases, yes, but they are edge cases that occur in nature. This is why cases like the bee example are important--bees have sexual trimorphism. Drones, workers, and queens all have different sexual characteristics that affect how they reproduce. Based on the reproductive function of bee anatomy, sex is not a binary for bees.

Also, I'd like to point out--for the record--that the ability to change one's sexual characteristics, and the presence or absence of sexual characteristics, has almost nothing to do with one's gender (beyond avoiding body dysphoria). This is an important distinction to make, because while we don't have full ability to change a person's sex (i.e., we don't have artificial wombs yet), a person's gender can be independent of their sexual characteristics (as evidenced not only by trans people, but also by intersex people who identify as cisgender).

No, they did not. They only did psychological assessment, and then referred on to endocrinology who would then do their own assessment and decide whether or not to prescribe PBs.

Here's the NHS England stand commissioning contract. On page 17 there's a flow chart, and you can see that after the assessment phase there's a box that says "Refer to Endocrinology Clinic + ongoing GIDS input", and that box exists because GIDS have never prescribed PBs, they referred children on to an endocrinology service who did their own assessment and made their own decision about whether or not to prescribe. Page 18 has a further flow chart that explains the endo referral process. Page 19 describes the referral and separate assessment process used by the endo service. Page 25 gives further details about referral to the endo liaison team.

https://www.england.nhs.uk/wp-content/uploads/2017/04/gender...

From the link you provide: "A standardised set of psychological questionnaires used in the GIDS clinic was completed at the time young people were deemed potentially eligible and referred to the medical clinic." and "Young people were considered for recruitment after lengthy assessment, spending an average of 2 years and up to 6 years within the GIDS psychological service before being referred to the endocrine clinic for assessment to enter the study." - I mean, come on.

One of the lead authors of the link you've provided: "Gary Butler". He's Professor Gary Butler, who works for the Department of Paediatric and Adolescent Endocrinology, at University College London Hospital NHS Trust. This is the service that provides endocrinology assessment and, if necessary, prescribing.

He doesn't work for Tavistock and Portman NHS Foundation Trust.

From one of the references in your link: https://adc.bmj.com/content/103/7/631

> Support for children and adolescents up to the age of 18 years has been provided through the Tavistock and Portman NHS Trust in London for over 20 years. The GIDS was nationally commissioned by NHS England in 2009 and extended to Leeds in 2012, providing regular outreach clinics in other areas of the UK. Endocrine evaluation and support has been provided through University College Hospital London for over two decades, and Leeds Children’s Hospital since 2013. Care is provided according to an agreed service schedule,3 taking into account international guidance from the World Professional Association for Transgender Health (WPATH)4 and the recent guidelines from the Endocrine Society.5

Puberty blockers would be "endocrine evaluation and support".

If anything, the UK has been an outlier because so few children had access to PBs, far fewer than in other countries. https://pubmed.ncbi.nlm.nih.gov/18667644/

GIDS at Tavistock and Portman never prescribed PBs. That prescribing was done, independently, by endocrinology services in other organisations.