The death was reported in the press this week of Russian social media influencer Zhanna Samsonova. The name may mean little to you, but Ms Samsonova had apparently gained fame for blogging about her extreme diet of raw tropical fruit. She died, aged 39, of malnutrition.

What, you may ask, has this got to do with Costa's advertisement of an androgynous looking cartoon character, with blue hair, yellow shorts, a cup of coffee ... and mastectomy scars? Well, the answer is simple – some behaviours should not be affirmed, because of the harm they cause. And Costa's advert is a case in point.

Costa claims as justification for its advertisement that it is promoting inclusivity and diversity. A spokesperson for the chain said, "At Costa Coffee, we celebrate the diversity of our customers, team members and partners ... We want everyone that interacts with us to experience the inclusive environment that we create, to encourage people to feel welcomed, free and unashamedly proud to be themselves." The image was apparently taken from part of a mural created in Brighton for last year's Pride month.

Seriously?

In the last few years, the number of children seeking treatment for gender dysphoria has sky rocketed, going from 250 in in 2011/12, to over 5,000 in 2021/22. A decade ago, the majority of referrals were for birth-registered males, but more recently that has been reversed, with far higher numbers of birth-registered females now seeking treatment in their early teens. Significantly, a very high proportion of children claiming to be suffering from gender incongruence, of both sexes, have mental health problems or are autistic.

If transitioning treatment genuinely did resolve all problems, one might possibly – just possibly – be able to say the advert was fine and that there was no cause for concern, but there is increasing evidence that it does not. Suicidal tendencies among transgender people following treatment remain far higher than among the general population, with between 32% to 50% attempting suicide at least once.

Similarly, rates of mental illness remain far higher, with 58% of transgender patients having at least one psychiatric diagnosis, as compared with 25% among non-transitioners. On top of that, though precise numbers still have to be determined due to the difficulties in accessing accurate information, we know that there are growing numbers of trans individuals who subsequently deeply regret their choices and actively seek help to detransition.

All of these are what could be called 'adverse outcomes' to gender transitioning treatment. Yet it might perhaps be said that as they only affect some – even if that 'some' is actually more than half – what does it matter? Well, it 'matters' because there are other outcomes, following medical and surgical intervention, that affect all trans people, ranging from infertility and difficulties relating to sexual arousal, to the lifelong need for medication, and a long list of possible health problems, such as, for example, blood clots and osteoporosis.

Put all these together, and it's no exaggeration to say that the efficacy of such treatment is at best problematic and, at worst, downright dangerous. The question has then to be asked: why would anyone with a grain of common sense seek to 'glorify' such unnecessary and hazardous bodily mutilation?

Costa is clearly on the woke bandwagon and intent on banging the drum, but encouraging vulnerable young girls to mutilate their otherwise healthy bodies is not just irresponsible, but abuse of the worst kind. Cutting off their breasts is not cool – as suggested by the advert – but rather medical masochism, which in the future there is every likelihood they will deeply regret. As said at the beginning, some behaviours should not be affirmed because of the harm they cause.

Costa claim they want to be inclusive and celebrate diversity, but exactly who are they 'including' here? Not women, clearly. And not those suffering from breast cancer, for whom the advert shows deep insensitivity. No, their claimed diversity is both selective and exclusionary. They should be ashamed.

Rev Lynda Rose is founder of Voice for Justice UK, a group which works to uphold the moral values of the Bible in society.