This puzzling rise in a poorly understood phenomenon has prompted some providers and European authorities to urge caution because of a lack of strong evidence.

In a new report from The BMJ Investigations Unit, an American women's health journalist, Jennifer Block, looked into the evidence base behind this surge in treatment. The BMJ [British Medical Journal] is one of the world's leading medical journals. Its misgivings cannot be dismissed as conservative fear-mongering.

Thus it was an article appeared in the Basildon and Southend Echo, complaining about the "trolls" who had "viciously targeted" St Mark's CofE church in Southend after they posted photographs online of children sat in the pews, "enjoying an age-appropriate drag queen event".

The decision to bless same-sex marriages is outrageous and deeply saddening. I myself lived as an openly gay male for 12 years and it ruined me, but by God's grace, not permanently. I thank God every day that I was shown the truth. I wasn't a Christian when I decided to step away from my gay life however; I learned the hard way that homosexual relationships are dysfunctional and the gay identity is self-seeking and by default self-destructive.

Following North Korea in the top 10 were Somalia, Yemen, Eritrea, Libya, Nigeria, Pakistan, Iran, Afghanistan and Sudan.

North Korea reclaimed the top spot this year due to the introduction of an "anti-reactionary thought law" that has led to "a new wave of violence" and the persecution of anyone found with foreign materials or literature.