We welcome the news that the Tavistock gender clinic is to be closed down and replaced with regional services by Spring 2023. The treatment of gender dysphoric children will be integrated within other paediatric mental health services to ensure the same standards of care as for any other child accessing mental health care services. The separation of gender dysphoria into a specialist area has led to the profound failings of a service which has replaced normal levels of care with a fast-track medical transition service for ‘trans kids.’
The separation of these children into their own clinic, away from other pediatric services, has helped to promulgate the idea at the heart of child transition activism: that these children are somehow ‘different’ to other children and fall outside normal understandings of child development and normal standards of safeguarding and patient safety. Separation from all other pediatric services has allowed lobby groups in unnoticed, to put pressure on an already ideologically captured management team and NHS Trust.
In no other area of pediatric care have unqualified political organisations been allowed to influence treatment protocols for children.
The separation of children struggling with gender-related distress has also served to frame the issue of ‘gender’ as a specialised area requiring the expertise of trained ‘gender doctors.’ This is another central tenet of the child transition lobby: ‘gender’ is complicated and clinicians and therapists must receive extensive training in the ‘new understandings’ of gender in order to work with ‘trans people.’ Together with the politicisation of children as ‘transgender’, this has led to the long waiting lists for the GIDS.
The ‘diagnostic overshadowing’ highlighted in the Cass interim report begins at the NHS CAMHS clinics. Therapists and counsellors confronted with an adolescent claiming to be ‘transgender’ will refer the child to the GIDS because they believe 1) they are not adequately trained in this specialist area and 2) because they are afraid of being accused of ‘transphobia’ or ‘conversion therapy’ if they apply the normal standards of care they are trained in to these children.
The result is that the waiting list for the GIDS grows longer, and meanwhile these children receive no support for the mental health issues ordinarily dealt with at CAMHS. As a result, as Cass points out, a child’s ‘gender identity’ may become solidified so that they arrive at the GIDS desperate for hormones. Meanwhile, self-harm and suicidal ideation may have increased due to lack of mental health support, and child transition advocates can use this as ‘evidence’ that children are more likely to consider suicide if they are denied medical treatment.
Shutting down the Tavistock GIDS is long overdue. From the first whistleblower, Susan Evans in 2005, through shocking revelations from GIDS clinicians in the Bell report, Keira Bell and Mrs A’s judicial review against the Tavistock and Sonia Appleby’s employment tribunal, the GIDS has remained firmly entrenched in its unassailable position. Arrogance and certainty in its ideological viewpoint has blinded the service to the harms of unethical, medical experimentation on children.
The NHS-commissioned review of the Tavistock GIDS revealed, in its devastating interim report, a service unconcerned with clinical research, data collection and evidence. The cavalier promotion of puberty blockers as a cure-all for troubled teenagers has led to irreversible harms to thousands of adolescents. The results of this experiment will not be known until this cohort grows up and maturation gives them the hindsight to reflect on decisions made in the maelstrom of adolescence. The affirmation of an adolescent’s self-diagnosis by the GIDS, with no attempt to explore underlying issues such as autism, trauma, internalised homophobia or mental health issues, has been a catastrophic failure of duty of care to young people.
In her letter to the NHS, Dr Hilary Cass specifies that:
“There should be a whole system approach to care across the network so that children and young people can access a broad range of services relevant to their individual needs, including supportive exploration and counselling.”
We are confident that the recommendations made to NHS England will achieve the aim of the Cass interim report to provide normal standards of care for children experiencing gender-related distress and we are very grateful to Dr Cass and her team for all their hard work to ensure that these children receive the best evidence-based care.
Questions now need to be asked about how a situation was allowed to develop within the NHS where children were put at such risk and given treatments causing lifelong harms:
- The influence of external lobby groups such as Mermaids, GIRES and Gendered Intelligence.
- Membership of the Tavistock and Portman NHS Trust in the Stonewall Diversity Champions scheme.
- The adoption by the GIDS of the WPATH standards of care.
- The development of NHS service specifications for children and adolescents.
- The role of the regulatory body, the Care Quality Commission, also a Stonewall Diversity Champion, in judging the GIDS to be ‘good’ in 2016.
Finally, there needs to be a public inquiry into the infiltration of gender ideologues into schools, youth organisations, charities and social services along with the NHS and the GIDS, how this was enabled, and the mechanisms by which we can prevent such a failure of safeguarding from happening again.