Clinicians and managers must be held to account for the travesty in which adult beliefs were allowed to drive healthcare for children
The Gender Identity Development Service clinic at the Tavistock and Portman NHS foundation trust in London was at the centre of the criticisms.The Gender Identity Development Service clinic at the Tavistock and Portman NHS foundation trust in London was at the centre of the criticisms.‘They deserve very much better,” the distinguished paediatrician Hilary Cass concludes in the final report of her independent review of NHS gender identity services for children and young people.
But that is exactly what has happened to a growing cohort of children seen by Gids, which has since been shut down. Disproportionately made up of girls and same-sex attracted children, many were put on an irreversible medical pathway without diagnostic criteria.
Because Gids failed to keep adequate data even on the children it was treating in this way, let alone keep track of their outcomes, it is impossible to know the scale of the harm that has been done to them, including how many have now detransitioned or experienced regret.
The Cass review sets out an ambitious new way of delivering care for gender-questioning children, grounded in a psychosocial approach that treats them holistically. It recognises that, for many, questioning their gender is not necessarily a sign they will have a fixed trans identity in adulthood, and that children referred to gender services are more likely to be affected by neurodiversity, co-occurring mental health issues, and to have suffered adverse childhood experiences.
They are also much more likely to be same-sex attracted; some clinicians have expressed concern that, instead of helping children process the fact they are gay, gender medicine has encouraged them to instead believe they are born in the wrong body. The review has been broadly welcomed; quite a feat given how contested an area of healthcare this has become.
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