London’s High Court to hear case against the NHS gender identity development service

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The UK High Court will hear proceedings this week in a landmark case against the NHS’s “gender identity development service” for children, to rule whether people aged under 18 should be able to give consent to undergo medical treatment for gender reassignment.

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The court will hear a case made by the mother of a 15-year-old patient seen at the Tavistock Clinic in Leeds and a former employee of the clinic, Sue Evans, who worked there as a mental health nurse between 2003 and 2007.

Lawyers acting for the plaintiffs will bring about a judicial review amidst concerns over the approaches and methods employed by the clinic, which runs the only NHS gender identity development service (GIDS) in the UK.

Both the mother – identified only as Mrs. A – and Evans argue that the state-sponsored child gender reassignment center provides an “inaccurate and potentially misleading” picture about the risks associated with the life-changing treatment.

The plaintiffs argue that a child’s consent is not valid

Lawyers will argue that giving puberty blockers and cross-sex hormones to people aged under 18 is illegal because children are not able to give informed consent. The plaintiffs say that children of this age cannot fully comprehend the consequences of such interventions and that the treatments should not go ahead based on their consent.

“We are essentially seeking to say that the provision at the Tavistock for young people up to the age of 18 is illegal because there isn’t valid consent,” said Paul Conrathe, a lawyer representing the plaintiffs.

Conrathe says he thinks the treatment should not be given as a “general approach,” but should require a court order in each case.

Former employees have criticized the clinic’s approach

The clinic’s approach has already been criticized by former employees who accuse it of “over diagnosing” children who have gender dysphoria and then providing them with what some refer to as risky, experimental medical interventions.

Many psychologists have resigned from GIDS recently

Over the last three years, as many as 35 psychologists have resigned from GIDS, with some expressing concerns over current practices. One psychologist said they feared that young people are being over-diagnosed and then over-medicalized:

We are extremely concerned about the consequences for young people… For those of us who previously worked in the service, we fear that we have had front row seats to a medical scandal.”

The clinic generally treats individuals under the age of 18, at least half of whom undergo therapy that can have severe adverse effects. The puberty-halting hormone blockers they are prescribed to buy them time to consider can delay normal physical development, and the hormone therapy that follows leads to bodily changes that are irreversible and can eventually cause infertility.

The number of children going through GIDS has soared

According to Tavistock’s figures, the number of children going through GIDS over the last ten years has risen by 30 times, from 77 patients per year in 2008 to 3,000 per year in 2018.

However, psychologists previously employed by the clinic warn that the clinic may be trying too hard to force a certain agenda and that patients may have other underlying problems that need dealing with instead. One previous employee said that currently, there is only one pathway through the service and that it is “a medical pathway, not a psychological one.”

Fears of being called transphobic

Medical specialists who have left the clinic have also said that the psychologists working there were constantly under pressure due to fears of being labeled transphobic.

One said he did not feel able to voice concerns and that he was often shut down by other clinicians if he did: “Looking back there are young people who I now wouldn’t necessarily put on medication.”

Tavistock’s response

The GIDS, which is controlled by the Tavistock and Portman NHS Foundation Trust, responded to the concerns expressed by former employees saying that it supports every young person on an individual basis and allows its specialists “to engage openly and supportively with patients and parents.”

The issue may be the same elsewhere in the country

The issue may not be limited to this one clinic in the UK; in late December it was reported that the number of children referred to such clinics in Glasgow had also soared, with referrals for 4 to 10 year olds increasing by 80% in just over one year.

Co-founder of local NGO, Trina Budge, expressed concern that children in Scotland may not be receiving the support they need before being offered the surgical option.

“Very vulnerable children who may be confused about their sexuality, be autistic, suffered trauma or have other co-morbid mental health conditions are at risk of being sent down an irreversible and experimental medical pathway, when psychological support and talking therapy may be more appropriate,” she concludes.

Sally Robertson

Written by

Sally Robertson

Sally first developed an interest in medical communications when she took on the role of Journal Development Editor for BioMed Central (BMC), after having graduated with a degree in biomedical science from Greenwich University.


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