More time spent evaluating facelifts than making life-changing decisions, reveals former Tavistock governor

Dr David Bell, former staff governor of the Tavistock and Portman NHS Trust, said staff came to him with ‘worrying’ concerns

Four years ago I wrote a report raising very serious concerns about the gender identity service known as GIDS at Tavistock.

About a third of his staff had come to me with disturbing allegations of harm to children.

These children were among the most difficult and complex cases they had seen in their long careers, they said.

Many of them were girls and all were in desperate condition, with a history of depression, autism, trauma, a family history of sexual abuse or internalized homophobia.

Many of them were actually lesbians or gays. And yet the very principles on which the Tavistock had been founded – engaging in complexity and gently exploring why someone might feel what they felt – had been abandoned when it came to treating these children.

Their chosen sex was affirmed, without a doubt. They were directed down a medical path to puberty blockers, cross-sex hormones and irreversible damage, despite the lack of evidence and sometimes after only a few appointments.

Few were able to weigh the pros and cons of this treatment, which includes infertility, sexual dysfunction, and possible neurological and psychological consequences.

Yet nothing was done after these concerns were raised. GIDS and Tavistock management dug in their heels, having been captured by a powerful ideological movement led by groups such as Stonewall and Mermaids.

Instead, I faced the consequences. I was threatened with disciplinary sanctions. Other staff felt intimidated for raising legitimate safeguarding concerns.

Now, with the Cass review, I and everyone else who has lifted their heads above the gender parapet, including many trans people themselves who disagree with this approach to children, have been vindicated. .

But it’s the children I feel desperately sorry for. Thousands of people will have passed through the doors of the GIDS by then.

Five thousand were referred in the last year alone, compared to just 138 in 2010. We know that 98% of children placed on puberty-blocking drugs continue to take cross-sex hormones such as estrogen and testosterone to start their so-called “transition”. ‘.

Dr Bell wonders how many of the children who have passed through the doors of GIDS at the Tavistock Center will go on to have 'regrets and serious psychological problems' as a result of their treatment

Dr Bell wonders how many of the children who have passed through the doors of GIDS at the Tavistock Center will go on to have ‘regrets and serious psychological problems’ as a result of their treatment

A proportion will undergo surgical castration, hysterectomies, breast removal and major genital surgery.

We do not know what happened to these children, how many have regrets, how many continue to have serious psychological problems.

We know there are a growing number of detransitioners – those who later recognized that it was the wrong treatment.

As a former patient told me: “I look in the mirror and I don’t see a man but a woman with a mutilated body. GIDS has twisted the affirmation model as giving children a voice.

But any sane person knows that listening to a child, taking him seriously, is not the same as agreeing with him.

Clinicians have a duty of neutrality. Simply affirming, without exploring the child’s story – which can take a considerable amount of time – is a total failure of this duty.

Consider an adult patient who was referred to me by a plastic surgeon. She visited the surgeon several times, convinced that there was something wrong with her face and wanted a facelift, but he sensed that something was wrong with her attitude.

After many sessions with her, it appeared that she had a long history of depression. Within a year of psychotherapy, she realized that her face resembled her father’s and, with help, was able to shake off her fear of identifying with him.

She also gave up on the idea of ​​plastic surgery. Yet, on the ground floor of GIDS, children were guided into much larger, life-changing alterations without any adequate exploration of the roots of their gender dysphoria.

Many GIDS therapists I spoke to said that when they mentioned the idea that there might be unconscious factors behind gender dysphoria, senior staff laughed.

“Don’t give us all this psychotherapy talk,” they were told. Given this history of abuse, it would be inappropriate for any of the GIDS staff to have anything to do with the new services announced by NHS England which will now be provided locally. Hospital management had many opportunities to intervene.

In 2006, the then medical director raised serious concerns. In 2015, a report by an outside consultant recommended capping referrals because the service was not coping.

These warnings were ignored. Trust chief executive Paul Jenkins has even tried to make GIDS’ closure a positive, writing in a letter to staff this week how “proud” he is of the service and the “hard work to care for patients”.

There is no humility, no acknowledgment of the damage done. This level of denial is very concerning.

Dr Bell argues that children with gender dysphoria have been put on waiting lists for a

Dr Bell argues children with gender dysphoria have been put on waiting lists for ‘poor treatment’

The trust’s senior staff saw GIDS as the crown jewel of the edgy and liberal Tavistock. They were so caught up in ideology that they couldn’t afford to have any doubts.

Elsewhere, Cass’s recommendations are even misrepresented when it comes to managing long waiting lists.

Let’s be clear – it was a waiting list for the bad treatment. The terrible sadness of this is that GIDS has tarnished the stellar reputation of Tavistock and caused untold damage.

What needs to happen now is a cultural overhaul, taking into account schools as well as gender clinics.

And now we really have to put the interests of children before those of ideologues.

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