Four careful stages that lead to body’s final change

THE Gender Identity Development Service is seen as a world leading centre for treatment of dysphoria.

It adopts a “staged model of care” to guard against children taking steps to change their sex and then regretting it.

Kids as young as three are offered counselling along with their parents when they first present at the clinic.

This can last for years. Assessments are done around self-harm and suicide risk. Just before puberty the patient can be prescribed hormone blockers.

The full psychological effects of these drugs, or whether they alter the development of the brain, is unknown.

But they allow the youngster time to explore their developing gender identity with a team of specialists.

The third stage, from age 16, is to prescribe either oestrogen or testosterone after a minimum of 12 months on hormone blockers.

This can cause irreversible changes to the body such as growth of breast tissues. Doctors require the person to be in education or employment in their preferred gender role.

Stage four is surgery to change the sexual organs.