Final nail for clinic that was deaf to concerns
Tavistock gender identity facility accused of failing children after brushing aside warnings over safety
EIGHTEEN years ago, Susan Evans blew the whistle on the NHS’S only gender identity clinic for young people at the Tavistock and Portman NHS Trust.
Alarm bells had started ringing for the nurse when she realised colleagues had referred a distressed 16-year-old boy who thought of himself as female for hormone treatment after only four appointments.
She saw a service that was under “tremendous pressure” from trans campaign groups such as Mermaids and she was alienated by other staff members for questioning the medicalisation of young people.
Her complaints prompted an internal inquiry in 2004, but nothing changed, Ms Evans said, and she felt she had no option but to walk away for her own mental health .
In the 18 years since, with more than 20,000 children referred, numerous staff members, parents and patients have made serious allegations about the running and safety of the NHS’S only gender transition clinic for children.
Allegations include that children were rushed into medical treatment, that doctors were “converting” gay children into thinking that they were trans and medics were failing to consider other mental health issues that vulnerable young people were suffering.
Numerous safeguarding issues were flagged but report after report alleged concerns were covered up. The clinic has fought back against employment tribunals and even a High Court challenge over its treatment.
Critics of the Tavistock believe its refusal to change, its denials of a problem in the face of repeated and sustained criticism, led to yesterday’s announcement by the NHS that they were going to shut it down.
The final nail in the clinic’s coffin was a warning from Dr Hilary Cass (right), the former president of the Royal College of Paediatrics and Child Health, that it being the only provider of gender identity services for young people was “not a safe or viable long-term option”.
But the issues she identified, including pressure on doctors to take an “affirmative” approach against normal practice and that puberty blockers were being handed to children without evidence – were in no way new.
The speed with which young people were referred for puberty blockers was raised by Dr David Taylor, in a review of the service in 2005 and he raised concerns that there was a lack of robust evidence about their use.
At the same time lobby groups such as Mermaids and the Gender Identity Research and Education Society (GIRES) were said to be becoming increasingly influential.
The number of children who identified as transgender was rocketing and a satellite clinic opened in Leeds, with puberty blockers given to teenagers.
Dr Polly Carmichael, the service’s director, likened them to a pause button that, when stopped, would have no longterm impact on the body.
Her employees thought differently. Dr Kirsty Entwistle joined the Leeds clinic in 2017 but was labelled “transphobic” when she raised concerns that part of the evidence that a teenage girl needed puberty blockers was that she had enjoyed Thomas the Tank Engine when she was younger.
Dr Entwistle was among those who began to realise that many teenage girls who came through the clinic’s doors had indications of autism, but the Tavistock did not investigate this.
She quit in 2018, the same year that 10 Leeds clinicians – about 20 per cent of its clinical staff – approached governor Dr David Bell, a distinguished psychiatrist, to raise concerns. Attempts were made to silence his warnings that the clinic was “fast-tracking” young people into life-altering decisions without looking at their personal history and acting as a “gateway” to puberty blockers.
A 2020 Judicial Review of their service in the High Court, brought by former patients, ruled that children were unlikely to be able to give informed consent to the drugs, but the Tavistock took the case to the Court of Appeal, with judges ruling that under 18s should not have to seek court approval before starting treatment.
Whilst the court battles played out in public, parents were at “war” with the clinic behind closed doors.
One parent from Bayswater Support Group, comprising 400 parents concerned about treatment, told The Daily Telegraph that after they raised concerns they were labelled “transphobic” and clinicians refused to talk to them.
Stephanie Davies-arai, the founder of Transgender Trend, which campaigns for evidence-based healthcare, said: “At every stage the Tavistock … would not listen. I think it is because they embraced a faith, an ideology, and once you have a faith you don’t need evidence … The Tavistock got stuck in an echo chamber with trans lobby groups.”