Britain closes Tavistock, its only gender identity clinic for children, after furious debate

Britain closes Tavistock, its only gender identity clinic for children, after furious debate

England’s National Health Service is to close a controversial children’s gender identity clinic following a damning independent review and a series of allegations from former staff and patients.

The clinic at Tavistock & Portman NHS Foundation in London will close in spring 2023 and be replaced by a number of regional centers at specialist children’s hospitals around the country. The new approach is designed to “ensure the holistic needs” of young patients are met rather than running the service through a single provider, which was deemed to be “not a safe or viable long-term option.”

The clinic became a lightning rod for debates about trans people and young people on both sides of the Atlantic.

The Gender Identity Development Service (GIDS) in Tavistock is currently the only gender identity clinic for children under 18 in the UK. It has been at the heart of a fierce debate in the UK over how to treat children diagnosed with gender dysphoria and has previously been accused by some doctors and patients of rushing young people into certain treatments.

Dr Hilary Cass, who is leading the independent review of the clinic, found that patients’ other mental health problems were “overshadowed” if they mentioned their gender to clinicians at Tavistock. She therefore called for the center to be replaced with an “appropriate multi-professional workforce to enable them to provide an integrated model of care that addresses the holistic needs of this population,” adding: “Staff should maintain a broad clinical perspective to embed the care for children and young people with gender uncertainty in a wider health context for children and young people.”

NHS England, which commissioned Dr Cass’s study in 2020, says it will fully implement her recommendations. The health organization says it will launch two new gender clinics for children next spring, with one in London and one in the north-west. It is believed that seven or eight services may eventually be set up.

Dr Cass also instructed the NHS to “enroll young people being considered for hormone therapy in a formal research protocol with adequate follow-up into adulthood, with a more immediate focus on the questions regarding puberty blockers.” She also said there was “a lack of agreement, and in many cases a lack of open discussion” about whether gender dysphoria tended to persist beyond adolescence.

The topic of transition – where a transgender person re-identifies with the gender they were assigned at birth – was at the heart of a legal battle involving Tavistock. England’s High Court had ruled that children under the age of 16 were unlikely to be able to give informed consent to receiving puberty blockers, only for the ruling to be overturned in 2021 by the Court of Appeal. The original case was brought against the clinic by a Tavistock patient, Keira Bell, who was given the drugs when she was 16 and identified as male, only to later transition to female.

Stonewall UK and Mermaids, which supports trans and gender diverse children, cautiously welcomed the plan to shift to a more regional system of clinics around the country rather than centralized in London.

“We welcome the news that NHS England plans to provide a more robust and robust gender identity service by 2023 by expanding provision and improving the quality of care received by trans, non-binary and gender diverse young people,” Mermaids said on Twitter.

Referrals to the clinic have exploded in recent years, especially for children on the autistic spectrum and young girls. While it had 138 referrals in 2010-11, it jumped to 2,383 in 2020-21.

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