Medical staff at the NHS’s only specialist gender clinic for children are rushing to affirm patients’ gender confusion without proper investigation for fear of being labelled transphobic, one of its former employees has said.
Dr Kirsty Entwistle, previously a psychologist at the clinic’s Leeds site, said many children had “traumatic early experiences” which might help explain their desire to change sex, but these are not being explored by fearful medical staff.
She set out her concerns in an open letter to Dr Polly Carmichael, the Director of the Gender Identity Development Service (GIDS).
In her letter, Dr Entwistle said: “I think it is a problem that GIDS clinicians are making decisions that will have a major impact on children and young people’s bodies and on their lives, potentially the rest of their lives, without a robust evidence base.
“GIDS clinicians tell children and families that puberty blockers/hormone blocks are ‘fully reversible’ but the reality is no one knows what the impacts are on children’s brains so how is it possible to make this claim?
“It is also a problem that GIDS clinicians are afraid of raising their concerns for fear of being labelled transphobic by colleagues.”
Dr Entwistle was also alarmed that the many public concerns raised by GIDS workers about the clinic’s practices “do not appear to have sunk in”.
“GIDS clinicians are afraid of raising their concerns for fear of being labelled transphobic by colleagues.”
She continued: “I think there are others, like me, who went to work at GIDS expecting to do complex assessments and differential diagnosis but the reality is that you run the risk of being called transphobic if you propose that, say, a child might have Body Dysmorphia rather than Gender Dysphoria.”
The clinical psychologist also hit out at GIDS’s propensity to affirm a child’s gender confusion.
“One of my biggest ethical dilemmas whilst working at GIDS was that there were parents who brought their child to GIDS anticipating that we would confirm that the child was not transgender”, she said.
“But we are not able to tell parents that actually there is some unspoken rule that means GIDS clinicians do not tell families, ‘your child is not transgender’.”
She highlighted cases in the North America of young people expressing regret at having transitioned after it was presented as the only option, and says she expects to see more cases emerging in the UK soon.
‘Serious ethical concerns’
GIDS is part of the Tavistock and Portman NHS Foundation Trust.
In February, Marcus Evans, a governor at the Trust, quit his position after GIDS dismissed a report which outlined “serious ethical concerns” at how the clinic was rushing children into life-changing treatment.
Evans and Entwistle’s concerns about rushing children into transitioning come as mayors of some English cities have urged the Government to speed up changes to the Gender Recognition Act to make changing legal sex much easier.
Sadiq Khan and three other Labour mayors wrote to Equalities Minister Penny Mordaunt to argue that the changes are “desperately needed”, and needed to be implemented more quickly.