On 28 July 2022, NHS England announced that the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust will close following recommendations from the Cass review’s interim report.
The Gender Identity Development Service (GIDS)
GIDS is a specialised service set up by NHS England to support children and young people with gender dysphoria. Once a diagnosis is made by the GIDS clinic in London, they are referred to satellite clinics in Bristol and Leeds for hormone treatment, including puberty blockers and feminising or masculinising hormones.
Following concerns raised by young people, parents, and professionals working at GIDS about the services provided, NHS England commissioned an independent review to assess how children and young people with gender dysphoria are being supported by the service.
The Cass Review
Dr Hilary Cass, a former President of the Royal College of Pediatrics and Child Health and former Chair of the British Academy of Childhood Disability, was appointed to head the Review.
In February of this year, Dr Cass and her team published their interim findings. They found that the “single specialist provider model is not a safe or viable long-term option in view of concerns about lack of peer review and the ability to respond to the increasing demand” and “the clinical approach and overall service design has not been subject to some of the normal quality controls that are typically applied when new or innovative treatments are introduced.”
Staff at GIDS reported they felt a “pressure to adopt an unquestioning affirmative approach”, which was “at odds with the standard process of clinical assessment and diagnosis that they have been trained to undertake in all other clinical encounters”.
This was mirrored as the Cass Review found that “from the point of entry to GIDS there appears to be predominantly an affirmative, non-exploratory approach, often driven by child and parent expectations.”
The Cass Review found that there was no apparent “standardised approach to assessment or progression through the process”. The Review also identified an issue of diagnostic overshadowing. Once adolescents were “identified as having gender-related distress, other important healthcare issues that would normally be managed by local services could sometimes be overlooked”.
Life-changing consequences for young people
As recommended by the review, NHS England have advised that the GIDS service at the Tavistock Centre will be replaced by regional centres working in collaboration with existing children’s hospitals to offer support to children and adolescents requiring specialist care.
The Cass Review team concluded that they were presently unable to comment on the hormone treatments prescribed at GIDS due to gaps in evidence. They intend to provide further recommendations once their research programme progresses.
Since the interim review was published, a number of service attendees have spoken publicly about their concerns that they were misdiagnosed. Those that had taken masculinising or feminising hormones are now left to live with the irreversible and life-changing consequences.
Do you have concerns?
For children taking puberty blockers, the long-term effects are unknown, but there are concerns regarding the psychological impact this has had.
If you or someone you know has concerns about the treatment they received at GIDS and would like more information, please speak with Pogust Goodhead’s lawyers by using our confidential freephone number 0800 098 8556 or via our online contact form.
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