England’s national health service will close a controversial gender identity clinic for children after a damning independent review and a slew of allegations made by former staff and patients.
The clinic at Tavistock & Portman NHS Foundation in London will be shut down by spring 2023 and replaced by a series 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 instead of 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 on transgender issues and young people on both sides of the Atlantic.
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The Gender Identity Development Service (GIDS) at Tavistock is currently the only gender identity clinic for children under 18 in the U.K. It’s been at the heart of a roiling debate in Britain about how to treat children diagnosed with gender dysphoria and has previously been accused by some doctors and patients of rushing young people onto certain treatments.
Dr. Hilary Cass, who is leading the independent review of the clinic, found that patients’ other mental health issues were “overshadowed” if they mentioned 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 manages the holistic needs of this population,” adding: “Staff should maintain a broad clinical perspective in order to embed the care of children and young people with gender uncertainty within a broader child and adolescent health context.”
NHS England, which commissioned Dr. Cass’ study in 2020, says it will fully implement her recommendations. The health organization says it will launch two new gender clinics for kids next spring, with one in London and another in the northwest. It’s thought seven or eight services could eventually be set up.
Dr. Cass also instructed the NHS to “enroll young people being considered for hormone treatment into 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 instances a lack of open discussion” about whether gender dysphoria tended to persist after adolescence.
The subject of detransitioning—where a trans person reidentifies 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 16 were unlikely to be in a position to give informed consent about receiving puberty blockers, only for the ruling to be overturned in 2021 by the Court of Appeal. The original case had been brought against the clinic by a Tavistock patient, Keira Bell, who was given the drugs when she was 16 and identifying as male, only to later detransition to female.
Stonewall U.K. and Mermaids, which supports trans and gender-diverse kids, cautiously welcomed the plan to shift to a more regional system with clinics around the nation rather than centralized in London.
“We welcome the news that NHS England plan to provide a more resilient and robust gender identity service in 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 exploded in recent years, especially for children on the autistic spectrum and young girls. While it had 138 referrals in 2010-11, that number jumped to 2,383 in 2020-21.
