Are whistleblowers being silenced at the NHS gender clinic?

The Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust carries out some of the most complex and contentious clinical work in the NHS. It deals with children and young people who are experiencing discomfort over their gender identity, but is it raising patient safety concerns?

Some of the children it sees go on to change their legal gender. Some receive physical treatment in the form of puberty-blocking medications. Some go on to have further treatments including cross-sex hormones and surgery.

The service, which is heavily over-subscribed, is a divisive one. A number say it offers vital, even life-changing care to children in great distress and need, others are less positive. The list of concerns raised about the work and processes of GIDS is quite long, and a number come from staff whistleblowers.

Some of these concerns include:

• The unexplained rapid rise in GIDS caseload and the fact that this caseload skews towards girls. The Government has commissioned research asking why almost three-quarters of new referrals to GIDS are female.
• The unknown long-term effects of the drugs used. The NHS recently changed its main online guidance about puberty blockers, while the use of blockers and cross-sex hormones is under review by NHS England.  
• Staff and officials say the GIDS is doing things that are not always in the best interests of the children it treats.

That last point deserves expansion because there is a striking list of reports and incidents where people in and around the GIDS have raised worries about its work.

Examples:

• Last year, Marcus Evans, a psychoanalyst and one of the governors of the Tavistock and Portman NHS Foundation Trust that runs the GIDS resigned over the management of the service
• In 2019, the Times reported five former GIDS staff had quit over worries about standards of evidence and care.
• In July 2019, Dr Kirsty Entwistle, a former GIDS clinician, wrote an open