|In July, NHS England made the announcement that it would replace the Tavistock Center's gender identity program with regional hubs. Picture: Guy Smallman via Getty Images
Senior gender identity experts in the UK have accused their professional organization of "contributing to an atmosphere of anxiety" surrounding young people seeking gender-related medical care.
In opposition to the Association of Clinical Psychologists UK's most recent position statement on the provision of services for children and young people who are gender-questioning, more than 40 clinical psychologists have signed an open letter to the organization. They assert that they think the proper consultation of subject matter experts or service users was not done, leading to a "misleading" statement that "perpetuates detrimental discourses about the work and gender-variant identities more broadly."
The Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS foundation trust in London, which served as the only NHS gender identity service for children in England and Wales, has about half of those signatories who currently hold or previously held senior positions, including the current director.
After receiving a warning from the interim report of the Cass Review into gender services for young people that having just one provider was "not a safe or feasible long-term alternative," NHS England stated in July that it will be closing the GIDS and replacing it with regional centers.
Dr. Laura Charlton, who worked at GIDS from 2014 to 2020 and is now the clinical lead at the Leeds Gender Identity Service, and Dr. Aidan Kelly, who worked at the service from 2016 to 2021 and is now the principal clinical psychologist at the Nottingham Centre for Transgender Health, who organized the letter, said that the letter was especially significant because it was the first time that these practitioners, who have a combined experience of many decades, had come together.
"We acknowledge that there were some legitimate worries about the GIDS program, not the least of which were the long wait periods, but we object to the way it is currently being presented. This is the first time that so many gender services specialists from the UK have banded together to speak out against how they are frequently portrayed by non-specialists.
"We know that colleagues are especially anxious to highlight that, if they departed GIDS, it was frequently due to the toxic media and political environment around the service rather than because they disagreed with the way things were done there," Charlton and Kelly continued.
Other practitioners have expressed serious concerns about the GIDS in recent years. Whistleblowers have criticized what they have called an "affirmative-only" approach and claimed that young individuals were put down a transitional medical track too soon.
Inspectors gave the service an overall "inadequate" rating in 2021 and cited heavy caseloads, poor record-keeping, and ineffective leadership, implying that thousands of vulnerable young people were at risk of self-harm while they waited years for their first appointment.
The ACP-UK stated that "the new, regional services will have to offer a radical alternative [following the closing of GIDS] to fulfill the needs of all young people with gender dysphoria" in a position statement that was published last month.
"GIDS employed a strategy that was largely affirmative, rather than exploratory," the statement infers. The letter writers counter that "being affirmative" actually means that no specific path or identity is prioritized above any other, as opposed to what is sometimes misunderstood to suggest that a trans identity is supported or considered as a desired conclusion.
The Cass study found instances of "diagnostic overshadowing," which is a phrase used to describe circumstances in which a person's various challenges are not given equal weight because they are viewed through a single lens. The ACP-UK also makes reference to these results.
"An alternate view," the letter advises, "is that assistance for gender identity-related distress can be provided where mental health needs and neurodiversity are also present, and stay cognizant of all issues within the formulation-based practice."
ACP-chair, UK's Mike Wang, reacted, saying, "When developing our answer, ACP-UK consulted with experts in children and young people, gender, and service users. With the exception of the signatories of the open letter, the response and feedback to our statement have been largely positive.