Interesting new article by two GIDS clinicians: The Value of Extended Clinical Assessment for Adolescents Presenting with Gender Identity Difficulties

[GrinitchSpinach]

Abstract
As the number of young people referred to specialist gender identity clinics in the western world increases, there is a need to examine ways of making sense of the range and diversity of their developmental pathways and outcomes. This article presents a joint case review of the authors caseloads over an 18-month period, to identify and describe those young people who presented to the Gender Identity Development Service (GIDS) with gender dysphoria (GD) emerging in adolescence, and who, during the course of assessment, ceased wishing to pursue medical (hormonal) interventions and/or who arrived at a different understanding of their embodied distress. From the 12 cases identified, 2 case vignettes are presented. Implications for the development of clinical practice, service delivery and research are considered.

www.docdroid.net/57t8V1q/clarke-2019-extened-clinical-assessment.pdf

Thanks for sharing. I haven't read it all but this bit jumped out at me.

^In conclusion, the adolescents included in this review met criteria for GD and initially requested medical interventions to resolve their difficulties. Over the course of the psychosocial assessment,
they came to understand their distress and its alleviation (at that particular point in time) differently and eventually chose not take a medical (hormonal) pathway and/or identified their gender identity
as broadly aligned with their biological sex^

Ad hominem TA attacks on Clarke and Spiliadis in 3... 2... 1...

Placemarking for when I've had time to read properly.

those young people who presented to the Gender Identity Development Service (GIDS) with gender dysphoria (GD) emerging in adolescence

That'll be the Rapid Onset Gender Dysphoria that according to TRA's doesn't exist...

Good to see serious clinical study of this cohort of young people. Thanks for posting OP

Yes, it is interesting. Thanks for linking it, Grinitch.

Because we are told that it never happens.

A trans child will be a trans adult, they never desist. No debate.

The report refers to "adolescent onset gender dysphoria".

The case studies are really interesting.

Only read Alfie's story so far (the case studies are anonymous of course). Seems like he had a lot to contend with, he was 14, bullying at his single-sex school, being called gay by classmates, divorced parents, fractious relationship with father, close relationship with mother, thinking he might be gay, Asperger's Syndrome diagnosis (which may not be true), self-harm and suicide ideation.

Although Alfie had not socially transitioned, Alfie was convinced at the start of the assessment process that he wanted medication and surgery in order to become female.

Afie had 7 sessions and cancelled the 8th as Alfie didn't identify as female any more. A review session 10 months later and Alfie said although he did still suffer from low mood, he considered himself male.

I will read the whole thing when I get a chance.

Haven't finished reading yet, but

" A significant proportion of young people in GIDS are also neurodiverse and may present with traits of ASC and/or a diagnosis. Between April 2011 and August 2018, 48% of children and young people who were seen in GIDS and whose parents com-pleted the social responsiveness scale (SRS), a quantitative measure of autistic behaviours in chil-dren and young people, scored in the mild to severe range"

I read it.

Really interesting to see it all laid out there.

"A significant proportion of young people in GIDS are also neurodiverse and may present with traits of Autism Spectrum Condition and/or a diagnosis. Between April 2011 and August 2018, 48% of children and young people who were seen in GIDS and whose parents completed the social responsiveness scale (SRS), a quantitative measure of autistic behaviours in children and young people, scored in the mild to severe range (n = 2073). Ten per cent of female-bodied young people scored in the severe range, as did 7% of male-bodied young people".

48%. My goodness.

This would be good reading for the urgent government enquiry into the large rise in teenagers wanting to transition...

I don't think any of us who have ASC kids will be surprised at these findings but it's great that these balanced articles are getting out.

In the UK there is very little support for ASC at puberty. My teen DS, who doesn't have gender issues but plenty of others, is about to be signed off from CAMHS even though things are tough at the minute because he is no longer on a medical pathway (medication) and they don't deal with ASC and only ADHD when medicated.

I'm really not surprised that gender clinics is where some of these kids are ending up because adolescence is particularly difficult for those on the spectrum and as a parent you're like Sandra Bullock in BirdBox - just blindly rowing hoping you get safely to the other side!

Thank you for signposting this GrinitchSpinach

Sorry, just cross-posted with Facts above regarding the 48% figure.

I found Louise's story absolutely heartbreaking. Bullied at school, admitted to hospital because of a restrictive eating disorder and self-harm. Diagnosed with ASC. Seemed to have a sensory issue with the "messiness" of periods due to her ASC. GIDS suggested contraceptive pill to help with that.

She seems to be doing much better now thankfully and identifies as female and no longer in need of GIDS's services.

Louise said ‘I felt that I had always wanted to put that poor girl in a box and put the lid on top’.

Could be Alfie saw that as a way out of being bullied at his single--sex school?

Does this mean there is an acknowledgement that ROGD exists, as long as we call it Adolescence Onset Gender Dysphoria?

Does the National Autistic Society still have a link to Mermaids on their website. If so, this should be forwarded to their chief medical/clinical person.

Mermaids still there on NAS website. They also linked to a training event on autism and GD held last week - it would be good to hear what their latest advice is - for parents and professionals.

Thanks for posting this. This is so similar to most of the parents stories I have read. I have read hundreds just for clarification. So many with autism, adhd, bullied and feel they just don’t fit in with their peers so they find a new identity that embraces them or more aptly grooms them.

Really shows the importance of talk therapy especially for teens experiencing gender dysphoria. Makes a mockery of people like Webberley pushing for an informed consent model for blockers/hormones.

The awful thing is that an adequate amount of resources are never in place for talk therapy especially such specialised talk therapy with the explosion of referrals they're getting.

Interesting that 20 female bodied were "intending to pursue medical interventions in adult services" but no male bodied people which even though there were twice the amount of female bodied to male the authors don't identify any male bodied that intend to continue.

Yet surely good talk therapy is more cost effective than surgery and a lifetime of hormones, or the serious therapy and intervention needed if transition turns out to be the wrong path?
What about young people - with the same comorbid difficulties, autism etc - who are adults but not mature? Don't they deserve the same level of care rather than 'informed consent'?
I wonder if WPATH will take this sort of study into account or continue insisting that regret and detransition are too rare to warrant consideration.

Really interesting study thanks for sharing. The final summing up has a really good phrase - ‘the inbetween-ness of adolescence’. That phrase really struck a chord with me.

Would be so great if Stonewall and Mermaids etc could put their energy behind campaigning for appropriate non-politicised professional emotional support for kids and young people, based on the available evidence and their best interests.

It really does put into sharp contrast the likes of Helen Webberley who will issue medication based on a Skype session.

And of course prescribe cross-sex hormones to a 12 year old.

Webberley retweeted this, where GIRES states that the detransition rate is 0.333%, and that one person later transitioned again. Their method (which only looks at current patients at one clinic and not any former ones who would be the ones most likely to detransition) looks distinctly dodgy. And of course they don't specify what transition actually is, therefore they would be hard pushed to identify what detransition actually is.

twitter.com/GIRESUK/status/1094288659241668609