Tavistock puberty blocker study published

Yes, that's what I was thinking, about the "irreversible effects" being about testosterone - it's another one of those "male as default" things isn't it, and one with such immediate and severe consequences for girls.

camhs.elft.nhs.uk/Conditions/Gender-Identity
Jay's story here is just heartbreaking, isn't it. That at that awful time that many (probably most) go through, of seeing childhood coming to an end, puberty starting, changes in relationships with boys and girls - instead of responsible adults validating that yes it is awful, we felt that too, things will get better - they're told the best thing to do is start medication, and that if they don't things will get even worse.

This does seem to be what's happened. When they talk about the 'irreversible effects' of puberty, they're actually talking about the irreversible effects of testosterone - such as the deepening of the voice and the growth of facial hair. There are no comparable 'irreversible effects' for girls.

@LangClegsInSpace

Total mystery why GIDS chose not to present this quality data to the court

There needs to be a criminal investigation.

It's like they just took a protocol they were using for boys, and continued it for the vastly increased numbers of girls, without really thinking it through. And it's tragic.

Why were puberty blockers ever thought to be a good idea for girls? Within their own logic, it's kind of understandable for boys who want to become trans women, stopping testosterone changes, but for girls?

Surely it would need to be something super-advantageous to make up for all the downsides? I just don't see it. And since girls would want as much height as possible if they want to be transmen, and since puberty blockers reduce this, surely they should be advised against blockers for this reason?

There are a million and one things to criticise GIDS for, but I really don't think this is one of them, or that it reveals anything negative about their management's perception of their service.

If you are on Twitter, these notes about a 2018 talk by Gary Butler are worth a read:

twitter.com/mum3sun/status/1337780068257558532?s=21

www.semanticscholar.org/paper/Puberty-suppression-in-adolescents-with-gender-a-Vries-Steensma/96113a2ebd53008744bb3ed275e0738c5c90c1c1

The last item in Table 1 of this paper records the sexual orientation of the participants. Nearly 90% are attracted to 'own natal sex'. Of the remainder, nearly all are bisexual.

I'm sure some of them do have L3 though. And it's profession-dependent: doctors are usually required to do L3 so, if the service is mainly delivered by doctors, L3 will be a given, whereas a nurse-delivered service may have a mixture of L2 and L3, depending on the nature of the service and their roles.

And the board said all GIDS staff members must do level 3, it wasn’t role dependent.

T&P is mental health trust, so all services are delivered by the same types of staff, all teams are multidisciplinary.

Marcus Evans, recent interview by Erin Brewer (I highly recommend Erin's YouTube Channel - she has a steady stream of interviews with clinicians, parents, detransitioners, Gender Critical trans adults, etc.)

"The Keira Bell Case and A New Therapeutic Model"

Video Description

Marcus Evans discusses his concerns about the "affirmation" model and the medical treatment path advocated by Tavistock's Gender Identity Development Service.

He offers important insights into how experimental and harmful treatments became the accepted norm for vulnerable children suffering with identity issues. He also discusses his wife, Sue Evans, Mother A, and Keira Bell's case in which the High Court ruled that puberty blockers are experimental and should not generally be used for children under the age of 16.

"The Evans' book Gender Dysphoria: A Therapeutic Model for Working with Children, Adolescents and Young Adults" Paperback is available for pre-order at: www.amazon.com/Gender-Dysphoria-Therapeutic-Children-Adolescents/dp/1912691787?tag=mumsnetforu03-21

Good article in the Economist (behind a paywall but you can read it if you sign up with an email address).

Extract below:

"Some children who feel they are in the wrong body will always feel that way and might benefit from altering their bodies. Others will change their minds—many of these will simply turn out to be gay. No medical test can tell these two groups apart. Children with mental-health problems or conditions such as autism are more likely to experience gender dysphoria. Untangling all this is extremely hard.
However, there are worries that rich countries have the balance wrong. One of the Dutch scholars on whose work the prescribing of hormones and surgery is based has said that her research is being applied to young people for whom it was not designed. And a growing number of people are dissenting. The Economist spoke to more than four dozen people in rich English-speaking countries, including trans people, parents, doctors, social workers, teachers and people who had identified as trans when they were children. Most of those who were critical wanted to be anonymous for fear of losing their jobs or being branded bigots on Twitter."

www.economist.com/international/2020/12/12/an-english-ruling-on-transgender-teens-could-have-global-repercussions

I'm not arguing for a moment that GIDS aren't as dodgy AF. I'm just not sure that the safeguarding training levels tell us much.

The issue of GIDS preventing staff from reporting concerns to the Trust Safeguarding Lead, Sonia Appleby, is covered in this BBC programme, June 2020:

"NHS child gender clinic: Staff welfare concerns ‘shut down"

It focuses on a leaked report of an internal Trust Review of GIDS plus interviews with several whistleblowers.

Some highlights:

• Every clinician interviewed as part of the 2019 Trust Review raised concerns about cases where children were prescribed PB and put on the “trans pathway” to life-long medicalisation and sterilisation when the primary issue seemed to be homophobic parents seeking “Conversion Therapy” to “trans the kid straight” (my paraphrase of the situation);

• Child prescribed PB just one hour into first assessment session with “executive clinician”. Junior staff present raised concerns with Polly Carmichael, who fobbed them off.

• Trust instituted “in house” safeguarding system for GIDS (cutting staff off from access to Trust Safeguarding Lead?)

• Staff were discouraged from reporting safeguarding concerns to Social Services

The CQC was meant to be inspecting GIDS again this Autumn. I wonder if that has happened yet? (It will be in those Board Minutes if it has.)

Thank you to those who are "unpacking" this as a lot of it is hard to grasp (I think, for me, partly down to sheer disbelief in a "they surely can't be saying xxx?" way).

It genuinely is horrifying. Those children.
I'm sorry I can't find the actual post back in the thread but the "sterilising children because they don't conform to stereotypes" is absolutely it.

I genuinely cannot see how the people involved in this scandal will ever be able to justify themselves.

It is a relief that this is finally unravelling and being properly exposed at last but it's terrible that so many children have been damaged so badly. To me it feels as they are the "behind the scenes" children being harmed whilst people (adults!) in front of them use these children. These adults used and exploited these children whilst cloaking their behaviour with meaningless sound bites, emotional blackmail, creating a culture where they couldn't be questioned.

Well we know exactly why they wanted blind acceptance and no questioning now the curtain is raised.

Have you looked at the other services tho? It ain’t asthma!

[quote PlantMam]The board are clearly aware of this because GIDs staff were expected to do the level three safeguarding course where staff in other departments only had to do level 2.

(Got that from the minutes too).

Here is the current list of services, so GIDs needing more safeguarding training than others is very, well
tavistockandportman.nhs.uk/care-and-treatment/our-clinical-services/[/quote]
I'm not sure that follows, tbh. I'd expect any service that includes discussion of topics around sexual function/sexuality to require Level 3 training. In our organisation, for example, nurses who do family planning/sexual health work with teens do level 3, whereas those who do - say - asthma management do level 2.

So I wouldn't read GIDS requirement for L3 training as an admission of concern, so much as appropriate (for once!) clinical governance.

[quote NeurotrashWarrior]This CAMHS refers to childline.

camhs.elft.nhs.uk/Conditions/Gender-Identity[/quote]
I hadn't seen the video of Jay before that is embedded in that link and it makes me so sad for such a sweet, naive child.

My 'journey' to becoming nobody of note (boring, mother, grandmother, worker) was identical to Jays including the cars, fantasy roles and disgust at being made to be a bridesmaid. Luckily I had no internet or YouTube videos to watch 50 years ago.

Whenever I do what Mermaids suggest i.e. listen to the children, I become even more convinced that its all a load of bollocks.

Here's what the CQC had to say about the Tavi in Nov 2018

^The monitoring of the quality and performance of the service lines was not sufficiently robust. At the time of the
inspection, this took place through line management and an annual service line presentation to the board. Other
governance systems looked across the service lines which could potentially lead to issues being missed or not given
the focused attention they required^

I would be very interested in seeing what the orders ,if any,for disclosure of evidence was in Bell snd in particular the extent to which this report or the material referred to in it could or would have been included in it

Judicial Review is special in that it just has a "duty of candour" which essentially means that the parties are required to put all relevant information and facts before the court. The parties are expected to honour this rather than there being any specific order for disclosure.

As mentioned above, it looks like some kind of summary of the evidence was put before the court (see paras 25 and 73), but I am surprised that GIDS didn't just give the court the draft report, even if it was still going through peer review. And you all know what it means when lawyers and judges say we find something "surprising".

No wonder they did not want to poduce this as evidence. So they knew this, and still tried to argue that it didn't happen?! Ghouls.

The board are clearly aware of this because GIDs staff were expected to do the level three safeguarding course where staff in other departments only had to do level 2.

(Got that from the minutes too).

Here is the current list of services, so GIDs needing more safeguarding training than others is very, well
tavistockandportman.nhs.uk/care-and-treatment/our-clinical-services/

This highlights the importance of involving the judiciary ie the court of protection in cases involving treatments on children . Bell shows at least judges can forensically examine the evidence and pro and cons of treatment in a dispassioned and logical way. I would be very interested in seeing what the orders ,if any,for disclosure of evidence was in Bell snd in particular the extent to which this report or the material referred to in it could or would have been included in it

From a risk point of view I would be interested in understanding what support clinicians can receive from within their team should they experience pressure from parents or outside groups which could impact on their professional duties or cause them stress. Outside of medical issues there have been numerous instances of accidents and other harms caused by pressurising people which is why proper risk management needs separate independent quality assurance functions who are not open to outside pressure and for appropriate independent internal controls who staff can discuss risk concerns with without fear of affecting their work position.

Also why was autism not properly explored before treatment given? It’s not as if a doctor is being faced with a choice of two harmless treatments for a common disease ( eg a skin infection where the only consequences of getting it wrong would be the rash doesn’t clear up and you switch treatment accordingly. How can a decision be made to give life changing potentially irreversible drugs without exhausting other avenues for diagnosis such as proper autism assessment first ? The risks snd stakes are so high surely it should have been throughly investigated? Did the children undergo any other tests to see if there were reasons for their distress ?

I saw in the minutes that the videos/radio programmes etc were discussed under "Marketing"

The 'Kids on the Edge' documentary series filmed at the Tavistock and Portman is still available on the channel 4 website, for those who are interested in watching. One of the episodes focuses on GIDS. www.channel4.com/programmes/kids-on-the-edge

Yes I found that. That counsellor is a member of WPATH