NHS review of adult 'gender' services

So children will be put on a "pathway" to these utterly inadequate adult clinics

Those things really do force material reality to the fore.

Because data and science obstruct fairytales.

And again no data

98. The review heard that, following assessment and treatment, some patients express regret or dissatisfaction; a smaller number choose to discontinue or reverse their gender transition. Some later decide to retransition.

99. The number of patients who express some form of regret, dissatisfaction or choose to detransition is unknown due to the absence of GDC outcomes data.

So they could release it on a wet afternoon in December less than a week before Christmas so no one would notice?? Perish the thought that that would be in any way deliberate

These points jumped out at me

13. The adult GDCs report that there have been significant changes in the population being referred to them. The population has shifted from an older cohort to a predominantly younger age group. The majority (57%) of referrals are now 18 to 25 years old.

17. The GDCs have informed the review that the new, younger cohort of patients has a higher proportion of additional neurodevelopmental conditions, such as autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD), and a broader range of biopsychosocial issues, such as mental health conditions, trauma or abuse during childhood, compared to patients referred in the past.

18. This reported shift has not been systematically evidenced due to a lack of data stratifying the presenting population by additional needs and conditions; however, some GDC clinicians report that 30 to 50% of their patients may present with additional conditions

My understanding is that they have been sitting on this report for a while. I'm not sure why.

Yes, the lack of outcome data is pretty appalling.

Everything I have seen from TRAs and the trans lobby in relation to this review is concern that it will put up barriers to accessing hormones and medical procedures. But don't they want to know that there is good evidence for medical interventions? If I was going to have major surgery, I'd want to know what the likely outcomes are.

They don't even record the sex of the patients consistently.

16. The GDCs have reported that the referred population has shifted from predominantly birth-registered males to a more even ratio of birth-registered females and birth-registered males. The review has not been able to obtain exact numbers, as not all GDCs report sex assigned at birth, but instead may report patient-reported gender (female, male, non-binary, other) and “not known”.

sadly I suspect there will be next to no coverage of this in the media and NHS England and the dept of health and social care will completely ignore it

WTAF

No follow up and no data.

This is not unexpected considering the lack of tracking from the Tavistock, but this is actually pretty horrendous.

I'm absolutely horrified (though sadly not surprised given what we already knew) at the lack of well everything - no data, no follow up, no patient safety considerations, no evidence - I mean there's fuck all!

no patient should be treated like this, I mean my god I'd seen the WPATH "we were winging it" stuff but fucking hell

did everyone involved forget every bit of medical training they'd had????

aside from waiting times data “there’s virtually no other data” available from the adult clinics, including to show patient outcomes and “minimal clinical audit”.

No interest in patient outcome; minimal auditing. An open invite to dodgy docs and zealous activists. Is there any other branch of medicine this unprofessional?

No patient outcome data.

None. NONE.

How long has this racket been going on for?

Levy Review now published:

https://www.england.nhs.uk/publication/operational-and-delivery-review-of-nhs-adult-gender-dysphoria-clinics-in-england/

Reported on in the Independent:

https://www.independent.co.uk/news/uk/home-news/nhs-england-wes-streeting-gps-press-association-b2887089.html

Agree Spinach.

I think it was a concerning move to move the Sydney clinic from Westmead Children Hospital team. The team there seemed to be much more inclined to keep questioning everything, and writing papers on their findings. Which is what outraged some who were horrified that their children were not just automatically affirmed.

It’s about time some sense and science is brought to government and the medical profession in Australia. So many lives have been impacted, bodies experimented on, and children (and adults) failed by zealots of GI.

Bring it on - I hope the true horrors of Australia’s ideological capture and the unconscionable actions of those who push GI and affirmation and surgical/hormonal/medical intervention for dysphoric children are laid bare and those responsible held to account for what they have perpetrated.

I hope Dr Levy has been well briefed in what to expect.

I admire any clinician who has the personal integrity and courage to take on the responsibility of leading such reviews knowing how much interest and possibly opprobrium they generate.

The BMA has called for a pause in the government’s ban on the prescribing of puberty blockers to children and young people aged under 18 with gender dysphoria, which was upheld in the High Court on 29 July.12
…
At the heart of the dispute is a series of systematic reviews that rigorously examined the robustness of practice and guidelines underpinning the care of young people with gender dysphoria, in particular influential guidelines by the World Professional Association of Transgender Health (WPATH).3
A total of seven papers by the York University systematic review group were published in the Archives of Disease in Childhood in April.4 The papers found that the evidence on the use of puberty blockers and hormones in young people with gender related distress was “wholly inadequate, making it impossible to gauge their effectiveness or their effects on mental and physical health.”5 Nick Brown, editor of the Archives of Diseases in Childhood, told The BMJ, “A common thread in the review findings was the breathtaking dearth of quality evidence to guide care in this vulnerable group of young people.”
Brown is adamant that the York research is robust. “All of the systematic reviews underwent expert, independent peer review, and each was revised accordingly. We were, and remain, entirely confident as to their veracity. Counter to claims to the contrary, rigorous methods were adhered to at every step,” Brown told The BMJ.
Brown continued, “Criticisms of the methodology hold no water. The single search strategy used by the York group is far more yielding than the scattergun approach advocated by those still struggling to come to terms with the findings.”
The Cass review warned that the use of puberty blockers and hormones for patients under the age of 18 relied on “shaky foundations” and associated guidelines were not supported by science.
An NHS spokesperson said, “Dr Cass spent four years gathering evidence for the most comprehensive report of its kind, and her expertise and advice has been invaluable in supporting the NHS to create a fundamentally better and safer service for children and young people.” Its findings have been backed by several academic bodies, including the Royal College of GPs and the Royal College of Psychiatrists.
The BMA’s chair of council, Philip Banfield, said that the ban on puberty blockers was “unsubstantiated” and “discriminatory” and blocked access to healthcare of a “group of important, valued, and unfortunately often victimised people.” Promising that the BMA’s own review would be produced in time to report to the BMA council in January 2025, Banfield said it was “vitally important we take time and care to get this work right.”
He said, “This is a highly specialised area of healthcare for children and young adults with complex needs, and as doctors we want to be sure they get the most appropriate care and support they need.”
An NHS spokesperson said, “We will shortly be publishing our plan to implement the report’s recommendations and findings, which includes setting out scope for further research, so children and young people can receive the best possible care.”

Thank heavens for this review. Agree and I hope they look at record keeping and stop funding clinics and practitioners who don't do this well or who refuse to share data.

Sinead Watson has publicly said that she still has high testosterone levels despite her last testosterone treatment being four years ago.

That should be very concerning for medical staff and for those on the treatment.

Agree. Taking hormones is exceptionally bad for both short and long term health.
I have a relative who had to take a hormone blocker for 3.5 years for a life threatening condition and it's ruined their health and made my life very miserable too. Also 9+ months later the effects still haven't worn off and it could take years to get back to normal.

This is the difficulty with assessing outcomes. Where the baseline (albeit falsely) is suicidal anything can be sold as an improvement.