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Feminism: Sex and gender discussions

NHS independent review into children's gender ID services

75 replies

carefulvulvadriver · 22/09/2020 15:59

What do we know about Dr Hilary Cass? A cold hard look and analysis sounds a good thing, although I wouldnt have much faith in the CQC's inspection of the Tavistock

NHS Announces Independent Review Into Gender Identity Services For Children And Young People
22 September 2020
www.england.nhs.uk/2020/09/nhs-announces-independent-review-into-gender-identity-services-for-children-and-young-people/

The NHS has today announced that Dr Hilary Cass OBE, former President of the Royal College of Paediatrics and Child Health, will lead an independent review into gender identity services for children and young people.

The review will be wide-ranging in scope looking into several aspects of gender identity services, with a focus on how care can be improved for children and young people including key aspects of care such as how and when they are referred to specialist services, and clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.

It will also set out workforce recommendations for specialist healthcare professionals and examine the recent rise in the number of children seeking treatment.

Dr Cass will then make clear recommendations for children and young people’s gender identity services reporting back next year.

The Gender Identity Development Service for Children and Adolescents is managed by the Tavistock and Portman NHS Foundation Trust.

The Care Quality Commission (CQC) is due to carry out a focused inspection of The Tavistock and Portman NHS Foundation Trust, Gender Identity Services for children and young people, during the autumn. The inspection will cover parts of the safe, effective, caring, responsive and well-led key questions and will include feedback from people using the service, parents, relatives, carers, and staff. Separately, Dr Cass will also review the service’s clinical practice with the support of the Royal College of Paediatrics and Child Health and engagement of other professional bodies to provide multi-professional insight working closely with the CQC.

The review includes an examination of the issues surrounding children and young people who are prescribed puberty blocking and cross sex hormone drugs.

Dr Hilary Cass OBE, independent chair, said: “It is absolutely right that children and young people, who may be dealing with a complexity of issues around their gender identity, get the best possible support and expertise throughout their care.”

“This will be an inclusive process in which everyone will have the opportunity to make their views known. In particular I am looking forward to hearing from young people and their families to understand their experiences.

“This review provides an opportunity to explore the most appropriate treatment and services required.”

A transparent and inclusive process for stakeholder engagement and consultation will be established to ensure that everyone who wants to can make their views known.

Dr. Michael Brady, the National Adviser for LGBT Health said: “Every child matters and children and young people who are exploring their gender or experiencing gender dysphoria, including those who are trans or non-binary, deserve the very best from the NHS.

“This is why this review is so important so that all health professionals can deliver the very best healthcare in a compassionate and understanding way.

“Throughout this process it’s critical we hear from children and young people, those who have accessed these services, their families and expert clinicians so I am pleased that Dr. Cass has put this at the heart of her approach.”

Professor Helen Stokes-Lampard, Chair of the Academy of Medical Royal Colleges said: “This is a multi-professional issue and we are pleased that a formal review is taking place to provide a comprehensive, evidence-based view on this sensitive and complex subject.”

The terms of reference for the independent review have also been published.

The independent review will present recommendations to NHS England and Improvement’s Quality and Innovation Committee.

OP posts:
Clymene · 23/09/2020 06:12

Where is the misgendering? Confused

EdgeOfACoin · 23/09/2020 06:24

One post said 'he' instead of 'she'.

I saw the name Hilary and just assumed she was a woman.

NecessaryScene1 · 23/09/2020 06:25

Sounds to me like Cass's team and Bell's team need to talk to each other as soon as possible.

We have Cass saying: The review will not immediately consider issues around informed consent as these are the subject of an ongoing judicial review.

But Bell is saying she's withdrawing the case because of the independent review.

They need to agree who is going to actually look at this, otherwise neither might.

FannyCann · 23/09/2020 06:42

I notice Hilary Cass is now retired. I wonder if they have purposely chosen someone retired as someone who will have no fear of consequences for their career?

NHS independent review into children's gender ID services
moptophairshop · 23/09/2020 07:47

I have a family member who is retired from a senior position in the NHS. They now do occasional work for them in an independent capacity - I think it's a case of using their expertise and knowledge from an objective position now they are no longer tied to a specific area or job role. Perhaps this is a similar thing. I think Dr Cass sounds like a perfect choice to take the review on.

FannyCann · 23/09/2020 07:52

Of course she has extensive expertise and knowledge. I am not suggesting she is, in any way, a poor choice. However it does seem that having someone who will have no fear for their career may be helpful?

moptophairshop · 23/09/2020 08:33

I agree FannyCann and didn't take your comment to mean she might be a poor choice at all. I was just saying my take on it was that looking for someone who is already removed will potentially help from an independent point of view.

rogdmum · 23/09/2020 08:42

@NecessaryScene1

Sounds to me like Cass's team and Bell's team need to talk to each other as soon as possible.

We have Cass saying: The review will not immediately consider issues around informed consent as these are the subject of an ongoing judicial review.

But Bell is saying she's withdrawing the case because of the independent review.

They need to agree who is going to actually look at this, otherwise neither might.

Keira Bell’s case about informed consent is still going ahead. Keira has withdrawn her other case around the Memorandum of Understanding as the new Cass review will be covering this issue.
ahagwearsapointybonnet · 23/09/2020 09:30

Do you think people with relevant input (eg parents of trans-identified or desisted children on here) will be able to get in touch and give input into the review? Or only people contacted by the review team? It would be great if some of our posters with experience in this area could get involved - especially any who avoided or no longer have contact with GIDS etc, who might not be known about otherwise.

I'd suggest as Dr Cass is tweeting about this, that's also a good opportunity to comment on the review (not as in giving formal input of course, but with any questions/suggestions)?

NecessaryScene1 · 23/09/2020 10:19

Keira Bell’s case about informed consent is still going ahead. Keira has withdrawn her other case around the Memorandum of Understanding as the new Cass review will be covering this issue.

Thank you - I'm an idiot. So many crowdfunders...

FannyCann · 23/09/2020 10:59

I think we're saying the same thing moptophairshop LOL. Smile

moptophairshop · 23/09/2020 12:32

Grin I think we were FannyCann, just in a different way!

Thingybob · 01/10/2020 21:22

Dr Cass has posted the principles that will guide the review process.

twitter.com/Hilary_Cass/status/1311725988670255105

It all looks very fair. She is centring the welfare of the children, as she should, and wants to "hear as many voices as possible"

NHS independent review into children's gender ID services
iguanadonna · 01/10/2020 21:27

Does anyone have a link to the more limited review she was asked to oversee last year?

Thingybob · 01/10/2020 21:41

@iguanadonna

Does anyone have a link to the more limited review she was asked to oversee last year?
I think it was this year but her message does suggest that it has concluded so I was wondering the same. Maybe any findings will be released with this more in depth review?
iguanadonna · 01/10/2020 22:16

I wonder if the change in the description of puberty blockers was precipitated by her review. But not sure what exactly its remit was.

iguanadonna · 01/10/2020 22:18

Thingybob, I'll learn to do quotes, sorry, that was meant as a reply to you! Maybe someone who has Twitter could ask her about the limited previous review.

Suffrajester · 01/10/2020 22:31

Has she said how she'll be hearing from people? i.e. is there any way we can submit statements to her? I'm really happy to see she has experience working with autistic people, as an aspie myself I and many of us are aware of how easily autistic traits can be misinterpreted as trans, how easily autistic children can fixate on something like gender that promises to help them understand social interaction, and how long a history there is of experimental and dangerous medical interventions on autistic people. Even as recently as the mid 2000s a US doctor, Mark Grier lost his licence to practise after it was discovered he'd been putting autistic kids on Lupron (one of the more common GnRH agonists or "puberty blockers") at great expense to their parents and at risk of causing horrific damage to the kids, and touting it as an autism cure. She's probably aware of all this as an autism expert herself but we've collected a lot of information and would like to share it with her, if nothing else to show that others are concerned about the issue and that autistics are rooting for her!

gardenbird48 · 01/10/2020 22:38

@Thingybob

Dr Cass has posted the principles that will guide the review process.

twitter.com/Hilary_Cass/status/1311725988670255105

It all looks very fair. She is centring the welfare of the children, as she should, and wants to "hear as many voices as possible"

Having said that she wants to talk to everyone, she is receiving quite a lot of advice on who not to talk to (those difficult women) and is being told to block them just to be sure.
Thingybob · 01/10/2020 23:02

There's no further detail at the moment Suffrajester but I'm sure someone will make you aware as soon as there are more updates.

pombear · 01/10/2020 23:21

Newsnight right now on an an obtained internal report from Tavistock 2005. Recommendations back then regarding the need for clinical audit, more research, worries about children with trauma and concerns about pressure to prescribe puberty blockers.

www.bbc.co.uk/news/uk-54374165

pombear · 01/10/2020 23:30

Dr David Taylor, Medical Director of GIDS 2001-6 interviewed, said it was likely that some of what he had recommended (in 2005 report) was likely to be resisted by some patients and patient organisations.

"If you try to set out to please or comply with someone, whether you're a parent or a clinician, then you won't be helping them. It's very important that you keep an independent perspective but I do think that maybe the service as it developed, to some extent, lost its compass in those respects."

pombear · 01/10/2020 23:42

Just putting up the complete Tavistock GIDS response from Newsnight film, as it's not in the online article:

This report from 2006 is not relevant to the circumstances and issues faced by the GIDS service today.

While the demand for the GIDS service has increased markedly from 2006 each young person does receive a highly personalised service from GIDS colleagues, though we are sorry this is now delivered after a longer wait than we would like.

It has recently been announced that Dr Cass will lead a wider review of the care provided to gender questioning young people. We welcome this and hope it will lead to better and quicker access to support for these young people.

Some of the young people we see in the service experience difficulties which may or may not be related to gender dysphoria.

GIDS is a specialist service which relies on an integrated care model in which it works closely with local CAMHS to support ongoing difficulties.

It is important to recognise that not all co-occuring difficulties will be resolved by accessing specialist psychosocial exploration of gender identity and related issues.

pombear · 01/10/2020 23:47

Kudos to Sue Evans and Dr Kirsty Entwhistle, both who will be familiar names to FWR, Tavistock whistleblowers who were also both interviewed in this piece, and have been instrumental in moving this forward.

NecessaryScene1 · 25/01/2021 20:48

Thread bump, as the review has just set up a Twitter account.

twitter.com/thecassreview

Welcome to the official twitter account of the Cass Review, the independent review by Dr Hilary Cass into the future of care provided to children and young people experiencing gender incongruence or questioning their gender identity. Please follow for updates about the Review.

Includes a "chair's blog - issue #1" which I might have managed to attach.

NHS independent review into children's gender ID services