Tavistock puberty blocker study published

[PaleBlueMoonlight]

www.bbc.co.uk/news/uk-55282113

Finds 43/44 (98%) progress from PBS to cross sex hormones

Thanks Plantmam

This CAMHS refers to childline.

camhs.elft.nhs.uk/Conditions/Gender-Identity

grahamlinehan.substack.com/p/childline-the-nspcc-and-the-gender

This one refers to mermaids

camhsdorset.org/about-camhs/what-can-we-help-with/gender-identity

Agree with all @sultanasofa's points. This is an abysmally designed study, abysmally written up.

A couple of things not already mentioned that leapt out to me:

They were comparing bone density to baseline, i.e. each individual's bone density pre- and post-treatment. That is bizarre when you are studying adolescent children. Their bone density should be increasing, so the fact that it didn't decrease during treatment isn't reassuring at all - quite the opposite. Where are the comparisons with a non-treated group? Even without a formal control group, they could easily have compared the treated children's bone density to average for their age group. The fact that they didn't suggests they are trying to gloss over the very worrying finding that PBs inhibit normal skeletal development.

One of the authors is Russell Viner. Guess what his job is now? President of the Royal College of Paediatrics and Child Health

The child who started blockers, then came off for 9 months to try to produce sperm to store for future use, wasn't "successful", then went back on blockers - I'm just gutted for them that they won't be able to father their own children.
Shouldn't this be recorded as some sort of adverse event?
Doesn't it suggest that children can't be sure as to their decisions about having children themselves in the future?

This study was small numbers as this was the number of children they expected to present at the time, before the massive rise in numbers.

In 2015, they note a change in presentations: "With the increase in referrals, the number of complex cases has increased; for example young people presenting with significant associated difficulties, features of ASD and challenging social circumstances" (board meeting 2015)

I'd like to know how their plans for research changed once they realised there was a massive increase in referrals, and that the client group was changing. What studies are they doing since numbers increased from the tens to the hundreds/thousands?

And did they really go ahead with offering a treatment that effectively sterilised these children and young people despite seeing these changes in referrals?

I'd also like to know - did they keep data on sexual orientation? (at presentation and in adulthood)? That would be interesting to see.

And I can see how it happened. Such pressure from external groups, people who bring up concerns aren't supported, and just leave, hence the massive staff turnover (was it something like 30 psychologists in two years?)

They couldn't really escape the pressure could they?

Prof Moore et al's book is on kindle now £10 btw. "Inventing transgender children and young people"

Inventing indeed.

@StellaAndCrow

And I can see how it happened. Such pressure from external groups, people who bring up concerns aren't supported, and just leave, hence the massive staff turnover (was it something like 30 psychologists in two years?)

35 resignations in 3 years, I believe.

I'd like to know how their plans for research changed once they realised there was a massive increase in referrals, and that the client group was changing.

From the bits I have extracted from the board minutes so far the increase in demand seems to have been actively encouraged via print and TV media engagement and the additional cash from NHS England to pay for it all was seen as very positive.
So far (I’ve gotten up to the end of 2017) there is no mention of curiosity around changing clinical presentations, only commentary on how great the expansion is going.

It's "interesting" that they started off, as per their study protocol, doing "'Early pubertal suppression in a carefully selected group of adolescents with gender identity disorders'"
What happened to that careful selection under pressure from external groups as the referrals rocketed, and presentations grew more complex? That's the study that I think would be informative.

the increase in demand seems to have been actively encouraged via print and TV media

quelle surprise.

And they didn't query that??

Most counsellors working within CAMHS are BACP accredited. BACP pushes a gender affirmative model.

Incidentally, where I live, there is no MH support for children with autism, even if they are assessed as being at Tier 3. Literally none. If your child is suicidal, they tell you to go to A&E.

So I can imagine getting a child off the CAMHS list and onto the GIDS one is very attractive to a lot of Trusts.

Thanks PlantMam, I hadn't really put that together. Yes, they must have been advertising for custom at the same time as the referrals were increasing.
I saw in the minutes that the videos/radio programmes etc were discussed under "Marketing".

Jesus.

Yes, this link on their website

www.bacp.co.uk/bacp-journals/private-practice/winter-2017/gender-mosaic/

leads to another below...

genderidentity.co.uk/about/

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

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

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 ?

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/

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.

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".

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^