@NonHypotheticalLurkingParent
tavistockandportman.nhs.uk/about-us/governance/council-of-governors/meeting-and-papers/
Tuesday 5 June – Meeting agenda and papers
The adult Gender Identity Clinic (GIC) that is based at Charing Cross is now under the Tavistock and Portman umbrella and, has been very fruitful, as it makes it easier for young people to make the transition from adolescent to adult. We are seeing much younger children making the transitions and we have close connections with CAMHS.
Ms Miller enquired what resources were available for face to face
counselling and psychotherapy within the service. Dr Carmichael said that the national service did not provide psychological support and that if required they would consult with the local psychotherapists to do the work through CAMHS.
Looks like the GIDS service is not set up to to offer counselling and psychotherapy. Referring to the local CAMHS is just shifting the funding/waiting list problem. Our local services only have one psychologist, no experts on trauma, etc.
So why is the service mostly staffed by psychologists then, eh Polly?
I just posted this on another thread, it’s from Kirsty Entwistle (former clinical psychologist at GIDS Leeds satellite) to Polly Carmichael.
May as well post it here too, while it’s still on the copy and paste clipboard of my phone - if you compare Kirsty’s experience to the CQC report you can see how the systemic failures flagged up by the CQC manifest in real, tangible ways. The whole letter is well worth reading (especially as it talks about the unsupportive culture and the intimidating atmosphere at staff meetings and Cade reviews) but the bits I had pulled out for the other thread highlight the vulnerability of the patients group, and the lack of promised joining up with agencies (CAMHS, Social Services etc) local to the child and their family.
There is a ‘system’ for scoring the referral as low, medium or high complexity. I frequently voiced my concern that colleagues were not seeing abandonment/estrangement by a parent as an indicator of complexity. For me, this was another reason that made me feel so disoriented. In my Clinical Psychology training and in other services the loss of or abandonment by a parent would be something to be explored and the impact understood but I felt that at GIDS this factor was often minimised or dismissed.
I was also shocked by the complexity of referrals. I read many referrals of children who have been sexually abused and many children have witnessed and/or been subjected to domestic violence.
I also felt that was an overrepresentation of the young people who were living in poverty. I had a young person whose family were living within such extreme financial constraints that he considered it a treat to buy a can of pop. I also had another young person who was living in a very complex and unstable arrangement who arrived to sessions in a poor state of hygiene and said that there wasn’t money for hygiene products. How is it ethical to undertake a gender identity assessment with the view to a medical pathway when there are children and young people do not have their most basic needs met?
In terms of complexity I also had on my caseload several young people who declined to communicate verbally or communicated verbally to a very limited extent. I think that at GIDS verbal communication difficulties are often minimised as transmales being afraid to speak because they have a ‘feminine voice’ but in all of these cases I believe that there was something more complex than that going on. Again, it’s very difficult to undertake a gender identity assessment with a young person who struggles to communicate verbally, especially within the time constraints of the service.
One of the other major factors that meant that I could not sustain working at GIDS was the failure of social care to provide support to the young people I referred. As the children come from all over the North of England I was dealing with several different social care teams trying to get support for my patients who were either doing risky things, living in risky situations or in contact with risky people. In none of my cases was input from social care secured.
How is it possible to undertake a gender identity assessment when young people are living in these circumstances and sometimes even more extreme? I do not believe that GIDS can claim to function effectively when it is part of a broader system that is failing to provide adequate support and protection for children and young people.
I also believe that there are clinicians at GIDS who are putting vulnerable children on the medical pathway when they are not receiving proper input from CAMHS and Social Care with regards to mental health problems and complex family and housing difficulties.
medium.com/@kirstyentwistle/an-open-letter-to-dr-polly-carmichael-from-a-former-gids-clinician-53c541276b8d
(Coming back to this open letter now, 18 months after it was published, with all that had happened in between, it seems to me that Kirsty Entwistle is an extraordinarily brave and principled woman.)