Tavistock data review

[McDuffy]

Gender change data to be scrutinised

www.thetimes.co.uk/article/cedc8a46-f7e3-11ec-84c1-32e852e780b0?shareToken=af430bf386b617dba5cad2f2f4b6b2aa

This was related to one of the questions put to that Irish Senator last week by the Equalities Committee looking at the GRR Bill in Scotland. She was given some tale of “Oh, we’ve been told about concerns around change of NHS records and trans people missing out on sex based checks, but that’s not true it’s it because it all works tickety boo in Ireland.”

Only to have Regina Doherty turn around and say, “Oh we never though of that. Yes, I can see that there’s a problem there. Learn from our mistakes!”

The changing of NHS number and not having a way to tie it to the old records is madness. Am very glad to see this research will now be possible and yes, TRAs if you are so convinced problems are so minute, you’ll welcome this with open arms as a means to vindicate your position.

Anyway, how does this work with people who feel like they are a different gender every other day? Do their NHS numbers change along with it? A persons medical history is their history, why wipe it out? Isn't this discrimination? And what about non-binary patients? Do they get a special marker?

It's so ill 'thought' out. I wonder which individuals and groups are influencing these NHS decisions 😕.

I totally support people choosing their gender if that's what makes them happy but that's all it is gender, not sex.

It would be great if people who identify as trans gender could be proud of their choice and rather than pretending to be actually the opposite sex promote that it's ok living as the gender they identify with while acknowledging their biological sex, that's got to be more inclusive and empowering in my view. Be who you are and be free to express your identity and personality as you see fit. Biology is real and can be scientifically observed (not 'assigned' 😂). Doesn't the NHS give evidence-based care any longer?

But surely this triggering isn’t happening, because apparently trans people are no longer denying their biological sex. Or so we are told constantly, despite the evidence to the contrary.

I have found the constant assurance that trans people acknowledge their biological sex to be misguided at best, otherwise demonstrably false. In fact, laughably false considering the outpourings we saw around the census and the insistence of changes such as NHS numbers etc.

TRAs if you are so convinced problems are so minute, you’ll welcome this with open arms as a means to vindicate your position.

I think we will learn that even ‘successful’ transitions will have significant negative side effects. Even from discussions here with transitioned males, they admit they have bladder issues or some negative side effect.

Excellent news!

Despite its centralised nature, which on some levels works very well indeed, there is a fundamental problem with coordination within the NHS and this issue is one example. Any patient with chronic, multiple health problems being looked after by different departments (even within the same Trust) will tell you their experiences of lack of continuity and communication between the elements. I think we assume that because of electronic records, our care is more joined up than it often is.

Changing the NHS number is arguably discriminatory against trans people. The secrecy thing is all because of the climate created by the GRA which imposes penalities on employers who reveal someone's trans status, thereby creating a culture which says that trans status must be hidden.

I've never understood why changing gender markers with the GP seems to be such an important rite of passage for children who believe they are trans.

Even the GIDS website advise children that this is what they should be doing

How do I change my name on GP Records?

There is a simple process for this, which is accepted by many government departments including the Department of Health:

the patient tells their GP, or directly informs the CCG, that they are transitioning and that in future they would be known by their new name and gender. They can write a “statutory declaration”, they may have a deed poll document, or they may simply make the request. This request should be in writing, signed by the patient

the GP writes to the Registration Office at the CCG. The GP may write a letter of support confirming the gender role change and that this change is intended to be permanent, but this is not a requirement

the Registration Office then writes to the Personal Demographics’ Service National Back Office. The National Back Office will create a new identity with a new NHS number and requests the records held by the patient’s GP. These records are then transferred to the new identity and forwarded to the GP

on receipt, the GP surgery changes any remaining patient information including the gender marker, pronouns and names

Trans patients have a legal right to change their name and gender on their NHS records and would be able to bring a civil claim against any GP or practice which I refused to accede their request.

gids.nhs.uk/young-people/

I dont even know why its a thing. Its unbelievable that this level.if entitlement is indulged.

Why can't people accept that their transition matters to them and them only. And it's not the job if everyone else to be involved in it some how. You cant claim something is mot a mental.health condition then behave as if it is by getting triggered etc when reality is acknowledged. You cannot have it both ways.

And it is not the job if medical.staff to play along.

Does anyone know which part of the GRA:

• says you can (in effect) erase your medical records?
• says an order must be made to change what's happened here?

S22 of the GRA does allow for the Sec of State to change the bit about disclosure and what's a related offence. But I just can't see the link with health.

This is excellent news

impartial assessment of the facts is all we want (well and sensible action based on those facts)

the ‘La la la can’t hear you’ years are truly coming to an end

This is really good news.

It seems like the service is not really fit for purpose. The waiting times are ridiculous, which I think means that by the time children and young people are seen, they (and their parents) may see hormonal intervention as the only good outcome.

I feel timely support exploring gender as a facet of identity would be much more beneficial. Forcing people to wait 3+ years for that doesn't help.

Hopefully this review will lead to a better, more ethically robust and properly funded service for young people

Things feel like they're really moving in the right direction now. I wouldn't mind him for PM, either.

Other issues aside, please don't move him from health at present, there's still so much to do.

Thoughtful comments from PPs.

Is it not the NHS confidentiality laws that allow someone to erase their medical records?

Changing those laws would still not allow the information to be shared if the person has a GRA as S22 would prohibit it.

So I'm guessing it is S22 that will be changed to allow the sharing of (some) health data?

Erasing medical records seems so utterly a daft thing to do. Those are essential! I have no memory of various procedures - what happened during childbirth, for example, is a total blur. I certainly don't recall my vaccination schedule, was astonished to find that the NHS had a detailed from-birth record of it.

The NHS are expecting trans people to just remember everything and recount it accurately? Surely that's not really happening?

It sounds like the very real and necessary facts are coming up hard against ideology and people's feelings/wishes, here.

Someone may find various things in their medical history upsetting (I found reading the notes on DS' birth quite hard going) but they are important to be recorded accurately.

Many procedures, histories and issues involve things we'd rather not be reminded of, I'm sure. And by its nature medical data is surely intensely personal and private and thus would have or should have extremely stringent privacy protocols in place.

I’m not a lawyer and don’t know where in the GRA this might be but it’s definitely the case that criminal and corporate liability plus (in this case, poorly thought through and ill defined, sexist GRA) amounts to a chilling effect on willingness to share data.

Think back to the Data Protection Act pre GDPR and all the ‘computer says no’ culture around that- also people refusing stuff and blaming ‘health and safety’. People will always be risk averse around scary criminal sanctions and huge corporate fines- but in complex or badly-written law their caution may or may not correspond with what the law actually allows them to do.

Its deliberate. It helps maintain the victim hood required to continue to mOw unreasonable demands and get them met.

Who's not gonna feel sorry for health care neglect in trans people. They probably won't even realise its self inflicted

If someone is having multiple serious health interventions in pursuit of transition then it seems even more important that someone records accurately their health stats, data, history, surely?

Would a patient who wanted a more sensible pragmatic & safe approach get it? If I transitioned and wanted my gp record to show that I shld be known by new pronouns & generally treated as the opposite sex in human interaction (setting aside debates about what it means to be treated as a mam for a minute), but also wanted my records to have my whole medical history and clearly show I am female because that's needed & safe - would they have a way of doing that? Is it all or nothing?

As this study is integral to the Cass review I imagine we are at least a year away from a final report which might stop children being taught these ideas in school?

At least a year away from anything resembling a final report. Longer, I should think nearer 18 months to 2 years and beyond.

I wonder if there will be a 2nd interim report until such time as there is fuller information? These timescales mean a lot in the life of a young person.

I can only assume that as Helen Joyce has said, this seems to have been conceived as a sort of "witness protection programme". I really don't see how this level of paranoia about being "outed" is justified.

Particularly since, as soon as anyone meets this person in real life and interacts with them/speaks to them etc, their sex will be very evident, as it always is when it's not a heavily filtered headshot photo of a woman's make-up'd face painted onto a man.

This "privacy" cannot happen in the real world.

Brilliant - about time that the medical evidence was comprehensively interrogated.

Dr Cass did specify that there were ongoing studies being undertaken in this nature so these studies were known to have been instigated. So, I expect they have been built into the timeline surely.

As to what is coming out supposedly in Summer?? It must have always been another 'interim' style document that was then going to require confirmation or follow up to the research.

The Australian and New Zealand Pyschiatrists wrote that they had studies and patient reviews underway too in their statement, so I wonder what that too will bring to light.

This is one of them....

bmjopen.bmj.com/content/9/11/e032151

I know that Covid restrictions would have impeded this studies progress, however, I wonder what stage it is now. And has anyone seen anything further about it...

Trans20 is a prospective cohort study based on children and adolescents first seen at the Royal Children’s Hospital Gender Service (RCHGS) between February 2017 and February 2020. Current estimates indicate the final sample size will be approximately 600. Patients and their parents complete online questionnaires prior to the first appointment with RCHGS and regularly thereafter as part of routine clinical care. On discharge from RCHGS, patients are invited to continue undertaking questionnaires biennially. In this way, a naturally forming cohort study has been created. The primary outcomes include gender dysphoria, physical and mental health, schooling, family functioning and quality of life. Subgroup analyses based on factors such as gender identity, birth-assigned sex and treatment received will be performed using bivariate and multivariate modelling as appropriate, and relevant statistical methods will be applied for the repeated measures over time.

This is fucking concerning!

Trans20 is a prospective, longitudinal cohort study, with a sample comprising patients aged 3–17 years when first attending the RCHGS between February 2017 and February 2020.

3 year olds!!! Seriously grim reading that.

Either way, it seems to be totally reliant on questionnaires. I could not see them mention that they would then correlate this data against anonymised health record data. Also Michelle Tefler is involved and is hardly going to be unbiased.