NHS to open detrans clinic

[fromorbit]

Amazing news:

NHS to launch first service for trans patients wanting to return to birth gender
Cass Review found children were being hurried down pathways involving powerful drugs and medical interventions

NHS officials said the next step was to “define an NHS pathway for those individuals who choose to detransition” because currently no guidance on how to care for them exists.
The health service said: “There is no defined clinical pathway in the NHS for individuals who are considering detransition. NHS England will establish a programme of work to explore the issues around a detransition pathway by October 2024.”
It said this would include examining the rate at which patients detransition and their reasons for doing so, as these are currently unknown, and would recognise “that individuals who choose to detransition may not wish to re-engage with the services they were previously under” as per the recommendations.

Dr Cass said a lack of long-term data made it impossible to know how frequently people detransitioned, although anecdotally it was “increasing”.
The lack of long-term evidence was also why the review said puberty blockers should not be prescribed outside of a clinical trial.
That trial is now set to begin from early 2025, the NHS confirmed, with the first patients enrolled from April next year.

https://www.telegraph.co.uk/news/2024/08/07/trans-first-service-detransition-cass-review-birth-gender/

Brilliant news. Shame the Telegraph didn't use 'detransition' in the headline. it's a word we're all going to be hearing a lot more of.

It's really good news, and makes a lot of sense and hopefully will mean that troubled children and young people get better care, rather than just being discharged.

But my god, the financial waste to an overstretched NHS of people who choose go down the navel gazing pathway, costing a lot of NHS money and resources on an ongoing basis, and who are then going down another pathway, taking up more precious NHS money and resources....I find that appalling, given the situation is down to their choice. Is my thinking unreasonable?

It's shameful that detransitioners have had no medical help until now. But at least some data can be collected going forwards. Will this be a world first?

Moral hazard but overall…

People regain weight after weight loss surgery or NHS supported diets. It doesn't mean that they shouldn't be treated.

Some people with diabetes (whatever type) go through periods of being able to control it and times when they don't/can't. We still treat them.

People who live with substance overuse disorders can go into remission and then relapse…

There are many examples of expensive healthcare where the recipients might relapse and accrue further costs. The NHS is a shared risk healthcare payer and in many ways, this works.

Whilst thus is true, there is (mostly) good evidence base for the original treatment, whether it 'failed' or not. That is not true if gender affirming care. So yes, it is a unconscionable waste of resources.

I wonder if detransitioning happened very often in the last century, and what the percentage is now? The original protocol was for people to live in their acquired gender for two years, and pass a panel because it was always supposed to be a permanent change. There isn't even a mechanism for people to detransition in the Gender Recognition Act, they have to apply to the panel and change their legal gender again.

Also healthcare doesn't generally cause patients harm or necessitate expensive lifelong follow up unless it's a question of life or death. I dont see why gender surgery is offered on the NHS tbh when something like IVF is often not.

No, not totally unreasonable but their choices were manipulated by others for their own reasons.

I would direct my ire at all the people and organisations who pushed them into it, emotionally manipulated the parents, gave the children & young people unrealistic ideas about the results of the process, alienated them from their families, coached them on what to say to game the system, etc.
They are the ones who should be picking up any NHS bills.

I wonder if the NHS will be expected to "detransition" this who have used private clinics to "transition". I am aware that botched, foreign cosmetic surgery is dealt with by the NHS (infection etc)

Good news, though. Future Watsons and Ritchies will have somewhere to go.

Very true and in the case of young people and children it should never have happened. They should never have been given any medical treatment incompatible with their birth sex.

Thank fuck!
Detransitioners should be treated with kindness, must be so hard to step away when you know doing so may lose you so-called friends and allies.

But I do hope the clinic gathers data on the "gender affirming" pathways taken in order to highlight the costs, both to the NHS and to the individuals needing treatment.

Which people and organisations pushed children into transitioning?

By emotional manipulation, do you mean warning parents suffering from Rapid Onset Trans Panic that trying to stop young trans people from transitioning due to trans-hostile ideology won't actually prevent them from doing so - it is just an extremely effective way of driving them away and going no-contact once they hit 18, then spending the rest of their lives decrying the people who could have saved them enormous suffering and expense?

By unrealistic expectations - do you mean the collective grief freely shared by the trans community over the limitations of current treatments?

I do agree that in a properly equpped and funded health service uniformly staffed by professional, consistent and conscientious staff who are able to comprehensively support their patients, the notion of coaching young people on the gotchas used to trip them up and deny them treatment would be unnecessary. Unfortunately we live in a world that is still recovering from the legacy of the well-known harm caused by clinicians like Richard Green and Sue Evans.

@ButterflyHatched How old are you? Because of most of us on here remember a time not so long ago when there was no trans "care" and the kids did just fine.

True, but I suspect the amounts we are talking about are minuscule compared to the wholly self-inflicted harm from e.g. smoking and type 2 diabetes. I don't think the blame for the waste rests with de-transitioners, rather an NHS which decided that medical interventions were a valid form of treatment in the first place.

But the point is those ‘going down the naval gazing pathway’ should have been properly assessed, given a differential diagnosis and then lots and lots of therapeutic support … thus avoiding the medical pathway and the potential costs of detransitioning? If you read the articles/watch the interview of people like Prisha, Richie Herron and others, they were woefully let down by a captured service in that failed to dig deeper, assess them for co-morbidities (CSA trauma or autism/ND assessment), did not give them space to explore their feelings about the GD or provide considered alternative pathways.

They were victims and should not be held culpable for the mess they are in. They had a right to expect independent, considered and professional support from their clinicians.

This ‘detrans’ clinic is a very small step towards the NHS accepting it failed them - and rather too little, too late.

And another point is that by the time it came to make decisions on surgery, the kids/young people had already had their puberty blocked and decision-making ability impaired.

I really hate the glibness of the phrase “going no contact”. I can only hear it in Jeffry Marsh’s creepy grooming voice. (Find him on TikTok if you haven’t come across him). It is a trite name for an immensely serious decision, with devastating consequences for whole families that cannot be seen and appreciated by emotionally immature teenagers.

It is a foul thing to hold it as a threat to parents who love their children, and to encourage teenagers to do this, or present it as inevitable as part of your “trans journey”.

How hard is it to step back from having gone “no contact” as a headstrong teenager? Once you have made that move, you have to keep digging into your position, keep your parents in the role of the baddies, and avoid anything that questions what you are doing to your body; it is too rigid a position to encourage anyone to adopt except in exceptional circumstances. To present it to teens and young adults as a simple solution to any kind of questioning or pushback from parents does them no favours.

They were caught in a captured NHS + internet influencers pincer movement, basically.

Will this be a clinic that finally offers people the therapy they should have had before they transitioned in the first place?

By your logic, if young trans people don't get access to treatment, their decision-making isn't impaired.

There are enormous numbers of trans people who expressed persistent gender incongruence throughout childhood and yet were denied or weren't even aware of the existence of treatment. They continued to seek treatment through into adulthood and transitioned as soon as they could.

Their statements are matched by the small numbers who were able to access this treatment. The unifying thread is that access to treatment at a young age is enormously beneficial. Those who couldn't access it are all too aware of the impact; those who could count themselves incredibly lucky.

The NHS is now creating 'detrans' clinics for small numbers of hypothetical people, the overwhelming majority of whom have never been able to access treatment on the NHS due to the ridiculous waiting lists and ban on healthcare for trans young people since 2020.

NHS policy now forces young people who age out of the child services (which don't provide treatment) at 18 to restart on the half-decade long adult service waiting list just in case they have, during the years they waited for treatment that doesn't exist, changed their minds. This means nobody will get any treatment whatsoever until they hit 23. They'll have gone through school and university and been forced into the workplace, enduring years of abuse, before they can even start to access any meaningful treatment.

What's important though is that there will be deserted 'detrans' clinics for the hordes of hypothetical people who don't exist, who want support to undo treatment they've never been able to access.

By your logic, if young trans people don't get access to treatment, their decision-making isn't impaired.

No, that interpretation is through the lens of a reader's reading comprehension and cognitive biases.

Decision-making that is skewed by unresolved MH issues will remain unresolved where there is no adequate treatment.

This entire exercise is such a transparent bone thrown to placate the right wing press and harness the 'gender critical' gravy train.

All trans people need effective healthcare. Not conversion therapy euphemistically packaged up under a 'holistic' buzzword. Not press-placating gesture clinics that cater to a hypothetical, unevidenced fraction of the marginalised minority group who need effective healthcare.

I refer the Honourable Poster to my previous response.

Many of us aged 40+ don’t need to think too hard to recall a time when we’d never heard the word “transgender”. It wasn’t actually very long ago.

Regarding the detransition clinic: didn’t the government recently open some “gender clinic hubs” in various parts of the UK? Is opening a “detransition clinic” tantamount to admitting that “transitioning” can be unsuccessful?