The clinic at Tavistock & Portman NHS Foundation in London will close in spring 2023 and be replaced by a series of regional centers in specialist children’s hospitals across the country. The new approach is designed to “ensure the holistic needs” of young patients are met rather than running the service through a single provider, which was deemed “not a safe or sustainable long-term option”. The clinic became a lightning rod for discussions on transgender and youth issues on both sides of the Atlantic. The Gender Identity Development Service (GIDS) in Tavistock is currently the only gender identity clinic for children under 18 in the UK. He is at the center of a tumultuous debate in Britain over how to treat children diagnosed with gender dysphoria and has previously been accused by some doctors and patients of forcing young people into certain treatments. Dr Hilary Cash, who is leading the independent review of the clinic, found that patients’ other mental health issues were “overshadowed” if they mentioned gender to clinicians at Tavistock. He therefore called for the center to be replaced with an “appropriate multi-professional workforce that will enable them to provide an integrated model of care that manages the holistic needs of this population”, adding: “Staff should maintain a broad clinical perspective to Integrate the care of gender indeterminate children and young people into a wider child and adolescent health framework.’ NHS England, which commissioned Dr Cash’s study in 2020, says it will fully implement its recommendations. The health organization says it will open two new children’s gender clinics next spring, with one in London and one in the North West. It is thought that seven or eight services could eventually be created. Dr Cass also instructed the NHS to “enroll young people being considered for hormone therapy in a formal research protocol with adequate follow-up into adulthood, with a more direct focus on questions about the blockers of puberty”. He also said there was a “lack of agreement and in many cases a lack of open discussion” about whether gender dysphoria tended to persist after puberty. The issue of transition — where a transgender person identifies with the gender they were assigned at birth — was at the center of a legal battle involving Tavistock. England’s High Court had ruled that children under 16 were unlikely to be able to give informed consent to take puberty blockers, only for the decision to be overturned in 2021 by the Court of Appeal. The original case was brought against the clinic by a Tavistock patient, Keira Bell, who was given the drugs when she was 16 and identified as male, only to later transition to female. Stonewall UK and Mermaids, which supports transgender and gender diverse children, cautiously welcomed the plan to move to a more regional system with clinics across the country rather than central London. “We welcome the news that NHS England plans to deliver a more resilient and robust gender identity service by 2023, expanding the provision and improving the quality of care that trans, non-binary and gender diverse young people receive,” Mermaids said on Twitter. Referrals to the clinic have exploded in recent years, especially for children on the autism spectrum and young girls. While it had 138 referrals in 2010-11, that number jumped to 2,383 in 2020-21.
