Without a robust evidence base

An open letter to Doctor Polly Carmichael, head of the Gender Identity Development Service (GIDS) at the Tavistock in London, from a colleague:

Dear Polly,

I am writing to you as a former clinician from the Gender Identity Development Service (GIDS) in Leeds. I wish to outline the concerns I had at the time of working there and the concerns that have either grown or developed since I left. I hope that you will address my concerns and also see the importance of investigating the concerns of other GIDS clinicians who have also left the service…

I think it is a problem that GIDS clinicians are making decisions that will have a major impact on children and young people’s bodies and on their lives, potentially the rest of their lives, without a robust evidence base. GIDS clinicians tell children and families that puberty blockers/hormone blocks are “fully reversible” but the reality is no one knows what the impacts are on children’s brains so how is it possible to make this claim? It is also a problem that GIDS clinicians are afraid of raising their concerns for fear of being labelled transphobic by colleagues.

That’s three five-alarm fires right there. Clinicians making life-altering decisions about children without a robust evidence base. Clinicians saying blockers are reversible when in fact no one knows that. Clinicians being afraid to talk about any of this because of fear of the “transphobia” label.

If gangs of sex criminals were grabbing children off the street and stuffing them with puberty blockers, that would be seen as a problem, yeh? But when it’s clinicians doing it, the establishment says aren’t they marvelous and anyone who says otherwise is a transphobe.

The author herself tried to raise issues and got called transphobic for her pains. Perhaps that’s one reason she left after a year.

Since leaving GIDS I have continued to follow transgender issues online and one of the things that I have felt concerned about is seeing the bullying and intimidation for those people who raise valid concerns about children making a medical transition being called ‘transphobic’ and ‘TERFS’ on forums such as Twitter.

I am also concerned that the attempts of Tavistock & Portman professionals, including former GIDS clinicians, to voice concerns about GIDS practice do not appear to have sunk in. Polly, as I’m sure you know very well, Clinical Psychologists are not known for going to the press but several former GIDS clinicians have done so anonymously. I cannot think of another time when Clinical Psychologists have gone to the press about concerns for the welfare of the children in their service, you have to take them seriously.

But the whole thing has so much momentum behind it now.

I also strongly believe that it is GIDS duty to make it known that it is highly unlikely that any child presenting there will be told that they are not transgender. One of my biggest ethical dilemmas whilst working at GIDS was that there were parents who brought their child to GIDS anticipating that we would confirm that the child was not transgender but we are not able to tell parents that actually there is some unspoken rule that means GIDS clinicians do not tell families, “your child is not transgender”.

So…they can confirm that the child is transgender, and do life-altering things in response, but they cannot confirm that the child is not transgender. Interesting. It’s almost like those arrangements where you go to a specialist in foot massage or eyebrow manipulation or crystal embracing and you ask if those things will fix what ails you and the answer is never ever No. Why isn’t it? Because Yes means cash and No means no cash.

I urge you to look up the stories of “detransitioners” (currently mostly American and Canadian young people) who report that they were not offered differential diagnosis of their gender dysphoria and that they were either coerced into medical transition or were not mentally well enough to give informed consent. I believe it is only a matter of time before we start to hear similar stories from British young people and that there needs to be a service available to give them support.

Many of these young people talk about feeling as though they have been in a cult and that they did not have access to any information or responses other than the affirmative approach.

It’s unmistakably a cult. The bullying, the reliance on dogmatic assertion and idiot repetition, the absolute ban on the least word of doubt or concern – that’s cult world.

There are going to be way too many needlessly miserable people in the years ahead.

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