David Bell replied to Bernadette Wren’s LRB piece; he paints a drastically different picture of GIDS from the conscientious, thoughtful, torn in many directions one that Wren painted.

As the author of the ‘damning internal report’ referred to by Bernadette Wren, I was one of several people to draw attention to concerns about the Tavistock Gender Identity Development Service (LRB, 2 December [2021]). In 2018, between a quarter and a third of the staff working in GIDS sought me out in my role as academic and clinical staff representative on the Tavistock and Portman NHS Trust’s council of governors.

They didn’t seek him out to ask about his holiday snaps, they sought him out because they were alarmed.

Wren writes that any ‘genuine disquiet’ about failings at GIDS should have been reported ‘through the institutional channels that exist to oversee and regulate clinical work’. But it was. And there’s no question that it was ‘genuine’. Before members of GIDS staff approached me, they had already raised their concerns with their managers; with the trust’s Speak Up guardian; with Sonia Appleby, the trust’s child safeguarding lead; with the trust’s medical director and with the CEO. It was clear that they had been intimidated and sometimes threatened and were anxious about the repercussions of approaching their staff representative.

Funny, Wren didn’t say anything about intimidation and threats in her piece.

Intimidation at GIDS was confirmed by the findings of an employment tribunal in September, which awarded Appleby £20,000 and criticised the trust for mishandling the issues she raised, including the active encouragement of young children to transition ‘without effective scrutiny of their circumstances’. For the record, the trust also tried (unsuccessfully) to prevent my report going before the governors and initiated disciplinary proceedings against me.

Wren made the trust sound so anguished and dedicated…not secretive and belligerent.

It keeps reminding me of Jonestown – not of the mass murder but of the groupthink, the discipline, the bullying, the secrecy, the absolute impermissibility of any dissent or questioning.

Many CYP [children and young people] who came to GIDS were gender non-conforming gay or lesbian children. For a number of reasons, including pressure from family and peers, they could not accept their sexuality and developed an internalised homophobia, manifested as hatred or rejection of their sexual bodies – a devastating condition, including for the clinician faced with it. Yet sexuality and sexual orientation were largely under-discussed in the service, having been displaced by an overriding preoccupation with gender.

Why that sounds like the rest of the world – where gender is The Hot New Thing while sexual orientation is old news [yawn].

Wren alludes to ‘subsequent feelings of regret’ on the part of patients who have transitioned. Detransitioners are a rapidly growing group, many of them young lesbians and gays, who now ‘regret’ the irreversible damage to their bodies, as in the case of Keira Bell (no relation, contrary to rumour), and the consequences of assessments which affirmed, rather than explored, the nature of their gender dysphoria.

“Affirmation” is not always the best medicine.