Where next for young trans healthcare?

The Gender Identity Development Service (GIDS) recently announced that the Tavistock clinic, currently the only gender clinic for under-18s, is going to be closed and replaced by two new clinics: one in London and one in the North West. These new clinics will be made of partnerships between existing children's hospitals in the area.

The media response to this was predictably bad, almost all of the mainstream press reported that Tavistock was being shut down due to it being unsafe and "rushing vulnerable children into treatment" - which is the exact opposite of what the Cass review said:

"Overall, GIDS faces a daunting task as a single provider in managing risk on the waiting list, seeing new referrals, reviewing and supporting those on hormone treatment, undertaking an ongoing transformation programme, recruiting and training new staff and trying to retain existing staff. This suggests that the current model is not sustainable and that another model is needed."

While some reported on the two new clinics, many neglected to mention this until later in the article, meaning all the headlines said was that the Tavistock was being closed. This is caused a panic, as many people who use the clinic thought that they were losing access to all care.

Although the NHS are not (yet) shutting down all care for young trans people, this change will not make things any better or easier for them and may risk making things even worse. Changing from one clinic to two clinics doesn't fix the problems with trans healthcare: treatment will still be kept behind psychological examinations and having to prove to a doctor that you are "trans enough" to get care.

The GIDS have not addressed how they will deal with reducing their waiting times, which are currently 4 - 5 years long, with young people that were referred in 2018 only now starting to receive their first appointment. The NHS say that the maximum legal waiting time for a non-urgent appointment is 18 weeks. The GIDS are very far over this limit.

The GIDS also haven't addressed how they will compensate people who have been on this list for over the maximum time or how they will compensate the families of people who have died because of the excessively long waiting times.

Potentially even worse, in the original press release they reported that under-16s would be forced to participate in a research project in exchange for endocrine care (puberty blockers). This part has since been removed from the press release, but nothing confirming they wont be doing this has been issued, so it could still happen out of the public eye.

Overall, even if these clinics are set up exactly to plan, it will not fix the fundamental problems with trans healthcare. It is also unlikely that it will even be rolled out and operated as they say, due to the pervasive institutional transphobia in both the NHS and the government.

Bella