Tavistock Clinic - treatment of children & young people

So worrying. We are going through this at the moment with a teenage much-loved family member.

What do you do? Respond to this young person's clear distress and suicidal ideation? Or tell them that this is a phase and it will pass?

How do you support and make evident your unconditional love, whilst also leaving that person an honorable get-out so they can change their mind without losing face? Believe me it is very very hard. A tricky balancing act.

We are just trying to get them through this difficult moment in their lives without anything irrevocable happening; so that they can make their own decisions when they are older. We will support their decisions, but they are too young yet to do so rationally.

My feeling is that it is a peg to hang other problems on. So very hard to get this right.

Lucky My feeling is that it is a peg to hang other problems on. So very hard to get this right
That is exactly what one of the consultants quoted in the article said - that a high proportion of girls presenting with gender dysphoria were anorexic, autistic or had other problems/difficulties.

The other worrying thing in the article was that the trans activists had made it very difficult for clinicians to challenge the use of puberty blockers etc & present another way of managing patients. Only those at the end of their careers with nothing to lose felt safe to speak out.

I find the suggestion that medical practice & proper research can be subverted & silenced by threats and online abuse alarming.

The other worrying thing in the article was that the trans activists had made it very difficult for clinicians to challenge the use of puberty blockers etc & present another way of managing patients. Only those at the end of their careers with nothing to lose felt safe to speak out.


It is extremely worrying when the views experienced and qualified clinicians are sacrificed on the altar of a fashionable ideology.
Puberty has always been a time of flux, a time when other problems can manifest themselves too a time of confusion for many.
Such young people should be supported through a very difficult and confusing time without the use of such powerful, life-changing hormonal treatment.

Affirming what children say is particularly damaging to them with the influence of social media. As adults we become aware of our own unconscious bias but I am not sure when this awareness first develops in children. This seems beyond the boundaries of Gillick competency. This is about discussions amongst children about anything under the sun with no adult in the room... except there are adults in the social media room, there are adults facilitating this.

The full article :

A global expert on autism has warned in newly released legal papers that girls who are autistic or anorexic appear more likely to say they want to become boys.

The evidence by Professor Christopher Gillberg was given in a High Court case that led to a landmark ruling last month saying children under 16 were unlikely to be able to give informed consent to undergo treatment with “experimental” puberty-blocking drugs, which almost always leads to taking cross-sex hormones to change their bodies.

The Tavistock and Portman NHS Foundation Trust, which runs the only NHS gender identity clinic for children in England, suspended new treatments pending an appeal against the ruling.

The Sunday Times won court approval to publish the evidence of several leading experts who appeared in the case.

Gillberg, a psychiatrist at Gothenburg University in Sweden who holds posts at several universities including Glasgow, is reviewing research into what happens to children who receive treatment for gender dysphoria. The study has not yet been published.

He told the High Court in a written statement that research showed that, left alone, the condition usually resolved itself, and that as girls grew up they accepted that they wanted to live as women. Gillberg said that in 45 years of treating autistic children, he saw few cases of gender confusion until 2013. Since then there had been a worldwide explosion in the number of children saying they wanted to change sex. In Sweden, as in the UK, he said, most were girls who wanted to be boys.

Research showed that teenagers with autism or anorexia as well as those who had endured difficult childhoods were more likely to say they wanted to change sex. One paper published last year suggested autism spectrum disorders had “a prevalence of 6%-26% in transgender populations, higher than the general population”.

Gillberg said teenagers were finding online transgender sites that suggested their problems would be solved if they changed sex. Autistic teenagers, he said, were particularly vulnerable to seizing on a single answer “to the lifelong identity problems they have suffered”.

“Thousands of adolescents are being offered ‘treatment’ with puberty blockers, sex-contrary hormones, and then, finally for some, with a variety of surgical procedures. In the UK as in Sweden, this is in spite of the non-existent research evidence that these treatments are of any long-term benefit to the young people in question,” he said.
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IQ might be damaged by puberty blockers, he added, and effects such as a deeper voice and facial hair, as well as possible infertility in girls taking the drugs, were irreversible.

Gillberg said there was “growing anecdotal evidence that many would regret their decision to undergo the biological sex change”. Doctors should tell families that they were “dealing with a live experiment on adolescents and children”.

“Adolescence can be a particularly turbulent time when young people often make reckless decisions they later regret. Young people with autism and young people with anorexia nervosa are particularly vulnerable,” he said.

Gillberg, who is also chief physician at Queen Silvia Children’s Hospital in Gothenburg, is on a list published by the media group Thomson Reuters of the most cited and influential researchers.

The expert evidence was presented to the High Court last year in a case brought by Keira Bell, 23, who was prescribed puberty blockers by the Tavistock centre when she was 16 and seeking to transition to a male. The landmark judgment means court approval is needed before the drugs can be prescribed to children who are confused about their gender identity.

Bell took testosterone, and had a double mastectomy at 20, but now lives as a woman again after “detransitioning”.

The number of referrals to the Tavistock’s gender service has risen sharply in recent years. In 2009, 97 children were referred. In 2018 that number was 2,519. Most of the children being prescribed puberty blockers from the clinic are girls. In 2011 the gender split was roughly 50-50 between girls and boys but by 2019 the split had changed so that 76% were girls.

Professor Sophie Scott, director of UCL’s Institute for Cognitive Neuroscience, told the court that “puberty blockers have profound effects on the developing body, and as part of the changes seen in adolescence involve hormonal effects on brain function, the impact of these drugs on the brain maturation are likely to be deleterious”. She said she was “concerned that the current treatment regime is exposing young people to significant risk of harm. The greater susceptibility to peer pressure in those under 18 may make them especially vulnerable to risk-taking, and this may well be enhanced by social media, where actions can be encouraged without any responsibility for outcomes.”

Stephen Levine, professor of psychiatry at Case Western Reserve University in Ohio, who specialises in sex therapy and has treated transgender patients for the past 40 years in America, gave evidence that it was medically impossible to turn a girl into a boy and vice versa. Many transgender people, he said, had sexual difficulties and suicide rates were high.

Levine also said that black and Asian children, adopted children, girls and autistic youngsters were more likely to be diagnosed as trans in America. “Contrary to trans persons’ hopes that medicine and society can fulfil their aspiration to become a complete man or woman, this is not biologically attainable ... It is a rare gender-dysphoric young person who has no associated psychiatric diagnosis or symptoms suggesting one,” he said.

Levine also told the court that because trans activists attacked critics as transphobic, few dared speak out. He said: “Critical and cautious voices are shouted down as transphobic, hateful and engaging in conversion therapy. Such a climate has created an intimidating and hostile environment where silence and acquiescence are the inevitable consequence. It is left to those of us at the end of our careers, who have nothing to lose, to voice our concerns.”

John Whitehall, professor of paediatrics at Western Sydney University in Australia, another expert witness, said that information given to families attending the Tavistock clinic “does not appear to share with confused children and their parents and carers the statistical assurance that almost all confused children will revert to an identity congruent with chromosomes through puberty, that ‘puberty blockers’ and cross-sex hormones have structural effects on the brain, and the warning that the rate of suicide in adults is significantly higher after transgendering.”

The UK is one of the pioneers of treating children for gender dysphoria with drugs. In America, where puberty blockers and surgery are readily available to children, there has been a push by Republicans for more regulation. South Dakota and Florida are among states that have tried and failed to criminalise it.

The Tavistock clinic said: “GIDS [the Gender Identity Development Service] is a safe and thoughtful service which puts the best interests of its patients and their families first. We have sought permission to appeal the judgment, and so won’t comment on ongoing proceedings.”

Chris Gill berg really knows his subject. He's an international expert with decades of experience in this field.

We will look back on this in years to come and will not be able to understand how this was allowed to happen.

Galaxy - We will look back on this in years to come and will not be able to understand how this was allowed to happen.

I agree with this wholeheartedly.

It is a very worrying situation; reading this makes me worry all the more. My dear relative who is in this situation does indeed exhibit some autistic traits - awaiting full assessment at the moment. I feel desperate that no irrevocable or potentially harmful treatment should begin at this stage of life. Already the pill is being used to suppress periods.

It is a desperately worrying situation - a vulnerable child has latched onto something to explain their distress and needs to be able to let it go without permanent damage if they change their mind.

I cannot begin to tell you how desperate we all feel about this at times.

This must be very concerning for those in this situation. Let's face it, adolescence can seem overwhelming with the worries it can bring and changing sex seems like a permanent solution to a temporary problem. Many of these experts seem to have disappeared down a rabbit hole and are taking distressed youngsters with them. Very sad.

It is very concerning - I am worried sick.

Luckygirl am so sorry your family is going through this I am sure you already know but there are many parents on MN who are going through similar who can provide support and just someone to talk to.

Oh Luckygirl I can only imagine your worry over this.
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I read with interest the child who had treatment, describing themselves as human guinea pigs. Teenage opinions are so forceful it must be very hard to challenge their conceptions about themselves without offending and upsetting them. That said, the young adult in question was sad, recognising too late that the triggers were tied into a mental illness and said counselling would have been better than hormones and surgery.

Luckygirl I hope this court ruling will mean that help for your relative is more likely to mean counselling which actually addresses their problems.

One of my g.children, when they were 15 year old, announced firstly, that they were gay - then, a few months later, that they actually were a boy in a female body.

They are now 17 yrs of age, and also been diagnosed with autism. At present they have no idea as to their sexual orientation - (note I use, as they wish - the pronoun They). They do wear skirts quite often, but also keeps a binder on their breasts!!!

Our whole family are very laid back about these things, so they had total support, not only from their parents but also from the very extended family. Only thing my daughter stopped at permitting was any sort of drug treatment.

The family finally got an appointment with Tavistock Clinic, and found it very disappointing. Throughout the first one, the people there just kept on asking the teenager about what family opposition they had received, and how they coped with it. Even with the patient, themself, saying that there had been no opposition, only complete support did not seem to change them.

During these years, my daughter (the child's mother) has actually set up, a regular meet-up for teenagers (under 18yrs) in the local area and the whole family (Mum,Dad, siblings) have all been really active in the local LGBT group).

As my g.daughter nears their 18th birthday, there are now more concerns as to whether they will start to go through any sort of gender changing drugs, etc. They are finding life very confusing at present, -complicated even further by this years events).

Franbern - your GD's situation sounds very similar to ours; and we are all, indeed, supportive to the child involved and have reassured them that, whatever they decide, they are loved unconditionally by us all. They have had suicidal actions in the past and this is why it all feels so fraught.