Gender variant children and young people need access to specialist services
14 January 2016
The transgender equality report points to some important issues and signals that the needs of gender variant people are being taken seriously at the highest level.
We support the call for better understanding amongst professionals of the issues trans people are facing in health, social care, education and other publically provided services.
Here at the Tavistock and Portman NHS Foundation Trust, our specialist Gender Identity Development Service works with children and young people who require support in the development of their gender identity. We work in collaboration with the network around the young people – this includes regular contact with local health services and outreach work in schools. We run frequent training events to help to build capacity and understanding amongst the professionals these young people come into contact with.
The transgender equality report also calls for a move away from the protected characteristic of “gender reassignment” to that of "gender identity", which fits more with the way we see and think about gender issues here and reflects that there are a greater number of gender identities emerging amongst young people.
While we are a mental health trust, we certainly don’t think about gender identity issues as a “disease” or a “disorder of the mind” as the report alludes to; we also don’t work in a rigid, diagnostic way. This is true for all the services we provide. The staff at our Gender Identity Development Service form a specialist, integrated inter-disciplinary team, which includes psychologists, endocrinologists, endocrine nurses, psychiatrists and psychotherapists. We believe that being an integrated team, led from within a mental health trust, is crucial for effective treatment.
The children and adolescents referred to us are expressing issues concerning their gender identity. In some cases, there are also issues such as social withdrawal, anxiety, low mood, self-harm and suicidal thoughts. In addition, a considerable number of young people referred to us are on the autistic spectrum, while others have significant associated mental health difficulties which need to be considered alongside care for their gender dysphoria.
Our highly specialist staff work therapeutically with children, young people and their families to provide the psychosocial support they may need during this period of consultation and exploration when they are making important choices affecting their future. This assessment and intervention is absolutely critical for ensuring young people are in the best position to make informed decisions. It has to be remembered that a proportion of the young people we see do not persist in asking for medical intervention and that the outcomes in gender identification are diversifying, as are young people’s choices about the care they feel would be helpful.
The report acknowledges the “hugely important” and “pioneering” work of the Gender Identity Development Service and reports on the increased demand for the clinic’s services – which we’re addressing.
It's true, the world moves on quickly and it’s important that we continue to consult on and discuss these issues; it’s the only way we can ensure we can provide high quality services which meet the needs of the young people we see here.