Recent reporting about our Gender Identity Development Service
23 July 2019
We are concerned at the biased reporting about our Gender Identity Development Service and the treatments offered to some of the patients who attend the service. GIDS is a thoughtful and safe service. It cares for young people at a vulnerable time in their lives. Our experience with this group of patients, which is a highly diverse group, indicates that the choice to do nothing is not neutral and may lead to significant harm. The service is thorough and systematic in its approach to exploring with the young people and families the best way of dealing with their distress and the implications of different choices.
The service is committed to increasing the evidence base that informs how to support young people experiencing distress around their gender identity. You can read about our Early Intervention Study on the GIDS website.
We strongly refute Newsnight’s portrayal of the study ‘Early pubertal suppression in a selected group of adolescents with GID’, known for short as the Early Intervention Study (EIS). Much of the evidence on which the segment relied was variously misleading, inaccurate and incomplete.
Data cited in the programme was largely drawn from non-peer reviewed, interim findings from a sub section of a very small cohort over a short period of time. The segment did not give appropriate weight to other available data. In our view, the programme did not adequately acknowledge the context around the distress experienced by the young people we see, the anxiety many of them feel as they enter puberty, and the options available to them outside the NHS, either privately or abroad.
The study was not undertaken in a vacuum but sought to address a genuine need and to examine if treatments, which were increasingly commonplace abroad and for which favourable outcomes had been identified in research, were the most appropriate course of action for some of the young people we saw. This treatment is offered in the great majority of established gender identity centres across Europe and the USA.
A great degree of thought and consultation with many experts in the field, nationally and internationally, went into the design of the study. The full results from this study, which only completed earlier this year when the youngest participant reached the point of making a decision about whether to move on to cross-sex hormones, are not yet published. We intend to publish in a peer-reviewed journal, in line with international best practice. However, our service has been sharing results about specific aspects of early intervention since 2014 with other professionals nationally and internationally and has published on some aspects, as appropriate, such as bone density.
We are disappointed with the assertions around a “significant increase in those agreeing to the statement I deliberately try to hurt or kill myself.” The data the programme had on self-harm are preliminary data from a very small sample and are too small to draw any generalisable conclusions. The research team considered the data at the time in light of their extensive clinical knowledge of the cohort, as all patients were seen regularly by mental health professionals working at the Tavistock, and they reviewed the evidence base published at the time. They concluded that there was no robust or generalisable evidence of harm that could be directly attributed to the treatment and that continuing to offer treatment and to collect further data was appropriate. The same paper suggested that partial data, including about 30 patients, showed a positive reduction in self-harm. Our considered opinion is that these numbers are far too small to draw final conclusions, and that both positive and negative shifts are seen. The changes in self-harm are, we believe, not interpretable, but if one takes the data at face value, the positive changes likely outweigh the negative.
The Care Quality Commission, our care standards regulator, and our national commissioners, NHS England, monitor our service very closely. The GIDS is one of the longest established services of its type in the world with an international reputation for being cautious and considered. Our clinical interventions are laid out in nationally-set service specifications.
For children and young people, and their families, who experience difficulties in the development of their gender identity.