Referrals to the Gender Identity Development Service (GIDS) level off in 2018-19

28 June 2019

The Gender Identity Development Service (GIDS), the NHS national service aimed at under-18s, has seen an increase of just 6 per cent in the number of young people referred to the service in the financial year 2018-19, compared to the previous year.

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In 2018-19 there were 2,590 referrals received at the clinic. This represents a 6 per cent increase compared to the previous year which had 2,444 referrals.

Prior to this year, there had been significant increases in referrals year on year, with a particularly notable doubling of referrals between 2014-15 and 2015-16.

GIDS is a highly specialised clinic for young people experiencing difficulties with the development of their gender identity. Some people feel discomfort or distress with the sex they were assigned at birth. These feelings may or may not change or develop over time. We help the young people who come to our service explore their feelings and their priorities, gain accurate information about different options, and choose the path that best fits their needs and their lives. We work with each individual on a case-by-case basis, with no preconception of what might be the best outcome for any given young person.

In England in 2018-19, 1,740 of the referrals were for young people assigned female at birth, and 624 were for those assigned male at birth. This continues the trend of a higher proportion of assigned female referrals seen at gender identity services, which is also being seen internationally. At GIDS we are alive to this issue, and have published research on this topic along with other international services. More research is needed in this area.

We work with every young person who comes to our service individually regardless of the sex they were assigned at birth, taking a case-by-case approach to explore the best outcome for them. The distribution of ages at which young people are referred to the service remains similar across the last ten years, with more young people referred in the age range 14-16 compared to the ages 3-10.

Dr Polly Carmichael, Gender Identity Development Service Director and Consultant Clinical Psychologist, said:

“We appreciate how distressing it can be for young people and their families who are waiting to be seen and continue to prioritise exploring ways to reduce the waiting list whilst not compromising care. The long-term health and wellbeing of the young people that we see is always our top priority. It would appear that we are now looking at a levelling off of referrals. Whilst we still have a substantial waiting list, this levelling off, if sustained, should allow us to more effectively anticipate the resources required to reduce waiting times. This is positive news for the young people and families referred to the service.”

“The reasons why we had previously seen sharp year on year increases in the number of young people referred to the service is unclear. In part it is likely to reflect greater awareness of support available for young people experiencing difficulties and distress around their gender identity development. The approach of the service is to work with individuals in a careful and considered way, whilst being well aware of potential emerging trends and the need to reflect this in the support we offer.”

“We are continuing to see a much higher proportion of assigned females at birth referred to the service. We are alive to this issue, and are exploring it. We continue to treat each referral on a case by case basis and explore with each young person and their family their feelings about their gender and how these relate to their wider development. What is clear from the work we do is that there is no single pathway for young people presenting to the service and many elements need to be taken into account in decisions about which path may be best for them.”

The figures – referrals to GIDS, 2009-10 to 2018-19

Total referrals, 2009-10 to 2018-19

These figures represent all referrals to GIDS, including those that were rejected due to age or other factors, from all countries that refer to the service. These figures were generated on 25 June 2019.

In 2017 we moved to a new electronic patient record system called Carenotes. As of this year, we will be using the reporting function from that system to produce the numbers for our referral figures. As a result of moving to this new reporting system, the numbers for those referred in previous years have changed slightly from those given out in previous years. However, the trends in referrals across time are unaffected by these adjustments.

GIDS total referrals FYs 2009-10 to 2018-19
GIDS total referrals FYs 2009-10 to 2018-19 graph

Age at referral, 2018-19

England only, including rejected referrals, generated on 25 June 2019 from CareNotes [Please note that we have combined the ages 3 and 4 to avoid publishing numbers equal to or under 5, which in some cases might identify or single out patients].

GIDS age at referral England only FYs 2009-10 to 2018-19

Sex assigned at birth 2009-10 to 2018-19

England only, including rejected referrals, generated on 25 June 2019 from Carenotes. Referrals made in 2018-19 are still being processed, so this is not known yet in all cases

GIDS total referrals FYs 2009-10 to 2018-19

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Gender identity development service (GIDS)

For children and young people, and their families, who experience difficulties in the development of their gender identity.