22 September 2020
Today NHS England announced a wide-ranging review into its support for children with gender dysphoria, led by Dr Hilary Cass OBE, to ‘ensure that the best model(s) for safe and effective services are commissioned.’ We really welcome this, and thank Dr Cass for her willingness to take it on.
The review’s Terms of Reference note that referrals to GIDS have risen during a time when the service ‘moved from a psychosocial and psychotherapeutic model to one that also prescribes medical interventions by way of hormone drugs’. The announcement of a review answers the request of parents for an independent look at whether the resulting treatment pathways – established to support young people with early childhood-onset dysphoria, before the more recent dominance of complex adolescent-onset cases – are still right today. It also delivers on the long-overdue government commitment for an exploration of why the numbers of girls suffering distress about their gender have grown sharply in recent years.
It is right that the review will not be limited to GIDS, but will also consider CAMHS and other specialist services. Two issues that merit consideration are not mentioned. Firstly, the transition to adult services, including the age threshold. It is essential that the NHS delivers developmentally-appropriate care to adolescents and young adults. Secondly, waiting lists and the affirmative management of gender dysphoria have created a worrying market for the private supply of hormones to young children with almost no clinical input.
We recognise, as do the Terms of Reference, that this review would not be happening had there not been significant public interest in this area of the NHS’s work. And so, we parents express our deep gratitude to the citizen campaigners, clinicians, journalists and others who have shared our concerns for the safety of our children. At the same time, we commend the responsiveness of the NHS to these concerns, in setting up this review: it is a sign that the system is working (albeit the GIDS contract expired six months ago).
About 200 families have approached us since we set up our group only a year ago. Supportive mums and dads from all over the UK, whose children – usually in their teens, and often in the context of other significant difficulties – have renounced their identities and set about a project to reinvent their bodies. We don’t know if this work will be implemented in time to benefit our own children, but we will watch with interest as Dr Cass’s work takes shape, and we wish her luck.