NHS to close Tavistock child gender identity clinic

The NHS is to close the UK's only dedicated gender identity clinic for children and young people.

Tavistock and Portman NHS Foundation Trust has been told to shut the clinic by spring after it was criticised in an independent review.

Instead, new regional centres will be set up to "ensure the holistic needs" of patients are fully met, the NHS said.

The trust said it supported plans for a new model due to a rise in referrals.

The changes will take place after an independent review, led by Dr Hilary Cass, said the Tavistock clinic needed to be transformed.

The new centres - one based in London and the other in the North West - should be fully open in spring 2023 and would run in conjunction with leading children's hospitals, including Great Ormond Street and Alder Hey.

They will aim to help support young people under the age of 18 who are struggling with their gender identity, and be linked to mental health care and GP services where relevant.

There will be no immediate changes for people already under the Tavistock's care.

The Tavistock has faced increasing pressure in recent years.

There were rising referrals and a long waiting list but at the same time some former staff were raising concerns about the way it operated.

Then, former patient Keira Bell went to court saying she had not been challenged enough about her decision at 16 to take drugs that began her transition from female to male - a decision she later regretted.

Earlier this year, Dr Cass's report said there was a lack of understanding about why the type of patients the clinic was seeing was changing, with more female to male patients and more autistic children. Dr Cass also highlighted inconclusive evidence to back some of the clinical decision making.

The clinic's imminent closure will be a source of worry for other young people wanting support with gender dysphoria. The hope is the services that replace it will be more helpful, useful and efficient.

The Tavistock clinic, named the Gender and Identity Development Service (GIDS), was launched in 1989 to help people aged 17 and under struggling with their gender identity.

But in 2020, questions about the service were raised after it was rated "inadequate" by inspectors, following concerns raised by whistleblowers and reported by BBC Newsnight.

The service was criticised for its care of patients both inside and outside of the clinic, with the service dealing with record waiting lists.

Earlier this year, Dr Cass said the service was struggling to deal with spiralling waiting lists, was not keeping "routine and consistent" data on its patients, and more care needed to be taken to ensure rising numbers of neurodivergent patients seeking help from the Tavistock were being treated responsibly.

She then suggested introducing local hubs, writing that the current provider model "is not a safe or viable long-term option".

The number of people seeking the clinic's help is 20 times higher than it was a decade ago, jumping from 250 to 5,000 referrals in 2021, according to the service's statistics.

LGBTQ+ rights group Stonewall said it was pleased the NHS had decided to act decisively to address "unacceptable" waiting times faced by young trans people trying to access gender-identity healthcare.

A spokesperson added: "The creation of new specialist regional centres in London and Manchester next year, with more to follow, will go some way to addressing the strain experienced by having just a single, centralised service."

Keira Bell, who brought a High Court case against Tavistock challenging its use of puberty blockers, said she was "over the moon" at the announcement.

Ms Bell, 25, was prescribed puberty blockers aged 16 but later changed her mind over her decision to transition to male. She argued the clinic should have challenged her more over her decision to transition.

In that case, the High Court ruled under-16s lacked capacity to give informed consent to the treatment, which delays the onset of puberty. This was later overturned by the Court of Appeal who ruled doctors could judge if under-16s could give informed consent to puberty blocker use.

Ms Bell told BBC Radio 4 World at One: "I'm over the moon. Many children will be saved from going down the path that I went down.

"I went through a lot of distress as a teenager. Really I just needed some mental health support and therapy from everything that I've been through. There needs to be mental health support first and foremost."