Staff Quit Transgender Clinic Over 'Experiments' on Children

11.04.2019

The only NHS clinic in the UK that treats gender identity problems in children is risking a “live experiment” by sending hundreds of children for life-changing medical intervention without sufficient evidence of its long-term effects, experts have warned.

In an investigation into practices at the clinic, the London Times spoke to five clinicians who resigned from the service because of concerns over the treatment of vulnerable children who come to the clinic presenting as transgender. They believe that some children struggling with their sexuality are being wrongly diagnosed as “transgender” by the Gender Identity Development Service (GIDS) clinic.

All five former staff were responsible for deciding which trans-identifying youngsters should be given hormone blockers to halt their sexual development. The vast majority of those who begin blockers go on to irreversible cross-sex hormones once they reach 16.

The NHS specialists warned that vulnerable children and teenagers had been sent down the path towards transition before experts had time to assess the causes of their gender confusion.

An Oxford professor has also raised concerns about the safety of drug therapies used by the clinic, saying the treatments were “supported by low-quality evidence, or in many cases no evidence at all”.

The number of young people referred to the clinic in north London has soared in recent years. In 2010 there were 94 referrals. By last year there were 2,519. The youngest child sent there was aged three. The five clinicians interviewed by The Times are among at least 18 clinical staff who have resigned over the past three years.

In an internal review, seen by The Times, the GIDS admitted it needed to improve its referral system and the way it obtained and recorded informed consent before young people were sent for life-changing medical intervention.

“I felt for the last two years what kept me in the job was the sense there was a huge number of children in danger. I was there to protect children from being damaged,” one clinician said. “This experimental treatment is being done on not only children, but very vulnerable children,” another said.

All five said they believed that transgender charities such as Mermaids were having a “harmful” effect by allegedly promoting transition as a cure-all solution for confused adolescents. The charities deny the allegation.

The clinicians said they were often under pressure to refer young people for life-altering treatment, even though they did not always believe it was in the child’s best clinical interests.

The clinic said it used licensed precocious puberty drugs whose long-term effects were known and insisted that its service was safe and that, “in the growing evidence internationally on the outcomes . . . there is little reported evidence of harm”. “We always place a young person’s wellbeing at the centre of our work,” it said.

Under the clinic’s rules, a young person who has already started puberty may be referred for hormone blockers. These are physically reversible, insofar as the body will continue to develop if they are discontinued, but the long-term effect on brain development is unknown. Irreversible cross-sex hormones can be prescribed from 16.

Carl Heneghan, director of the Centre of Evidence-based Medicine at the University of Oxford, said: “Given paucity of evidence, the off-label use of drugs [for outcomes not covered by the medicine’s licence] in gender dysphoria treatment largely means an unregulated live experiment on children.”

The service insisted that its internal review “did not identify any immediate issues in relation to patient safety or failings in the overall approach taken by the service”.

The Times. April 8.