Gender Identity Development Service

In the late 2010s, the GIDS became controversial because of growing public attention on trans issues and concerns about the service, including a huge increase in patients and a lack of longitudinal evidence to support the treatments it gave.

In July 2022, the NHS decided to close GIDS and replace it with regional healthcare centres, following the release of the interim report of the Cass Review, in order to reduce waiting lists and provide better quality care to young people.

In 1948, with the creation of the NHS, the Tavistock Clinic launched its children's department, which developed many works by James Robertson and John Bowlby on attachment theory.

[9] In its early years, the service took a primarily psychoanalytic approach reflecting object relations theory, drawing from Di Ceglie's training.

[7] In 2016, the Women and Equalities Committee released a report which said that a number of trans advocacy groups had raised concerns that patients could not access treatment quickly enough and under current protocols and that Gillick competence was not being observed.

[20] In February 2019, it was revealed that the National Institute for Health Research (NIHR) had announced a £1.3 million grant for a voluntary study following young people referred to GIDS, to compare outcomes for those who elect to medically transition and those who do not.

[1] Critics raised concerns about the service, including the role of trans advocacy groups in clinical decisions, a lack of longitudal studies supporting the prescription of puberty blockers to TGGNC youth, and allegations of rushed treatments without sufficient prior consultation and assessment.

[35] The report was highly critical, saying GIDS was "not fit for purpose", could result in "damaging consequences" to children's lives, and failed to fully consider a child's mental health background.

[36] Since releasing his report, Bell has said that some children who identify as trangender might resolve their gender dysphoria without the need for gender-affirming care if other troubles, such as internalised homophobia and intergenerational trauma, were addressed.

[37] Dr Marcus Evans, a longstanding member of the Tavistock and Portman NHS Foundation Trust governance board, resigned that week in response to Bell's report, which he supported.

[38] Marcus Evans went on to co-found the Society for Evidence-Based Gender Medicine, which the Southern Poverty Law Center described as a hub of anti-LGBT pseudoscience.

[39][40] In July 2020, it was reported that Sonia Appleby, the "Named Professional for Safeguarding Children" at the gender identity clinic, had been in dispute with her employers since November 2019.

[42] In September 2021, Appleby was awarded £20,000 by an employment tribunal which found the Trust's "quasi disciplinary treatment" of her had damaged her professional reputation and "prevented her from proper work on safeguarding".

In a judgment delivered on 1 December 2020, the judges said that it was "highly unlikely that a child aged 13 or less would be competent to give consent to the administration of puberty blockers", and that it was "doubtful that 14 or 15 year olds could understand the long-term risks and consequences" of this form of treatment.

[49] Amnesty International and Liberty issued a joint statement emphasising their concern on "the wider implications this will have on the rights of children and young people of all genders, particularly on consent and bodily autonomy.

The report said the existing model was "neither safe nor viable", partly as the rise in referrals had left GIDS staff overwhelmed and led to "unacceptable" waiting times, and recommended the creation of a new network of regional centres.

[54] It criticised the care at GIDS, saying that its clinical approach "has not been subjected to some of the usual control measures" expected of an innovative treatment and sidelined the patients' other mental health needs.

[63] In February 2023, Newsnight journalist Hannah Barnes published a book on GIDS, titled Time to Think: The Inside Story of the Collapse of the Tavistock's Gender Service for Children.