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This is a detailed case study of the Tavistock's Gender Identity Development Service (GIDS) for children, from its opening at St. George's Hospital, South London, in 1989 under the leadership of Dr Domenico Di Ceglie, to the announcement, in July 2022, by NHS (National Health Service) England, of its closure. This service was for children whose gender identity didn't seem to match their biological body, a condition called “gender dysphoria”. The book is a compelling, even-handed, and disturbing read.
BBC Newsnight journalist Hannah Barnes describes the metamorphosis of GIDS, which had twelve referrals in 1994 and provided “a unique and safe space for children and their families to talk through their gender-related distress”, to a service with more than 2,000 referrals in 2016—a fast-track route to endocrinologists for the prescription of puberty blockers. This frightening description is interspersed with accounts of the experiences of seven service users. These are varied, some children happy in their new gender, others who are struggling, and one who “de-transitioned”.
Barnes outlines the conflicts within GIDS, as well as within the wider Tavistock and Portman NHS Foundation Trust and NHS England. She details the split amongst GIDS staff between those who were comfortable with the services provided and those who were concerned that children might be being harmed. The levels of distress of the referred children were high and an audit in 2000 showed that about 70% had more than five “associated features”, in addition to their concern about their gender. Amongst these features were autism, difficulties in family/peer relationships, depression/misery, family mental or physical health problems, traumatised backgrounds, suicidal feelings/threats, and the possibility of physical or sexual abuse.
Concerns include the small number of assessment appointments prior to referral for puberty blockers, and the known and unknown risks, such as infertility, involved with taking blocke