Showing posts sorted by relevance for query Tavistock. Sort by date Show all posts
Showing posts sorted by relevance for query Tavistock. Sort by date Show all posts

Friday, December 08, 2023

UK
TORY REVANCHISM
Children will only be referred to transgender clinics if their parents agree

Michael Searles
Thu, 7 December 2023 

Susie Green, the former chief of the transgender charity Mermaids, bypassed GPs and sent children to the Tavistock’s clinic - Ken McKay/ITV/Shutterstock

Children will only be referred to transgender clinics if their parents agree, under a planned overhaul of NHS rules.

The health service is set to clamp down on the lax referral processes that have led to incidents such as Susie Green, the former chief of the transgender charity Mermaids, bypassing GPs and sending children to the Tavistock’s controversial clinic.

Teachers, social workers and GPs have all historically been able to send children to the Tavistock without having to gain parental consent.

Under the new plans, outlined in a public consultation document published on Thursday night, children will only be referred to one of the new gender services if they, their parents and a specialist agree that it is in the best interests of the child, in two separate reviews.

It is the latest in a series of proposals to overhaul the children’s services following a damning review by Dr Hilary Cass, the former president of the Royal College of Paediatrics and Child Health.

Dr Cass’s interim report found that the approach under the Tavistock, which was the sole NHS gender clinic for children, put its patients “at considerable risk” of poor mental health and was not “a safe or viable long-term option”.

Experts have criticised the clinic’s “affirmative” approach to treating children with supposed gender dysphoria, where they feel that they are not the same sex as they were born, and a lack of exploring alternative health conditions before putting children on puberty blockers.

The new documents confirmed that the Tavistock’s gender identity development service would be permanently closed from March 31 – a year later than initially planned.

It will be replaced by regional centres, with sites in London and Manchester set to be the first two to open in the spring.

The NHS has also committed to limiting the use of puberty blockers to a clinical trial, although more than 100 children have been put on the treatment in the almost 18 months since that announcement.

The proposals follow a review by Dr Hilary Cass, the former president of the Royal College of Paediatrics and Child Health

Under a new “referral consultation service”, children who may be sent on to a gender service, will have a “consultation, advice and liaison meeting”.

This will involve parents, clinicians and the child in question agreeing on the best path forward, deciding whether or not that involves a referral to a children’s gender service, and then creating a care plan with other services that can be accessed while on the waiting list.

The consultation document said these steps were necessary “in view of the relatively high number of children and young people who present to gender incongruence services with other complex needs, such as mental health needs, neurodiversity or autism”.

It added that it would also help address concerns raised by the Care Quality Commission “about the lack of support or risk assessment” for children on a waiting list.

Previously, children did not need parental consent to be referred to the Tavistock, and in some cases it was not needed to start puberty blocker treatment under Gillick competence rules, which allow clinicians to determine if a child is mature enough to make a decision themselves.

Despite plans to tighten the referral practice, the NHS did not row back on plans to introduce a minimum age of seven for a child to be referred, which was first revealed by The Telegraph.

It will also be temporarily introducing a maximum age of 16. Teenagers aged 17 can be referred to an adult clinic.

Any children who have already been referred to a gender identity service and are yet to be seen – of which there are as many as 8,000 – will not be subject to the new referral restrictions, the NHS said.

A spokesman for the NHS said: “These proposals are intended to ensure that children who may be experiencing challenges with their gender identity are properly connected to local services and that age-appropriate referrals are made to the new specialist gender service which will go live next year.

“In a separate consultation, NHS England has also proposed that the new specialist children’s gender service will not routinely be able to provide any medical intervention, including the use of puberty blockers, to children under 16 years of age.”

Thursday, July 28, 2022




Why the UK’s only gender identity clinic for children is closing and how the NHS plans to replace itEXPLAINED

The NHS said it is taking ‘immediate steps’ to establish two services led by specialist children’s hospitals instead

The Gender Identity Development Service (GIDS) clinic at Tavistock 
Tavistock and Portman NHS foundation trust, the UK’s only dedicated gender identity clinic for children and young people, is to close after an independent review criticised its services
 (Photo: Peter Nicholls/Reuters)

By Joe Duggan
July 28, 2022

The NHS is closing Britain’s only gender identity clinic for children and young people after a critical report found that having only one provider was “not a safe or viable long-term option”.

Instead, the health service will replace the Gender Identity Development Service (GIDS) at the Tavistock & Portman NHS Foundation Trust in London with a regional network.

The NHS is aiming to close the clinic by next Spring following an interim review led by Dr Hilary Cass. It intends to build a “more resilient service” by expanding provision through the network.

The NHS said it is taking “immediate steps” to establish two services led by specialist children’s hospitals in London and the North West, with a view to build a national regional network of around eight services “given the urgent requirement to stabilise current service provision for patients”.

It said the network will take a more “holistic” approach to treatment and examine other mental health or medical issues patients may present alongside any gender work.
Why is the clinic closing?

The Tavistock GIDS clinic opened in 1989 to help children under 18 who were struggling with their gender identity.


Thursday’s announcement of its closure comes after recommendations from Dr Cass, who is leading an independent review into gender identity services for children and young people.

Earlier this year, Dr Cass found that the number of children seeking NHS help “is now outstripping the capacity of the single national specialist service” and there was a need to move away from the model of a sole provider.

In her interim report, released in March, she wrote: “It has become increasingly clear that a single specialist provider model is not a safe or viable long-term option in view of concerns about lack of peer review and the ability to respond to the increasing demand.”
What problems have previously been identified?

Dr Cass’s interim report found the rise in GIDS referrals at the trust had left staff overwhelmed and under “under pressure to adopt an unquestioning affirmative approach”.

This had left young people “at considerable risk” of distress and deteriorating mental health, with the service struggling with long waiting lists.

In a highly critical report, the Care Quality Commission (CQC) told GIDS that their services and waiting times “must improve significantly”.

The CQC demanded a report of the number of patients on the waiting list, including monthly figures of new referrals awaiting an assessment.

A High Court case was brought against the Tavistock challenging its use of puberty blockers, a treatment offered to children and young people questioning their gender.

The case was led by Keira Bell, who was referred to the service at 16 and prescribed hormone blockers to pause her puberty. She underwent further treatment as an adult before deciding she no longer identified as transgender.

How will people get treatment after GIDS closes?

The NHS said it intends to build a “more resilient service” by expanding provision into a regional network, and is taking “immediate steps” to establish two services led by specialist children’s hospitals in London and the North West.

The health service hopes to have the services fully up and running by spring, 2023.

It described the two new services as the “first step” in a national regional network “given the urgent requirement to stabilise current service provision for patients”.

Altnough the final number in the network has not yet been confirmed, up to eight services could ultimately be put in place.
Where will the services be based?

One London-based service will be led by Great Ormond Street Hospital and Evelina London Children’s Hospital, with South London and Maudsley NHS Foundation Trust providing specialist mental health support.

A second service in the North West will be led by Alder Hey Children’s NHS Foundation Trust and the Royal Manchester Children’s Hospital, with both trusts providing specialist mental health services.

These two services will take over clinical responsibility for all GIDS patients, including those on the waiting list.

How much demand has there been for GIDS?


Over the past decade there has been a sharp increase in referrals to the clinic, with more than 5,000 in 2021/22, compared with less than 250 in 2011-12.

But as demand surged the waiting times for assessments lengthened, and the Cass review was commissioned in September 2020 to ensure that children and young people are able to access the best possible support from the NHS.

The NHS also highlighted a “lack of clinical consensus and polarised opinion” around the best model of care for children questioning their gender, as well as a “lack of evidence to support families in making informed decisions about interventions that may have life-long consequences”.

The NHS said the clinic in London is set to be replaced by regional centres which it hopes to open fully in the spring (Photo: Reuters/Peter Nicholls)

There had been a “dramatic change” in who was being referred, with more children registered female at birth, neurodiverse children and children with mental health needs.

The review’s interim report warned that many of those being referred have complex needs but that, once they are identified as having gender-related distress, other healthcare issues “can sometimes be overlooked”.

Its final report is expected in 2023.

What has the reaction been?


A Stonewall spokesperson said the organisation was pleased that “the NHS has acted decisively to address the unacceptable waiting times faced by trans young people in accessing specialist gender identity-related healthcare, by expanding the support it provide” following the interim Cass Review.

“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,” the spokesperson added.

Ms Bell said she was “over the moon” at the announcement the clinic would close.

A GIDS spokesperson said the service appreciated how difficult long waits are for young people seeking treatment, and the new measures represent “significant progress in expanding capacity” and that the trust supports the need for a more sustainable model amid the rise in referrals.

Following recommendations by Dr Cass, the NHS also said it will carry out clinical research to track under-16s who are on puberty blockers into adulthood in order to counter “polarised opinion and conjecture” with evidence.”

The NHS said it will ensure greater transparency around “the uncertain clinical benefits and longer-term health impacts surrounding their use”.

While the research is ongoing patients will continue to be able to access treatment, it added.

Tuesday, September 26, 2023

UK
Alice Litman’s parents speak of ‘torture’ of trans people left on waiting lists 
Alice Litman with short blonde hair, wearing sunglasses, black dungarees and a pink t-shirt, smiling as the sun shines on her

The grieving parents of Alice Litman, a transgender woman who is thought to have taken her own life after waiting almost three years for gender-affirming healthcare, have spoken about the “torture” trans people face while left on NHS wait lists in the UK.


An inquest into the death of the 20-year-old, from Brighton, who died in May 2022 – her family believe she took her own life after enduring a more than 1,000-day wait for an initial assessment at an NHS gender clinic – was opened on Monday (18 September). 


NHS waiting times for trans healthcare have been a serious issue for the community for a long time, and have been branded “unlawful” by some.


The family have now spoken about their belief that Alice would still be alive if she had been supported by the healthcare system. 

Speaking to Channel 4 News, her distraught parents, Caroline and Peter, shared their belief that their daughter had “lost hope [in the] battle” to try to get an appointment at the Tavistock and Portman Gender Identity Clinic, in north west London.


Litman’s mother, who worked as a psychiatrist for the NHS for 12 years, added: “It’s torture to be left on the wait list, to be left hanging [on] for so long with no end in sight and no power and no control over your destiny.” 


In an interview with Sky News, the couple said their daughter’s death should be a wake-up call. “Transgender people are hung out to dry,” they claimed.


“Alice was a smart, intelligent young person and she could see that no one was taking care of her, and no one cared.”


“My daughter was failed by the NHS and I don’t want other parents to lose their daughter, and for other children to lose their sister, the way that our family has done,” she said, according to a BBC report.

At the age of 16, Alice Litman told her family she wanted to be a woman, and was referred to the NHS Gender Identity Development Service in 2019, but was kept on a waiting list for 1,023 days for a first appointment.


In 2019, was also referred to Child and Adolescent Mental Health Services following a suicide bid. She was discharged the following year, the inquest was told, despite a second attempt to take her own life.


Peter Litman said of the long wait: “It’s kind of an act of aggression. If you know something’s there and you do nothing about it, it’s not a neutral act. It’s quite deliberate.”


On Wednesday (20 September), coroner Sarah Clarke said: “It seems to me that all of these services are underfunded and insufficiently resourced for the level of need that the society we live in now presents.”


At the hearing, The Tavistock and Portman NHS Foundation Trust, and Alice Litman’s GP, WellBN, accepted there was a delay but said there was no denial of life-saving emergency treatment.

The head of the gender identity clinic told the court that the number of transgender people needing gender-affirming healthcare was an “order of magnitude” greater than they could provide.


According to The Guardian, a spokesperson for The Tavistock said: “We were deeply saddened to learn of the death of a patient who was waiting to be seen at our gender identity clinic and offer our condolences to her loved ones.”


Information uncovered from a freedom of information request last year has suggested a 35-year waiting time for trans people seeking gender-affirming care.


The coroner said she would be writing to various NHS bodies to recommend ways of preventing future deaths. Adjourning the hearing, she added that she would deliver a narrative conclusion in two weeks’ time.