The U.K.’s largest pediatric gender clinic has been accused in a new book of medicalizing teens with comorbidities, including more than a third of patients who showed signs of “moderate to severe” autism.
The book, “Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children” by BBC Newsnight journalist Hannah Barnes, alleges that the the Tavistock Clinic, an NHS facility in the U.K. officially called the Gender Identity Development Service (GIDS), ignored evidence that 97.5% of children seeking chemical and surgical sex reassignment services had autism, depression, or other problems that may have explained their unhappiness.
“Some staff feared they could be unnecessarily medicating autistic children,” Barnes wrote.
After conducting over 100 hours of interviews with clinicians and patients during research for the book, Barnes found that staff at the facility sought to push a pro-transgender policy and, as one whistleblower put it, treated children who might not have been transgender as “collateral damage.”
According to the book, former staff said many children, including those with neurodevelopmental disorders like autism and ADHD, were unnecessarily prescribed drugs and even surgery. The book reports that less than 2% of children in the U.K. have an autism spectrum disorder, but approximately 35% of GIDS referrals “present with moderate to severe autistic traits.”
Children and adolescents on the autism spectrum are disproportionately represented among the large, newly emerging cohort of children claiming to be transgender. Over the past 10 years, there have been at least nine studies connecting Autism Spectrum Disorder (ASD) and transgender identities. Rates of autistic traits in these studies range from 5% to 54% among those with gender dysphoria, significantly higher than among the general population.
Some researchers believe the percentage of young girls with autism who believe they’re experiencing gender dysphoria is actually higher, and that many females who have autism go undiagnosed. Up until recently, autism was considered a “boy’s diagnosis,” affecting males-to-females by a ratio of 4-to-1. Experts now believe that girls’ autistic traits present differently, which may require a separate diagnostic criteria to detect.
A recent study published in 2022 used a mathematical model to predict the true male-to-female ratio, which they estimated as being closer to a 3-4 ratio. The study notes, “Eighty percent of females remain undiagnosed at age 18, which has serious consequences for the mental health of young women.”
Similar concerns among Tavistock staff were raised about unnecessarily medicating children who were gay. In 2012, GIDS surveyed adolescents who were referred to the clinic about their sexuality and found that over 90% of females and 80% of males identified as same-sex attracted or bisexual. As a result, some clinicians, including Anastassis Spiliadis, believed that GIDS was effectively providing “conversion therapy for gay kids,” and there was even a dark joke circulating amongst the team that there would be “no gay people left at the rate GIDS was going.” Barnes reports that when gay clinicians expressed their concerns to those in charge, they were dismissed as being too close to the work and therefore not objective. The clinic has disputed this claim.
According to the book, children as young as 10 were referred to the clinic for a prescription of puberty-blocking drugs after as little as 20 minutes of consultation, and others were referred without adequate investigation of co-occurring psychiatric conditions. A social worker Barnes interviewed estimated that as few as “2 or 3%” of children treated at the clinic would have stayed transgender for life if they had not been given the controversial drug therapy.
Children referred to GIDS were ten times more likely than the national average to have a registered sex offender as a parent, while 42% had lost a parent through death or separation, and 70% had more than five “associated features” such as anxiety, depression, abuse, self-harm, bullying, eating disorders, or suicide attempts.
Barnes reports that some staff at GIDS felt that children who would have reconciled themselves with the bodies they were born with were being denied that chance by the use of drugs. Dr. Anna Hutchinson, a senior clinical psychologist at GIDS, stated that the service quickly began to “accept everyone.”
Although puberty blockers were intended to give children “time to think” about whether they wanted to transition fully, Dr. Hutchinson realized that almost all of them ended up taking cross-sex hormones such as testosterone and estrogen, which have irreversible effects. When she recognized this, it was a “holy f***” moment for her.
“Because what are the chances of 100% of people, offered time to think, thinking the same thing?” said Dr. Hutchinson. “If the service was getting this wrong, it was getting it wrong with some of the most vulnerable children and young people.” She now believes that “some of those kids would not have identified as trans had they not been put on the medical pathway.”
“Of course, that doesn’t mean to say that identifying as trans is a bad outcome,” she added. “But what is a bad outcome is creating a cohort of people who are medically dependent who’d never needed to be. And not only medically dependent, but perhaps — we don’t yet know — medically damaged.”
She now describes GIDS as “scandalous in its negligence and scale.”
Barnes also chronicled how the transgender charity Mermaids put huge pressure on the clinic to refer children for drugs at a younger age and to recommend surgery. One clinician said they would be “absolutely attacked by Mermaids for just trying to stop and think with children.”
In the wake of a highly critical interim report in February 2022 by Dr. Hilary Cass, a highly respected pediatrician who was brought in by NHS England to examine the clinic, it was announced that the Tavistock will close this spring. Dr. Cass’s conclusion was that services were “not a safe or viable long-term option” and a “fundamentally different service model” was required.