Thirty-five psychologists have resigned from the children’s gender-identity service in London in the last three years as there has been an exponential increase in referrals for gender dysphoria in the last decade, according to a British television news report.
Sky News reached out to 20 of the 35 psychologists who resigned in the last three years from the National Health Service’s Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust in London.
The Tavistock and Portman NHS Foundation Trust is a clinic where children as young as three come to receive puberty-blocking drugs and cross-sex hormone treatment, which can have life-long effects on children.
The six former NHS psychologists who spoke with Sky News expressed concerns about the over-authorizing of hormone treatment to children with gender dysphoria and felt they couldn’t properly explore underlying psychological factors.
Their resignations come at a time when the number of children referred to GIDS for gender dysphoria has increased from 77 in 2009-2010 to 2,590 last year, according to Sky News’s research.
As a result, the caseload for clinicians at NHS is “three times higher than the average” health service at about 120 to 130 per junior clinician, one psychologist told Sky News.
Additionally, over 3,000 kids are on a waiting list for the GIDS. Kids who have been referred to the clinic will have to wait as long as three years to receive an appointment, according to The Guardian.
"Our fears are that young people are being over-diagnosed and then over-medicalized,” one psychologist told the outlet, asking to remain unnamed.
"We are extremely concerned about the consequences for young people. ... For those of us who previously worked in the service, we fear that we have had front row seats to a medical scandal."
The psychologist explained in an interview published in a short documentary that on one occasion she was working with an NHS executive who decided to refer a young person for hormone-blocking treatment after two appointments.
The psychologist said that the patient had a history of trauma and suffered from “other things happening to them,” such as abuse.
“This was not really explored by the clinician,” she said.
The psychologist said that she didn’t feel she was able to voice her concerns and that when she did, she was “often shut down by other affirmative clinicians.”
"Looking back, there are young people who I now wouldn't necessarily put on medication,” the psychologist stressed.
Another psychologist told Sky News that “therapy is not an option in this service.”
Another said: “We fear that we have had front row seats to a medical scandal.”
In a statement, GIDS assured that psychologists “have regular supervision sessions where they can discuss any concerns.” The service added that it “supports every young person on a case-by-case basis, as an individual.”
“There are numerous other forums in which to raise issues and concerns," the GIDS statement reads. "GIDS takes a considered and thoughtful approach, and supports clinicians to engage openly and supportively with patients and parents.”
GIDS conducted exit interviews with all departing staff to understand their reasons for resignation, according to the statement.
"The work is demanding and the pressures of operating in a busy service facing a high level of unfair criticism are intense,” the statement added.
For its documentary, Sky News interviewed Thomasin, a 19-year-old who spent many of her teenage years identifying as a male. Although she was diagnosed with gender dysphoria by GIDS at the age of 17, she never medically transitioned and has since de-transitioned back to living as a female.
"Mainly the thing that was fueling me was that I didn't fit in and I didn’t know anything. And then I was slowly drip-fed this idea that you could change sex," Thomasin explained.
“I wanted to have hormones and be a man, have top surgery and go down beaches topless and living my life like that.”
Sky News reports that about half of the children referred to GIDS are put on hormone blockers to block the impact of puberty on prepubescent children before they can begin cross-sex hormone treatment at the age of 16. But doctors have warned that going through hormone therapy and even puberty suppression can have an irreversible impact on the health of a child.
GIDS Senior Clinician Bernadette Bernadette Wren was also interviewed for the documentary. Wren said that the clinic fully informs children about the consequences in their teenage years.
“The work that we do to really inform these young people as fully as we can for what this means … for them physically, what the irreversible impacts [are], what are the impacts on fertility, what are the possible impacts on their sexuality, relationships in the future,” Wren said.
“The young people who perhaps come to us and thought they would like to review their decision, they always said that they felt that we have done everything that we could to make clear to them the gravity of the choice that they are making.”
Fueling the rise in children being referred for gender services in the U.K. is a drastic rise in biological females coming forward to seek therapy. Sky News reports that the proportion of patients referred to GIDS who were female at birth has risen from 44 percent to 77 percent in the last decade.
“The numbers started growing from 2012, when we started seeing more females coming forward,” the unnamed psychologist said in the documentary. “This has happened across the Western world.”
The psychologist was asked by the interviewer if she felt that she was able tell a parent that she didn’t believe their child was transgender.
“No,” the psychologist said. “This is one of the reasons why I decided to leave the service. As a psychologist, I felt if I ever spoke to a family like this, I would immediately be called ‘transphobic.’’’
In July, the 50,000-member Royal College of General Practitioners warned about the lack of “robust evidence” on the long-term effects of puberty-blocking drugs and cross-sex hormones.
“There is a significant lack of robust, comprehensive evidence around the outcomes, side effects and unintended consequences of such treatments for people with gender dysphoria,” the RCGP policy statement reads.
The RCGP statement warned that the lack of evidence prevents doctors from “helping patients and their families in making an informed decision.”