Letters to the Editor: Trans clinic is failing vulnerable children The Sunday Times. 17.11.19

The original letter is here.

Your article “Sex-change sorrow” (News Review, last week) highlighted the Tavistock Centre, England’s only clinic devoted to treating transgender children. I am the governor who resigned from the Tavistock board after Dr David Bell wrote a report containing staff concerns about the rush to medical intervention, which bypassed thorough psychological evaluation.

I did so because I believed the trust tried to bury these important concerns about an experimental treatment of vulnerable children. It also displayed its prejudice by trying to discredit Dr Bell, a respected clinician, and the staff he spoke to.

The treatment of gender- dysphoric children has become highly politicised and, in many ways, operates outside good medical practice. There is pressure to view patients as consumers who have a choice over their gender, rather than people with underlying conflicts about themselves and their relationship with society.

In the absence of long-term outcome studies, services often quote Dutch research that found positive results for transition, ignoring the small size of the cohort. Ten other studies show that 80%-90% of gender-dysphoric children desist in their wish for social or medical transition if given psychological support.

We do not know why there has been such a rapid rise in late-onset gender dysphoria in girls in the past five years, and we show little interest in the damage done by treatment. When I was governor, the Tavistock was not following up children it had seen, and yet we are carrying on as if we know what we are doing.

The mental health services will look back at this episode as another dark chapter in the treatment of people with psychological difficulties.
Marcus Evans, psychoanalyst, former deputy clinical director in adolescent and adult clinical services at the Tavistock and Portman NHS Trust

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