Clinically Insane

In her new book, Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children, journalist and investigative reporter Hannah Barnes examines the rise and fall of Britain’s Tavistock Gender Identity Development Service (GIDS) for children with gender dysphoria. Barnes highlights how the GIDS transformed from being a counseling service for children struggling with gender identity issues to a pill mill for prescribing puberty blockers and cross-sex hormones. The Tavistock Gender Identity Development Service (GIDS) was founded in 1989 as a counseling service to help and support children struggling with gender identity issues and their families. It was accredited by England’s National Health Service and was the only gender clinic for children in the country.

Over the years, GIDS began receiving a growing number of referrals, with many more natal girls seeking help as they neared puberty. In response, the clinic reduced requirements for psychosocial assessment of patients and reduced the age for prescribing puberty-blocking drugs, as well as becoming a significant source of revenue for the Tavistock and Portman health trust. However, many GIDS staff raised concerns about the impact of gender-affirming procedures, such as puberty blockers and cross-sex hormones, on children’s mental health, bone density, brain development, and ability to give informed consent. Furthermore, groupthink, political pressure, and revenue generation led to blind spots for even the most well-intentioned professionals who might have spoken up. Consequently, those who did dare to question the practices risked being labeled transphobic and ignored.

Following investigations by BBC journalists, critical court decisions, and an NHS-instigated inquiry by a leading pediatrician, the Tavistock gender clinic is closing. Yet Barnes’s work raises significant lingering questions about the politicization, medicalization, and commercialization of transgender treatments for children, as well as the responsibility of safeguarding children’s best interests. For instance, events at Tavistock mirror what is happening in the United States, where trans activists push to shut down any questioning of medical intervention for children with gender dysphoria. Parents, physicians, and activists push for gender-affirming treatments without considering the long-term implications. However, amid this wave, we should consider who is going to take responsibility for objectively deciding what is in the child’s best interests.

Review: Tom Rawlings is an Atlanta-based attorney and principal of Child Welfare & Justice Transformation, International.