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UK under-18 gender identity services most ‘cautious’ in world

Vic Parsons July 18, 2019

The Equality March in Krakow, Poland in 2019. (Beata Zawrzel/NurPhoto via Getty Images)

Children with gender identity issues go through one of the most “cautious and painstaking” processes in the world when accessing healthcare on the NHS, say experts from the UK’s gender identity development service.

Dr Bernadette Wren, head of psychology at NHS England’s gender identity development service (Gids), said in an interview with the BBC that the UK’s gender-identity development service for children and teenagers was internationally seen as one of “the most cautious, painstaking and thoughtful.”

Wren added that young patients currently have to wait around two years after being referred by their GP to see a gender-identity specialist, and that if they haven’t been seen by the time they turn 18 they shouldn’t have to join the waiting list for adult services.

In some parts of the country, patients have been waiting over three years for a first appointment at a Gender Identity Clinic (GIC).

Dr Polly Carmichael, consultant clinical psychologist, director of Gids and Wren’s colleague, said that helping children with gender-identity issues is “complicated” and that they need “help from all sides” as they are also likely to be dealing with mental-health problems.

“We think about all the needs of young people and try and work closely with local services to clearly manage risk around self-harm, and other difficulties, but also to raise awareness around gender issues,” she said.

“I think there is sometimes a danger there can be a split – if someone is presenting with issues around their gender identity, that local services perhaps think that’s going to be the answer to everything.

“Whereas in reality it’s a complicated picture that needs to be addressed from all sides.”

Public awareness of gender identity is increasing

The two experts also told the BBC that they had seen an increase in the popularity of social transitioning – where children and young people change some or all of their gender expression, name and pronouns — before having any treatment through Gids.

Fewer than half of those referred to Gids decide to have any physical treatments, they said, adding that most of those referred to them are aged 14-16 and won’t be provided with hormone blockers until they begin puberty.

Gids is based at the Tavistock clinic in London, where referrals of under 18’s have more than tripled since 2015-15.

Wren and Carmichael said the jump in referrals was probably because of greater awareness and acceptance of gender identity issues.

Part of this rise in awareness came in April this year, when Prince Harry offered his support to Mermaids, a UK-based charity that supports trans children and their families.

More: bernadette wren, gender identity development service, polly carmichael, tavistock clinic

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