There are currently "no locations, no staff, and no services" in place for trans young people in Britain, just weeks ahead of the closure of the country's only dedicated children's gender identity clinic, NHS sources have told VICE World News.
Last July, NHS England announced that the Tavistock clinic would close “by Spring 2023” and it would be replaced by at least two regional service centres, after it was criticised in an independent review.
However, three NHS doctors have told VICE World News that this deadline, and even a potential June extension, are now “totally unachievable.”
“There are no employees signed up to move, there is no training for wider NHS staff, and our waiting lists are paused. The reality is that we have to accept there is currently no NHS service for transgender young people, and there is unlikely to be any service made available to them in the near future,” one senior doctor said.
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The senior doctor, speaking on the condition of anonymity in fear of a backlash from anti-trans groups, added: “All I can really do now is wrap these trans kids up in cotton wool through these difficult years with no support, and then get them as ready as possible to get into adult gender services when they hit 18. It’s hard to not think that this was a deliberate act by NHS England, and they’re deliberately hurting trans children for a political win.”
The original clinic – named the Gender and Identity Development Service (GIDS) by the Tavistock and Portman NHS foundation trust – was launched more than 30 years ago to help children and young people struggling with their gender identity. However, with trans lives being debated with more hostility over recent years, the Tavistock’s work has been criticised, with frequent attempts to shut down its services.
Some LGBTQ campaigners initially saw the new regional model as a positive, as it would involve more services being spread out across the country, meaning young people could see gender specialists without needing frequent expensive and exhausting trips to the capital, or its northern clinic in Leeds. However, some specialists involved in the move have told VICE World News that they believe the centres may not happen at all.
The senior doctor who spoke to us anonymously added: “NHS management were like ‘we're hoping that this new trans kids’ service will be launched in April 2023.’ But we’re in February now, and nothing’s been done, so are you joking? The resources, the skills, and the people are just not there. They just don't exist.”
They continued: “I think it was very short sighted to shut down the Tavistock without having an adequate replacement in place. There should have been a much more phased rollout to these things, perhaps five years or longer, so services at the Tavistock could gradually be scaled back, alongside some new regional services being brought up to speed.”
Another clinician, who has recently decided to quit the NHS to work privately within the gender space, added: “I would be surprised if the new services outside of London are even ready this year. They’re not only delayed, they’re flawed and set to fail.”
The new regional centres were promised to reduce waiting times, after an independent review said the Tavistock clinic needed to be transformed. In 2021 the Care Quality Commission watchdog rated the service overall “inadequate,” citing high caseloads and poor leadership.
While some gender-critical groups celebrated the Tavistock closing, and it was labelled “a win for the anti-trans movement”, the author of the review clarified that “the purpose of the regionalised model is to improve access, networked care, research capacity and workforce development.”
The waiting time to be seen for an initial appointment at the Tavistock was notoriously lengthy, with some believing there are over 5,000 young people in line, each waiting for several years. While the true number is now unclear because of referrals being paused ahead of the clinic’s closure, the GIDS website says its team is currently only now seeing young people who were referred in 2019.
Even though the original NHS England goal was “to be operational by Spring 2023” – which doctors have told us “can’t be met” – a representative from NHS England told VICE World News that work is continuing to deliver the new centres on time. Asked if the NHS is still assisting trans young people with gender care, the spokesperson replied “yes”.
Clinical staff working at GIDS, along with those involved in admin and research have told me that they are “disgusted” by the lack of communication around the upcoming closure, particularly in relation to their own jobs.
“We’re six months down the line, and NHS England has still given us no indication whatsoever about what’s happening to our jobs, or our pay, and whether we’ll be able to transfer into the new services. We have mortgages, we have families, and we’ve been told that our service is closing without any idea about what’s happening to us next,” said the clinician working at GIDS, who agreed to speak on the condition of anonymity because they feared a backlash from anti-trans campaigners.
“As a result, lots of people have resigned and left the service, and that’s meant we’re even more under-resourced and we’re struggling with our growing caseloads. Trans young people are being failed by NHS England because of this move. They said by the end of March we would have new services up and running to move these young people into, but that’s never going to happen. Some said June would be the new deadline, but even that won’t happen.”
Another doctor questioned whether the expertise needed for the new centres even exists in the UK, now that “the best specialists have been pushed out.”
“We’re losing staff with years and years of experience dealing with transgender kids, and children dealing with gender identity problems, and this is not the kind of stuff that everyday doctors would see as part of their work. Trying to recruit qualified people into these services is an absolute nightmare,” said the clinician, who also spoke on the condition of anonymity.
“You can’t just upskill people, so to recruit people with all of these skills that are willing to live in random parts of the UK, they’re probably going to need to recruit from overseas. NHS England is hoping for the best, but it’s already at the worst and not changing any time soon.”
They added: “And while I’m stressing about potentially being made redundant, I’m having to help families who are hugely uncertain about their gender services continuing, with severely distressed young people.”
The doctor believes that the service would not be able to close this spring anyway, because the NHS trust “hasn’t served the 6 month notice to close it down”, meaning that any closure would be postponed until at least August 2023.
Staff told VICE World News that NHS England bosses have only come to speak to them “once in the entire six months since the closure was announced” and representatives “dodged every question”.
The senior doctor – who said no employees were signed up to the move and who has several young patients questioning their gender – told me: “Children haven’t stopped coming out as trans just because the Tavistock is closing. GPs are still needing to make referrals, but our forms are effectively just being held in a virtual filing cabinet, waiting for the new gender services to come online. But when will that be? These children need help.”
Responding to the testimony by the three doctors, Jolyon Maugham, director of the Good Law Project – which has advocated for trans rights – said: "The NHS swore in a witness statement that 'sustained efforts are being made to address' waiting times. However, the reality looks to be a complete withdrawal of all services for young people."