The London clinic Tavistock, which – according to its own directors – had been offering a first-rate service in the diagnosis and treatment of gender dysphoria in minors, is profiled as a candidate to occupy the bench of defendants in a lawsuit that 1,000 patients are preparing against her, and that the law firm Pogust Goodhead will pursue.
According to a representative of the law firm, the lawsuit would concern the “effectiveness of prescribed treatments ” in the center, therapies that would have caused in former patients “physical and psychological wounds that will last for the rest of their lives”.
For the clinic’s authorities, this is just another bad news among the many that the northern summer brought you. On July, the British National Health System (NHS) announced that the facility will close before the spring of (2023. The government decision is a consequence of increasingly frequent complaints about the reductionist approach with which minors who had various disorders were treated there, and about irregularities in the diagnosis and treatment processes detected by an external investigator, pediatrician Hilary Cass.
“Diagnosis: Gender dysphoria (without much compromise)”
The Cass report reveals serious problems in the clinic’s procedures . First, he cites the pressure to which the medical team is subjected to adopt an “unquestionable affirmative approach” in the face of cases of alleged dysphoria – if a boy said he “feel” like a girl, it was not to be doubted: he was, and he was dumped towards the hormonal blockers of puberty. This, points out the specialist, goes against the standard process of clinical evaluation and diagnosis for which doctors are trained.
The doctor thus coincides with an observation made by the Multiprofessional Review Group – in charge of the NHS to supervise the implementation of assessment procedures and obtaining informed consent – which had detected in Tavistock a predominance of an “affirmative, non-exploratory approach, often guided by the expectations of the minor and his parents” and by the “degree of social transition that was reached because of the delay in providing the service”.
It is worth adding here, although Cass does not mention it, that the pressures also come from lobbies LGTB, such as Pink News, Gendered Intelligence and Mermaids, who sometimes “get ahead” of the doctor when giving the diagnosis of gender dysphoria, and who in fact impose their verdict. Sue Evans, a former psychiatric nurse at this center, was able to testify to this (see box).
The indiscriminate affirmation of the “desired gender” also includes the risk of real psychiatric problems being covered up – and neglected – by the “Once it is established that (minors) experience gender-related suffering, other important health issues that would normally be managed in local services are subsumed under the gender dysphoria label,” notes the researcher. .
On the other hand, Cass noticed, in the medical team at the clinic, “a lack of agreement and, in many cases, In many cases, an absence of open discussion about the degree to which gender incongruity in childhood and adolescence can be an inherent and immutable phenomenon for which the best option (…) is the transition” to the opposite sex. The minors were, in the author’s words, at the mercy of a kind of “clinical lottery”.
Hormonal blockers, not innocuous
The report also gives space to puberty blockers (gonadotropin releasing hormones), given to prevent the appearance of secondary sexual characteristics in adolescence. The idea is to “pause” it to give time to the minor, once reached the 18 years, to decide if he will undergo opposite sex hormone therapy and surgery.
“The most difficult question – warns Cass – is whether puberty blockers really give children and young people valuable time to think about their options, or if they don’t actually ‘confine’ them to a treatment path that culminates in the progression towards feminizing/masculinizing hormones, by impeding the usual process of sexual orientation and gender identity development”.
What is much clearer for the doctor is that this suppression of puberty can have a negative impact on brain maturation, with effects that she defines as “unknown impacts on development, maturation and cognitive abilities, if a child or young person is not exposed to the physical, psychological, physiological, neurochemical and sexual changes that accompany sudden increases in hormones in adolescence”.
Finally, the pediatrician includes critical observations of the centralized model of an institution that provided care 50 patients in 2009 and became 2. 500 in 2020 (with 4.2009 on waiting list). The problem, however, is not so much the long wait for patients, but rather that – according to specialists who worked at the clinic – this leads medical teams not to spend enough time in examining each case, to issue diagnoses of gender dysphoria of faster way and to put the patient on the path of hormone blockers and subsequent treatments.
According to Cass, the Tavistock model is not “a safe or viable option in the long term, in light of the concerns about the lack of supervision” by other physicians, “nor about the ability to respond to the growing demand”.
Will anyone be held accountable?
With the report in hand, the NHS appropriated the specialist’s suggestion to decentralize attention. Cass bets on regional centers run by “experienced pediatric care providers”, where professionals “maintain a broad clinical perspective to integrate care for children and youth with gender uncertainty within a broader child and adolescent health context”.
The NHS has therefore decided to create regional centers that address cases of presumed dysphoria and that are connected with mental health services and primary care. It also announced that, together with the National Institute for Health Research, it will design and put into operation the necessary infrastructure to investigate in depth the effects of puberty blockers.
In this new framework, the lobbies from the trans cause have come out publicly to welcome Cass’ recommendations and the NHS decision as a “win” because decentralization will help shorten the lengthy waiting lists, a phenomenon for which precisely these groups are responsible, for their pressure on medical teams to quickly – and erroneously – diagnose as “dysphoria” the psychological complexities of children and adolescents.
On the other hand, for the philosopher Heather Brunskell-Evans, an activist for the rights of minors in the face of gender identity politics, there are reasons to celebrate, but for different reasons: “It is a triumph for our children, our grandchildren and future generations, as well as for parents who were once they are helpless in the face of the madness of gender identity. (…). Tavistock and the approach it pioneered collapsed before our eyes. What makes me wonder is whether they will now be held accountable for all the damage caused.”
The answer is that at least one law firm and a thousand affected are already heating up the machines to do so. .
“Finally the government is listening”
