Unsurprisingly, it's always the principled few who push against the current and take all kinds of risks to get the word out. It's really, really difficult. So I have experienced those issues before, but I think perhaps not to the scale here. Hannah Barnesis an award-winning journalist at the BBC’s flagship current affairs programme Newsnight. She led its coverage of the care available to young people experiencing gender-related distress, which helped precipitate an extensive NHS review and unearthed evidence that was later used in several sets of legal proceedings. Newsnight’s reporting also led directly to an inspection by the healthcare regulator the Care Quality Commission, which branded the NHS’s only youth gender clinic in England ‘Inadequate.’ The management team of the clinic was disbanded as a result and the work was nominated for an array journalism awards, including the prestigious RTS Television Journalism Awards. Actually, there isn't agreement amongst frontline clinicians working with this group of young people about how best to care for them, and how there may be different ways to care for different people.

Time to Think, The Inside Story of the Collapse of the

It hadn't really crossed my mind before that, at a particular time at least, this was a really close-knit group of professionals, and they were encouraged to think of themselves as almost a family. And it becomes even harder then to raise concerns because you're somehow letting down the people that you cared about. And one clinician puts it this way: ‘What do you do? It's a major dilemma. Do you screw over your colleagues to help the service users, or inadvertently screw with service users to help your colleagues?’ As numbers increased, the caseload per clinician increased beyond safety levels. In 2015, in an attempt to calm the over-worked clinicians, an organisational consultant was called in. The subsequent report warned that GIDS was “facing a crisis of capacity to deliver effectively on an ever-increasing demand for its service” and recommended immediate action to cap referrals. This was ignored by GIDS director, Polly Carmichael. The caseloads continued to rise, first 50, then 70, , 90 or 100 patients each. One clinician reported an astronomical caseload of 140 patients. With some caseloads comparative to the size of a small primary school it is little wonder that clinicians had difficulties recognising their patients when they arrived for their second appointment. FiLiA: You include lots of different perspectives and lots of different voices from people who were actually there, who were actually involved, and had direct experience. So it's not a sort of commentary from folks on the side lines. Dr Anna Hutchinson, in particular, plays quite a large role in the book. She kind of opens and closes the work with that question: ‘Are we harming children?’ You do seem to be quite careful about choosing a range of different stories with a range of different outcomes in terms of kids who've actually been through GIDS themselves and have different perspectives, and some of them seem quite positive. So do you think it's fair then to characterise what happened at GIDS as a “serious medical scandal”? And in that case, why? To begin with, the extent of the GIDS’ involvement with the pressure groups Mermaids, GIRES and Gendered Intelligence right from the start is staggering. These are political campaign groups, two of which are run by parents, with very set ideas and beliefs based on the unscientific concept of innate gender identity. They are not politically impartial. As Mermaids became more politicised and extreme in their belief in gender identity ideology, so did the GIDS.It is stressed repeatedly throughout the book that many senior clinicians who desperately tried to raise concerns with management and executive members were not only being repeatedly ignored or silenced, but were also very often - if subtly - being told their view was wrong and if they couldn’t get on board with what GIDS was doing, perhaps they should look for another job. I think the clinical dilemmas stem from the fact that the evidence base is weak and that the existing weak evidence base has been used on a very different group of young people from that for whom it was designed. So, GIDS have actually been open about the fact that they extended the so-called Dutch protocol, which was designed for a group of young people who were psychologically stable, who had gender incongruence from childhood, who had stable supportive living environments. They extended that medical pathway and the evidence for it, if you like, to a group of young people who didn't fit those criteria, whose gender incongruence started in adolescence, who had multiple other difficulties that they were contending with, and who sometimes had quite chaotic living arrangements. And we've seen that shift in the people presenting to gender clinics across the western world. So, I think it's the uncertainty surrounding the evidence base and the fact that the one-size-fits-all approach doesn't seem to be working. I don't know if that's answering your question. Sorry! An absolute must read for anyone who has heard anything or been involved in the transgender debate. And I think what's striking is that those clinicians raise those concerns over and over and over again. To numerous people at numerous levels over a number of years, including with the Medical Director of the Trust in an official review, who said, ‘Our safeguarding procedures are adequate,’ and who was told by several clinicians, ‘No, they're not.’ Where was NHS England in all this? How did the Care Quality Commission judge the service ‘good’ in 2016 when the following year so many concerns were relayed to David Bell? A blunter question may be: why did the GIDS and the Trust not care enough about teenage girls, autistic, gay and troubled children to provide them with a service in line with normal standards of paediatric health care?

book by Hannah Barnes: ‘Time to Think: The Inside Review of book by Hannah Barnes: ‘Time to Think: The Inside

It's also striking that it took till 2019 for GIDS to have a standard operating procedure around safeguarding. And that was one of the results of the review. But to have operated for 30 years without seemingly the feeling that there needed to be one, I think is interesting. And then not to include your safeguarding lead for children, so Sonia says, in the drafting of it is also rather striking. Transgender Organisations and Activists Transgender and LGBT organisations, charities and activistsSome patients were very clear, from very young, about their identity. But others presented puzzles. How to approach a child professing three alter egos, two with Australian accents? Or one wanting to transition both sex and race to “become” Japanese, or survivors of trauma with compelling reasons for wishing to leave their old selves behind, or kids with complex mental health diagnoses? Cooke, Rachel (19 Feb 2023). "Time to Think by Hannah Barnes review – what went wrong at Gids?". The Guardian. Archived from the original on Feb 19, 2023.

Time to Think by Hannah Barnes | Waterstones

Many of them were same-sex attracted – the same was true for the boys attending GIDS – and many were autistic. Their lives were complicated too,” Barnes writes. This book contains so much more than is outlined here. It should be read carefully by everyone involved in the care and safeguarding of children, including schools and government ministers. What other institutions are in thrall to transgender activists, leaving the most thoughtful professionals afraid to speak out? Where else do we see the same failure of safeguarding demonstrated at the GIDS? Why are the same ideological groups that influenced the GIDS allowed to influence policy in schools? Medical harm may be the most extreme result, but what other harms are being caused to children in schools, social care and child agencies by the failure to put facts and evidence ahead of ideology?The results were not good; “the children’s gender-related distress and general mental health – when based on clinical measures of things like self-harm, suicidal ideation and body image – had either plateaued or worsened.” Moreover, “Researchers reported a statistically significant increase in those answering the statement ‘I deliberately try to hurt or kill myself ’ as well as a significant increase in behavioural and emotional problems for natal girls.” Even though there was no clinically measurable positive impact on psychological well-being, GIDS chose instead to focus on the children’s self-reports of being “highly satisfied with the treatment”.

Hannah Barnes: I told the truth about what was going on at Hannah Barnes: I told the truth about what was going on at

In the late 2000s and 2010s there was a dramatic rise in the number of children who had gender dysphoria. In 2009-10 GIDS saw 97 children, by 2015-16 this had increased to 1419 children. The rise in female at birth patients went from 32 to in 2009/10 to 1981 in 2019/20. The story begins in 1989 when a psychoanalyst called Dr Domenico di Ceglie became convinced there was a need for a clinic that focused on gender identity issues in children. . Whether GIDS operated within the framework of gender identity theory or a more developmental understanding of gender dysphoria never seemed to be properly clarified. This ambiguity seems to be a fatal flaw in the service as clinicians operated from different theoretical perspectives. It was only when the first referrals were old enough to have their care transferred to the adult service at St Colmcille’s Hospital in Loughlinstown that concerns were raised. As someone who knew about this years ago, as people were writing to me asking my former newspaper to investigate it, it would suit my agenda to say this was all down to trans activism. But it’s not that simple. This was a time when two thirds of referrals were boys, average age 11 at referral. Over 25% had spent time in care (compared to a rate of 0.67% for the general children’s population (2021)). 42% had experienced the loss of one or both parents through bereavement or separation. Only 2.5% had no associated problems; about 70% had more than five ‘associated features’ such as physical abuse, anxiety and school attendance issues. 42% suffered from ‘depression/misery.’ Close to a quarter of those aged 12 and over had a history of self-harming and the same percentage exhibited ‘inappropriately sexualised behaviour.’Some had been sexually abused, she says, some were struggling with their sexuality, and some had suffered early traumas in their lives. Others were autistic or were being bullied in school.”