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This is a thread about @Mermaids_Gender & @TNLComFund looking at (1) the National Lottery Fund’s recent Review, (2) the Proposal from Mermaids, (3) and the Fund’s original Assessment of it (obtained via FOI request) All documents are here: drive.google.com/drive/u/2/fold… 
The NLF’s original assessment in order to award funding was very slight – it is about a page long and basically repeats assertions from Mermaid’s proposal. Whereas the review is 20 pages long, w an extensive bibliography and draws on discussions with @TaviAndPort and others.
The NLF say its review “has not found adequate evidence to support a withdrawal of the grant. However, it has identified some areas in which Mermaids should improve practice, governance, relationship management & quality assurance”:
1)The assessment says Mermaids is "an authoritative voice on transgender youth”. The review emphasises that Mermaids is a peer-to-peer support network and cites @TaviAndPort saying “on occasion their views and the views of Mermaids do not align”.
The Review calls for Mermaids to work towards strengthening their relationships with other key players & says “Mermaids should clearly explain the stated NHS position in the UK and provide relevant information, advice and support in a responsible and accountable manner.”
2) The original Assessment repeats Mermaids claim that 45% of transgender pupils have attempted suicide, the Review questions this, drawing on other studies and highlights the risk of sensationalizing suicide.
The Review says “The Big Lottery Fund believe that any data or information used should be done so responsibly and thoughtfully given all the audiences for which it is relevant”.
3) On the validity of claims made in Mermaids training, the review highlights the responsibility of training providers to be clear about the difference between opinion, experience and facts.
The Review says. “Mermaids undertakes to provide scripts to the Fund on this point so that the Fund can continue to be confident the best available statistic are being used.” (NB: This is new, there is no sign that they asked for this when assessing the proposal)
4)The Review highlights the difference between the outcomes for gender questioning children who attend Mermaids (who mainly transition) and those that are seen by @TaviAndPort (who mainly desist). This issue was not raised in the original assessment, and is a huge thing to miss
The Review says "Mermaids should work with an academic partner/evaluator to explore the reasons why their longer term outcomes may differ from other services such as the Tavistock. The findings of this should form part of the Big Lottery Fund grant management activity."
5) On signposting the private practice “Gender GP”on its website the Review says “Mermaids should consider the implications of this and review the appropriateness of retaining details of this practice on their website at least until the current GMC inquiry is resolved.”
6) On the challenge growing from being an informal self help group to a national charity the NLF says “ Mermaids should pay attention to ensuring that their governance, infrastructure and quality assurance are strengthened in line with the growth in their operational activity.”
What is really noticeable is that none of these utterly foreseeable issues and risks were identified by NLF’s original assessment. In the section under “risk” it came up with something about making sure rural areas were included 🙄
As the Review states this is a difficult & rapidly moving area where there is limited evidence, and where the welfare & health of children and young people is at stake. As such NLF’s initial risk assessment seems wholly inadequate. This should prompt some internal reflection
While Mermaids can clearly raise funds by appeals to the public, the role of funders such as the NLF is also to help the organisations become more robust and evidence based. This is a really difficult task for funders (remember Kids Company?) but it is really important.
It is positive that the NLF has stepped up to support Mermaids in improving the quality assurance of its peer-to-peer support (and this would not have happened without the scrutiny of @MumsnetTowers @Glinner @fairplaywomen @thesundaytimes etc...)
As the NLF goes forward with this grant it should ask itself how its risk assessment processes missed 6 important risks (!) and how it will assess & support the quality of research into Mermaid’s approach, and its safeguarding practices. These remain two areas of concern:
RESEARCH: The Review suggests that Mermaid’s planned research will answer the critical question of why so few of Mermaid’s cohorts desist compared to those seen by @TaviAndPort . But there is nothing in the research plan that suggests this is the case.
The research plan in the proposal sounds quite closely linked to Mermaid's advocacy, and will be managed by same staff who will also run support groups and do training. It is not clear that they will have right skillsets & governance to also manage robust research partnerships.
SAFEGUARDING: The Review barely mentions it. The original proposal only mentions it in relation to hate crime & hostility. It does not consider that some children's gender issues may reflect sexual or emotional abuse (incl. homophobia) underlying MH issues or online pressure
Knowing the issues raised by David Bell's report on @TaviAndPort this seems like a huge oversight and risk 😨 thetimes.co.uk/article/staff-…
Given how much was missed by the original assessment, it would be a good idea for NLF to put in place a process (maybe a panel drawing on some of the people who raised the issues it missed) to strengthen accountability & transparency on quality assurance, research & safeguarding
