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Psychological assessment to determine if a trans adolescent meets a stereotype ridden diagnosis of gender dysphoria is both unnecessary & stigmatising. Telling a young person they require (years of) mandatory assessments simply because they are trans can be othering & harmful 1/
Making this assessment (by psychologists & psycholanalysts not medical doctors) a barrier to accessing medical support is harmful & stigmatising in and of itself. Making even access to that assessment practically impossible (no self referral, 2 year waiting list) is abusive. 2/
I entirely support providing patient centred trans inclusive therapy to all children & young people (& their families) who desire it. I would have loved some counselling when we went through a really hard time when my child came out. This shouldn't however be a barrier to care 3/
The current UK gatekeeping model for gender care doesn't work. The system is fundamentally flawed. The expert on a child's gender is that child, the only way to know a person's gender is to ask them. 4/
When gender dysphoria is not a mental illness, why in the UK service do psychologists & psychoanalysts have total control? The current service has a total monopoly, & a vested interest in maintaining that monopoly. 5/
They are currently fighting tooth & nail in the media, in academia, in hushed conversations within the NHS to maintain their control. They are saying how complex their cases are, how highly specialised their training is, how comprehensive & thorough their assessment process 6/
The fact is they don't have a clue. They're lost because as psychotherapists they are trained to identify & treat a psychological problem. Being trans isn't a problem of the mind & can't be cured. Evidence shows reparative (conversion) therapy is both ineffective & harmful 7/
So what can they do? They put our kids through the ringer. Months & years of sessions attempting to divine why are young person identifies as a different gender. They ask ridiculous & often upsetting questions about toy & clothing preferences, feelings about parts of the body 8/
They ask parents about their own upbringing, wider family, past trauma, their dreams, their pets. They ask adolescents about computer game characters, masturbation, sexual preferences, social media habits friendship groups, society's gender expectations 9/
They try really really hard to find anything that might provide a sliver of a suggestion that a child might not, after all, be transgender, but there is some other explanation, which is then seized on & talked about again & again for months & years 10/
I can't blame them, this is what they are trained to do. They are psychologists & psychoanalysts after all. It must be frustrating for them that many of the young people they say don't engage. They clam up, stop talking, hate going to appointments, leave upset & traumatised 11/
The young person is often accused of not engaging, many engage in selective mutism. As I was told by one young person, "why would I want to discuss my gender with someone who only cares about trying to prove I'm not trans". 12/
Polly Carmichael head of GIDS has worked for them for nearly two decades but has done nothing to advance a comprehensive training programme. Instead they continue to employ people who by their own admission are thrown into the job without training or adequate support. 13/ 
It is unsurprising GIDS/Tavi recruit staff as inadequate & unethical as those currently being given voice in the transphobic press. Until last year when we complained, GIDS job adverts explicitly stated they wanted training in Gender Identity Disorder. 14/
It can't be a nice place to work, constant negative media attention, operating under outdated protocols which woefully fail to meet International Standards of Care. They probably don't get paid enough either. This means they struggle to recruit & retain staff. 15/
They therefore seem to be accepting any psychologists with a vague interest in gender who go in wanting to do interesting psycho-dynamic assessments & differential diagnostic work, many of whom seem to be coming from a trans exclusionary or pathologising position. 16/
As shown this week by the GIDS press conference. This systemic cisnormativity is endemic within the service, starting at the very top. You have psychologists & philosophers trying to find psychological explanations for the existence of trans people 17/
They are more than 2000 children & young people on a waiting list who will be forced to progress through these stigmatizing gatekeepers. It is inhumane & it isn't working. We need decentralised services led by doctors & social workers not psychologists #nhsfailingtranskids
I want to add that that there are a number of caring, trans-inclusive clinicians working at GIDS/Tavi. They are having a really tough time & doing their best to improve a system that fundamentally discriminates against trans children. We are grateful to them.
