Thread by @BayswaterSG

Recently, @BBCNewsnight reported on a 2005-6 review of @TaviAndPort ’s Gender Identity Development Service (then known as GIDU), by Dr David Taylor. We have obtained the report via FOI and are publishing it below.

Taylor’s report was prompted by staff disquiet at GIDS, which has continued ever since. @sueevansprotect was the whistleblower then, and has continued her work to safeguard children at GIDS most recently by launching a judicial review with Mum A and @keira
crowdjustice.com/case/protect-c…

The report’s concerns are ominously familiar to those raised by staff more recently. As The Times reported in April 2019, many more staff have turned whistleblower in the years since.

thetimes.co.uk/article/calls-…

Indeed, a further report was written by one of Dr Taylor’s successors, Dr Sinha, whose recommendations the Trust are still implementing.

tavistockandportman.nhs.uk/about-us/news/…

But what’s most striking are Dr Taylor’s proposed solutions, the most important of which were not implemented, but still could be. @Hilary_Cass is leading a review of all this - could the ideas here be a blueprint for helping the Service out of the hole it’s dug?

Away from its focus on organisational problems, Dr Taylor’s report is a still-relevant primer in the various ways of understanding gender distress in children, and the approaches to helping them.

Dr Taylor identifies the pressure that clinicians come under “to provide immediate solutions through physical interventions which may not always, in the long term, prove to be helpful or beneficial”

The rationale for physical interventions “may be valid. However, as far as we could tell they are relatively untested and un-researched.” Sadly things are little changed today, 15 years on.

Dr Taylor asks: “is it true that [puberty blockers] purchase time in the ways proposed? Is empirical information being gathered about what patients do with the extra months and years by which puberty is delayed?” If it’s been gathered, unfortunately it hasn’t yet been published.

“it is the consistent impression of a number of GIDU staff that the service was coming under pressure to recommend the prescription of drugs more often and more quickly, and that the independence of professional judgment was also coming under increasing pressure.”

“there are powerful lobbies from older patients pressing for the use of medication, which even more worryingly, is now available without regulation via the internet. Clinicians will differ in their ability to resist the pressure to comply.”

Taylor suggested that gender dysphoria was part of “a family of serious developmental disorders emerging in adolescence” alongside eating disorders and body dismorphic disorder (BDD) & that GIDS should sit in a team dealing with these, within the Trust’s Adolescent Department.

GIDS should “become an integrated part of a culture of clinical practice”, sitting alongside other services dealing with similar age groups, with “permeable” boundaries between each. This would help “maintain the compatibility and quality of clinical services”.

Finally, this report came to light through FOI, but @TaviAndPort resisted disclosure, initially to @BBCNewsnight. You can read the Information Commissioner’s decision below.

ico.org.uk/media/action-w…

The Trust told the BBC that Dr Taylor’s report “is not relevant to the circumstances & issues faced by the GIDS service today”. We really wish that were true, but the report & GIDS’s subsequent history show that these controversies remain all too current.

bbc.co.uk/news/uk-543741…

apologies to Keira, she is @KLBfax !

Here is the @BBCNewsnight journalist’s detailed thread on Dr Taylor’s report.

https://twitter.com/hannahsbee/status/1312114107642855424