Thread by @BayswaterSG

.@TheEconomist reports on concerns about @NHSEngland 's new pilot gender clinics for adults. The protocol is blatantly unsafe esp for vulnerable young people (17 and above), whose mental health needs are overlooked.
economist.com/britain/2022/0…

The clinics adopt a US-style 'affirmative' approach and use generalist clinicians to prescribe powerful hormones without undertaking a detailed psychological evaluation of the patient's readiness.

Talking therapies to overcome gender dysphoria are "not offered routinely".

The treatment protocol "will sideline mental-health expertise & thereby not address co-existing mental health problems that might be worsening the gender dysphoria".

Four current & past members of the @RCPhysicians ethics committee expressed concerns: "We did not get the sense that gender medicine was open to scrutiny or self-criticism on standard medical criteria, such as side-effects & long-term outcomes" said Prof @AlasdairColes

We know from recent studies how poor NHS services are for young adults with gender identity problems - including the v long waits for help. Many young adults are vulnerable who've suffered years of mental illness. A free-for-all is no kind of solution.

Gender clinicians themselves admit that the "model of care in adult GICs is based on experience with older transwomen, not younger transmen or non-binary service users" for whom it may represent a risk to their long-term health.
cambridge.org/core/journals/…

The pilot gender clinics offer hormones for patients with non-binary identities, but there's no evidence they help. Dr Leighton Seal, consultant endocrinologist at the @TaviAndPort gender clinic says: "we have to accept that there is no robust literature on this subject" ...

Dr Seal again: "there are no clearly established guidelines for the hormonal treatment of non-binary people, and a lack of empirical evidence on which to base practice".

[source: Richards et al, Genderqueer and Non-Binary Genders (2017)]
link.springer.com/book/10.1057/9…

Rates of detransition or stopping treatment, as measured in two recent studies, are very significantly higher than historic estimates, and are as common as 20%.
mdpi.com/2227-9032/10/1…

We're worried the pilot clinics are offering a one-size-fits-all, highly invasive & burdensome medical approach. The NHS should trial psychological interventions, to find the most effective way to help patients manage their dysphoria.
link.springer.com/article/10.100…