Thread by @JolyonMaugham

I have now seen further evidence that, since the Bell decision in the High Court (1 December 2020), there has been a huge increase in deaths of young trans people on the NHS waiting list - and that NHS management has sought to suppress that evidence.

CW: Suicide 🧵

When the High Court handed down its decision in Bell, the NHS immediately pulled down the shutters on healthcare for young trans people.

But when the Court of Appeal overturned that decision - on multiple grounds - the NHS unaccountably left those shutters in place.

Kemi Badenoch has explained that much of this happened because her Government chose to prioritise ideology when it came to appointing key positions in health.

But the evidence shows the outcome was predictable (and predicted): a huge increase in deaths of young trans people.

First, the whistleblowers.

I have now personally spoken to two: I have seen their staff IDs and each has provided me with some internal Tavistock documents. There is no doubt they are who they say they are.

First, Whistleblower One.

W1 tells me that in the seven years before the High Court decision (on 1 December 2020) there was one death of a young trans person on the waiting list but in the three years afterwards sixteen deaths.

These figures are said to come from a presentation to Tavistock staff given by the Named Doctor for Safeguarding Children.

I have seen emails to that post-holder expressing concerns about those numbers - after much chasing they promise to set up a working group.

W1 also says they raised these concerns with Hilary Cass and a Director of the Tavistock. I have seen an email to both which sets out these death numbers.

That email also complains, vigorously, of the failure of both to engage with these numbers or W1.

We put these points to the Tavistock and Dr Cass. The Tavistock chose not to engage.

Dr Cass's team directed us to paragraph 5.65 of her report, on which see the following tweet.

Paragraph 5.65 does acknowledge that there were deaths by suicide of young people at the Tavistock.

But it also presents those deaths in such a way as blurs the impact of the restrictions imposed by the NHS in December 2020 following Bell.

Then Whistleblower 2.

W2 confirmed they agree with the numbers on the presentation prepared by the Named Doctor for Safeguarding - the numbers given above in respect of W1.

W2 says that when staff working at the Tavistock planned an open letter they were threatened with disciplinary proceedings and being reported to their regulatory bodies if that letter contained the death numbers.

W2 believes there was a deliberate attempt to suppress them.

I have also reviewed the Minutes of Tavistock Board Meetings in the period - 2018 to 2023 - referred to in para 5.65.

(For the uninitiated, GIDs refers to Gender Identity Development Service (up to 18) and GICs to Gender Identity Clinic (after 18).)

In the three years to December 2020 (Q3 2020/21), I found reference to one death - an “apparent suicide” - in GIDs: image from the Board minutes for July 2019.

In Q3 of 2020/21, there is a further reference to a death "likely to be suicide" of a young person known to GIDS: image from the Board Minutes of March 2021.

In Q1 of 2021/22 there is another suicide in GIDs: image from Minutes of September 2021.

In Q2 of 2021/22 there appear to be a further two suicides. Images from Minutes of November 2021.

The Minutes for January 2022 contain a reference to seven deaths “in gender” in the quarter - of which two or three are probably suicide.

For the first time, no breakdown is given as to whether they are GIDS or GICS. There is talk of an audit of suicides in the trans group.

In Q4 of 2021-22 (to 31 March 2022) the Tavistock “discovers” a huge gap in its data: 21 deaths in Gender services. Again, no breakdown is given as to whether they are within GIDs or GICs or suicides. Image from 26 July 2022 Minutes.

The April 2023 minutes disclose that there were five deaths on GIDS from 1 April 2022 to “present”. The Tavistock and Portman continues its new practice of no longer reporting on whether they are likely suicides.

These figures ignore attempted suicides.

And they will not capture all deaths.

Without explanation, the Tavistock has not published a number of Board Minutes including those at the end of the period (10/23, 12/23).

They ignore that care for young trans people passed over to NHS Arden & GEM CSU in, I believe, March 2023.

It does not seem to publish its minutes.

And these figures ignore that, as para 5.65 of the Cass report acknowledges, a trigger for suicides is young people moving from GIDS to GICS. Those suicides will be captured in the GICS (which is also appalling - but not explicitly addressed in this thread) but not GIDS data.

A few more points from the Minutes.

Although the Tavistock says it is committed to reporting deaths (image 2/2024), the Minutes of the Tavistock (see eg from 3/2021) suggest that “GIC (and GIDs) related responses” are withheld from FOIA responses due to reputational impact.

In January 2021, the Board notes the “profound” effect on its patient population of the Bell decision and the impact it will have on capacity and waiting times.

There are many mentions of eg an increase in "malicious emails, leaflets and Twitter for the GIDS service.”

And in 2021, the Board notes “the ongoing public campaign” and “the media interest in and ‘political’ nature of the GIDS service.”

In June 2023, the Board notes an increase in media and targeted harassment including the naming of GIDS clinicians.

It views this harassment sufficiently seriously that it has to be notified to the police.

Unsurprisingly, all of this has an effect on staff morale with possible failure to deliver the GIDS action plan.

Eventually they draw the threads of Bell and harassment together (3/22): “If GIC waitlists continue to grow, there may be an increased chance of a serious incident” and “The risk is very real, and sadly we have lost a patient on the waiting list in this past quarter to suicide.”

The Minutes for May 2022 disclose an especially grim budget line of £50,000 for expenditure on “Toilets - Anti Ligature/Gender Neutral.”

And all of this is happening against a background of what I read as a shrinking GIDs caseload: image from Minutes from September 2022.

Good Law Project has supported several inquests into the deaths of young trans people on NHS waiting lists, I have spoken to the families of young trans people who have taken their lives whilst on the waiting list, and my inbox is full of emails from terrified parents.

Our debased national discourse around trans people - the harassment of clinicians; its politicisation by some Ministers, journalists, cheerleaders, in the NHS has, I think on the evidence, led to young people taking their own lives.

This is a profound, emerging national scandal.

Just before parliament was dissolved on 30 May, the health secretary Victoria Atkins locked the shutters with an immediate ban on trans young people obtaining in the UK puberty blockers prescribed by regulated prescribers in France, Germany, Switzerland and throughout Europe.

I am aware of a number of young people - who entirely predictably - tried to take their own lives in the immediate aftermath of Victoria Atkins’ emergency regulations. They will inevitably make things worse.

We are challenging those regulations: see here goodlawproject.org/crowdfunder/tr…