£1.3 Million Research Award Into Child Gender Dysphoria

Peter Russell

February 25, 2019

The Tavistock and Portman NHS Foundation Trust in London has been awarded £1.3 million to help unravel some of the complexities surrounding care and treatment of children, young people, and their families experiencing difficulties in the development of gender identity.

The grant, made by the National Institute for Health Research (NIHR), comes at a time when England's only NHS gender clinic for children, The Gender Identity Development Service (GIDS), which is run by the Trust, has received sustained criticism for fast-tracking young people into changing gender.

The Tavistock and Portman said it wanted to explore some key questions surrounding the issue, including whether early transition was always helpful for gender diverse young people, at what age physical interventions should be considered, and how young people in that position could be best supported.

Search for Robust Evidence

The service acknowledged a widening debate about care and treatment, fuelled by a lack of good quality evidence on the subject. It said there was an urgent need for robust longitudinal studies.

With that aim, researchers on the new Longitudinal Outcomes of Gender Identity in Children (LOGIC) study would follow a whole group of volunteer young people who had been referred to GIDS. The outcomes for these participants would be monitored regardless of whether they remained in contact with the NHS service and no matter what path of treatment or no treatment they pursued.

This would allow the researchers to compare and investigate outcomes for the entire cohort, including both those who go on to use physical interventions such as hormone blockers to delay adolescence, and those who do not. 

Increasing Numbers of Referrals

The Tavistock and Portman said the findings generated would enable better, more individualised care for young people and their families "struggling with issues relating to gender identity".

Figures from the Trust showed an increase of referrals for gender identity issues to GIDS of 25% over a 12 month period. In 2017 to 2018, there were 2519 referrals, compared with 2016 the previous year.

Dr Eilis Kennedy, director of research and development at the Tavistock and Portman, said: "We are delighted to have been awarded this funding from NIHR and to be working on this study with an outstanding team of researchers from University College London and the Universities of Liverpool and Cambridge.

"This will be one of the largest studies in the field to date and we very much hope it will generate important new knowledge of direct benefit to young people and their families."

Dr Polly Carmichael, director of GIDS, commented: "While we know how children and young people are doing in our care, we have struggled in the absence of such research to understand how the care we provide affects them in the longer term and what choices they go on to make as they move into adulthood.

"This research, alongside other research that we are conducting, will add to the evidence base around the best ways to support young people with gender dysphoria. We welcome all rigorous research from across the health and care spheres and are excited about the insights that this study will bring."

Concerns About Methods at the Clinic

Hormonal treatment of children and adolescents with gender dysphoria has been hotly debated recently. Medscape reported earlier this month how doctors had called for more good quality evidence to prevent children being used as guinea pigs "in the rush to embrace early medical treatment of many youths with gender dysphoria".

Concerns have been raised about policies in place at GIDS, with a report last year by Dr David Bell, who was then staff governor, which said that children who came to the clinic were not being properly assessed.

In its response, GIDS said the trust had thoroughly investigated the concerns raised in Dr Bell's report but that "none of the concerns around safety or safeguarding were upheld by our medical director".

Marcus Evans, a consultant psychotherapist, who had worked at the Tavistock and Portman for more than 30 years, resigned last week because of concerns at the way the report by Dr Bell was handled. Mr Evans told the Today programme on BBC Radio 4 this morning: "I think there isn't sufficient time and thoroughness in the examinations to understand what's going on with these children and young adults, and with their families."

On the same programme, Dr Carmichael said: "I think there's a need for proper debate, and thoughtful debate, about the very polarised views that are currently being expounded and are making it incredibly difficult to work in this area."


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