More than 40 clinical psychologists have signed an open letter to the UK Association of Clinical Psychologists protesting the organisation’s recent position statement on the provision of services for gender-queer children and young people. They say they believe there was a failure to properly consult with experts in the field or service users, resulting in a “misleading” statement that “perpetuates damaging conversations about work and racial identities more widely”. Around half of these signatories are current or former senior post holders – including the current director – at the only NHS gender identity service for children in England and Wales, the Gender Identity Development Service (GIDS) at Tavistock and Portman NHS trust in London. NHS England announced in July that it would close GIDS and replace it with regional hubs after being warned by the Cass Review’s interim report into youth sex services that having just one provider was “not a safe or viable long-term option”. The letter’s co-authors Dr Laura Charlton, who worked at GIDS from 2014 to 2020 and is now clinical lead at Leeds Gender Identity Service, and Dr Aidan Kelly, who worked at the service from 2016 to 2021 and is now lead clinical psychologist at the Nottingham Center for Transgender Health, said the letter was particularly significant because it was the first time these professionals, who share decades of experience, had come together publicly to voice their concerns. “We recognize that there were some valid concerns about the GIDS service, notably the significant waiting times, but we disagree with the way it is now portrayed. It is the first time that so many experts working in UK gender services have come together to talk about their portrayal, often by people who do not share our specialist knowledge.’ Charlton and Kelly added: “We know that colleagues are particularly keen to highlight that if they were leaving GIDS, it was often because of the toxic media and political environment surrounding the service rather than because they disagreed with practice there.” Other professionals have raised significant concerns about GIDS in recent years, with complainants criticizing what they described as an “affirmative-only” approach and suggesting young people were sent down a medical transition pathway too quickly. In 2021, inspectors branded the service “inadequate” overall and highlighted overwhelming caseloads, poor record-keeping and poor leadership, suggesting record waiting lists meant thousands of vulnerable young people were at risk of self-harm as they waited years for their first appointment . . In a position statement published last month, ACP-UK wrote that “new, regional services should offer a radical alternative [after the closure of GIDS] to meet the needs of all young people with gender dysphoria”. The statement suggests that “GIDS adopted an approach that was predominantly affirmative rather than exploratory.” But the letter’s authors argue: “Being ‘affirmative’ is often misinterpreted to mean that a trans identity is encouraged or treated as a preferred outcome, when an alternative understanding is that this practice is a stance in which no particular path or identity he has privilege. nothing else.” ACP-UK also refers to the findings of ‘diagnostic overshadowing’ in the Cass review, a term used to describe situations where a person’s multiple difficulties are not given equal weight because they are viewed through a single lens. The letter suggests: “An alternative interpretation is that it is possible to provide support for gender identity distress where mental health needs and neurodiversity also exist, and to remain aware of all factors in formulation-based practice.” Mike Wang, the chair of ACP-UK, responded: “ACP-UK involved gender experts as well as child and youth experts as well as service users in shaping our response. The reaction and feedback to our statement has been overwhelmingly positive in addition to the open letters signed.”
