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Arguably, GIDS moved from being a disorganised, ill-thought out service to being the centre of a medical scandal when, in the 2010s, numbers grew exponentially. The demographics also changed –across the world – as there came reports of an unexplained rise of teenage girls presenting at clinics with gender-related distress. In the gender identity literature there had never been significant numbers of teenage girls; pre-pubescent boys had always been the largest proportion of the paediatric cohort. In addition, the cases of these teenage girls appeared to be complex, happening within the context of wider identity confusion. One Finnish study showed that “Thirteen per cent were in care or living independently, and well over half had been ‘significantly bullied at school. But close to three-quarters of those had been bullied before they came to think about their gender identity. Most startling was that the fact that 75 per cent of the young people ‘had been or were currently undergoing child and adolescent psychiatric treatment for reasons other than gender dysphoria when they sought referral’.” Cooke, Rachel (19 Feb 2023). "Time to Think by Hannah Barnes review – what went wrong at Gids?". The Guardian. Archived from the original on Feb 19, 2023. Gender identity activism and social transition in schools – a 15-year-old girl’s account September 7, 2023 Additionally, only since 2018 has modern research with all the capabilities it has today – considered this a possibility. SEE here Maternal DES Exposure and Intersex Development in Males – Hormones Matter and here – Geneticists make a new discovery about how a baby’s sex is determined — ScienceDaily.
Waterstones says ‘no truth’ in claims it refuses to sell
The testimonies in the book are raw, honest and moving. More than that they are a vital piece of evidence that shows – without prejudice – where things went right, where things went wrong and, remarkably, the thousands of cases of young people where we still don’t know’ Emily Maitlis Katy Hayes of the Irish Independent called the book "meticulously academic, thoroughly footnoted and referenced", though it is "a dense, clotted read". Hayes notes that interviews were "almost exclusively" with former GIDS employees who "dissented" from the direction the leadership took. Therefore, while "Barnes has her well-argued position, and the questions she raises are legitimate", "the result makes the book feel very one-sided. All the clinicians talk about how they harmed children. There is very little mention of how any clinician might have ever helped anyone." Hayes complains that the "book occasionally slides into innuendo" (such as about funding), which Hayes says is "a pity, because they make Barnes sound biased", and that "the overall tone of the book is so hostile that it is likely to become another weapon in the unfortunately loud and bitter war over this subject." [10] So I don't use that phrase, for the very reason I don't think we know yet. I think we know that some people say they've been helped by GIDS, and some of those stories are in the book. And we also know that some people have been harmed by GIDS, and some of those stories are in the book as well. And I think what we don't know yet is the numbers on either side, because we don't have that data. GIDS haven't been collecting data on outcomes. Ever. They've been running since 1989. So we don't know. And hopefully, Dr Cass and her team can start to answer some of those questions. So I personally don't describe it in those terms. But I think it's very striking that a number of the clinicians who were there and were trying to help these young people fear that it may end up being a serious medical scandal because of their experiences. But I think at the moment, everybody would like some certainty, but I don't think we have it. Many children referred to the service had suffered trauma, had mental health problems or had experienced ‘deprived or injurious upbringings.’” The results were not good; “the children’s gender-related distress and general mental health – when based on clinical measures of things like self-harm, suicidal ideation and body image – had either plateaued or worsened.” Moreover, “Researchers reported a statistically significant increase in those answering the statement ‘I deliberately try to hurt or kill myself ’ as well as a significant increase in behavioural and emotional problems for natal girls.” Even though there was no clinically measurable positive impact on psychological well-being, GIDS chose instead to focus on the children’s self-reports of being “highly satisfied with the treatment”.Time to Think shows what happens when the exponents of an ideology, so certain of its righteousness, capture a field of medicine, silencing critics, refusing even to collect follow-up data on whether its treatments actually work’– The Times Best Books of 2023 So Far about 70 per cent of the sample had more than five ‘associated features’ – a long list that includes those already mentioned as well as physical abuse, anxiety, school attendance issues and many more” It hadn't really crossed my mind before that, at a particular time at least, this was a really close-knit group of professionals, and they were encouraged to think of themselves as almost a family. And it becomes even harder then to raise concerns because you're somehow letting down the people that you cared about. And one clinician puts it this way: ‘What do you do? It's a major dilemma. Do you screw over your colleagues to help the service users, or inadvertently screw with service users to help your colleagues?’ Those discussions are taking place in gender clinics across the world. They took place at GIDS. They're taking place in Europe, and in the United States we're hearing as well. So it was really trying to bring this out of the gender clinics and into wider society because of course, of course, this is an issue for the trans community, but it's also an issue more generally about children and young people.
Swift Press | Time to Think
The story begins in 1989 when a psychoanalyst called Dr Domenico di Ceglie became convinced there was a need for a clinic that focused on gender identity issues in children. . Whether GIDS operated within the framework of gender identity theory or a more developmental understanding of gender dysphoria never seemed to be properly clarified. This ambiguity seems to be a fatal flaw in the service as clinicians operated from different theoretical perspectives. This book is a testament to the moral courage of Hutchinson and colleagues who sought to expose the chaos and insanity they saw while practising by stealth the in-depth therapy they believed young people deserved … And Hannah Barnes has honoured them with her dogged, irreproachable yet gripping account’ – The Times I think there was a complicating factor that, in some cases, safeguarding concerns… you know, there was a grey area between the safeguarding concern and the trans identification. And the service was very keen not to stigmatise these young people, not to pathologise. And so, there was a line to tread whereby a concern about a young person wasn't a questioning of their gender identity. But on balance, many clinicians felt that the bar was too high. Because of that… fear, if you like, in the service, the bar was too high for referring, for taking these concerns as seriously perhaps as they would in other services. So it is always difficult to persuade people to go on the record, especially when there's an emotional attachment to the story as well. I can think of other stories where people have wanted to be granted anonymity because they still work in the field. Not necessarily medicine, but perhaps politics or the charity sector or what have you. It's difficult speaking out against your peers, and that was certainly an issue here. And it was more, it's not just your peers, it's people that you really like and you got on with and I think that was really striking about GIDS as I wrote the book. An absolute must read for anyone who has heard anything or been involved in the transgender debate.Some patients were very clear, from very young, about their identity. But others presented puzzles. How to approach a child professing three alter egos, two with Australian accents? Or one wanting to transition both sex and race to “become” Japanese, or survivors of trauma with compelling reasons for wishing to leave their old selves behind, or kids with complex mental health diagnoses? To raise safeguarding concerns about children and young people who happen to be experiencing gender related distress should be viewed in the same way as it should be about anybody. It's not transphobic. Sonia was accused of being transphobic. But for what? For asking for data and for relaying concerns about some of the young people under GIDS’s care. It's striking. And some of those young people did seem to be in desperately difficult situations. And it seems that really anybody who raised concerns about the safeguarding of children was dismissed in some form or another. Camilla Cavendish of the Financial Times described it as a "meticulously researched, sensitive and cautionary chronicle" and a "powerful and disturbing book" that reminded them of other NHS scandals. [6] Rachel Cooke, writing in The Observer called her work "scrupulous and fair-minded" and, with regard to GIDS, "far more disturbing than anything I’ve read before". Cooke says the account is of a "medical scandal" and "isn't a culture war story", concluding: "This is what journalism is for." [7] I think the clinical dilemmas stem from the fact that the evidence base is weak and that the existing weak evidence base has been used on a very different group of young people from that for whom it was designed. So, GIDS have actually been open about the fact that they extended the so-called Dutch protocol, which was designed for a group of young people who were psychologically stable, who had gender incongruence from childhood, who had stable supportive living environments. They extended that medical pathway and the evidence for it, if you like, to a group of young people who didn't fit those criteria, whose gender incongruence started in adolescence, who had multiple other difficulties that they were contending with, and who sometimes had quite chaotic living arrangements. And we've seen that shift in the people presenting to gender clinics across the western world. So, I think it's the uncertainty surrounding the evidence base and the fact that the one-size-fits-all approach doesn't seem to be working. I don't know if that's answering your question. Sorry! FiLiA: There was this kind of siege mentality, let's say, because there was pressure being put on the service from all sides. I suppose one of the questions I had also was about whether or not there was a kind of worry about feminists from that perspective, too, if that makes sense. So the sort of questions around ‘TERFs’ or ‘gender criticals’ or if there was any sort of sense of that sort of dialogue also affecting folks at GIDS, when it was happening?
Hannah Barnes and Time to Think — FiLiA Hannah Barnes and Time to Think — FiLiA
Cultural Influences and Debate Wider cultural influences, indoctrination in “gender identity” and debate/argument Some who had come into the profession to do talking therapy did almost none, as patients were referred for drugs sometimes after two sessions. Meanwhile, some of the gay staff were wondering if this all just conversion therapy for gay kids. Some staff felt under surveillance; they had doubts but they were reticent as expressing them could lead to accusations of transphobia. To say that sex itself is immutable was clearly heretical. At one point, that's how it was described to me. So I think it was very difficult for people to speak out. Lots of different competing emotions. But I don't want to suggest that others who didn't speak to me don't care about these young people, either. I think it's a story about how well intentioned people can go wrong. And an intervention that is well intentioned, can be overused for a group for whom it wasn't intended, perhaps.The trans rights group Mermaids is described as having put some pressure on GIDS and at times to have had a say in hiring decisions.
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