Time to Think: The Inside Story of the Collapse of the Tavistock's Gender Service for Children

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What is most inexcusable in this story is the fact that the failures of the early days of the service have simply been repeated down the years. The GIDS not only failed to take account of its own data, learn from it and put in place structures to ensure a safe service for children, it doubled down, allowing pressure from activists to dictate. The service became increasingly ideological, not less. Many children referred to the service had suffered trauma, had mental health problems or had experienced ‘deprived or injurious upbringings.’”

Hannah Barnes | Book review | The TLS Time to Think by Hannah Barnes | Book review | The TLS

It traces various reports made by clinicians raising concerns: the David Taylor review (2005), David Bell report (2018), Dinesh Sinha's GIDS review (2019), Helen Roberts report (2021), and Hilary Cass review (2022).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. An exemplary and detailed analysis of a place whose doctors, Barnes writes, most commonly describe it as “mad”. This is a powerful and disturbing book’ – Financial Times

Time to Think review: the book that tells the full story of

Dr Anna Hutchinson is a clinical psychologist who has specialised in adolescent mental health and embodied distress over many years. She was a senior psychologist in the GIDS service between 2013 and 2017 and her concerns relating to the clinical practice she witnessed there formed a key part of the narrative in “Time to Think”. LOCATION Not only is this pathway wrong, but unlike claims made to the contrary, it almost certainly is hurting children and we simply aren’t hearing enough of the detransition/regret stories (and neither are they) because it has turned into a bizarre political and ideological battle, where instead of encouraging free thinking, doctors and providers are being forced to STOP thinking and prescribe to the status quo, or find somewhere else to work. And I wondered a little bit about, do you think that there's something about, like you were saying, we're not really sure if it's a disease, we're not really sure if it's a condition or if it's just a state of identity, but is there something that is almost inherently troublesome with the condition or the question of gender dysphoria and paediatrics itself? That is causing perhaps, less of a focus on child safeguarding? As in, is this a problem with the idea itself? Or is this an issue of different practices locally that seem to be going beyond the scope of what is considered to be reasonable medical practice? Given that these sorts of issues are cropping up in lots of different places?

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.

Time to Think: The Inside Story of the Collapse of the

The book has a narrow focus on GIDS and does not comment about the way in which the number of children with gender dysphoria increased so dramatically. This is to the book’s credit. The narrow focus on the exposition of events at GIDS in such a careful way is very impressive. Many of them were same-sex attracted – the same was true for the boys attending GIDS – and many were autistic. Their lives were complicated too,” Barnes writes. 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 FarFiLiA: I think one of the difficulties, is that it’s at every level. At the individual, when there's the two clinicians in the room, looking at the patient. Then beyond that, it's in that team meeting where you're allowed to speak but nothing seems to then happen. And then it's going to the more senior people, and having these secret meetings with, for example, Dr Bell or someone and creating this report. Then making those reports and then nothing happens from the reports. And then you have this top safeguarding lead [Sonia], who you're then not allowed to speak to because that's apparently going to be perceived as a hostile act. And so, I think is one of the questions that, I was thinking was: ‘Well, what is it about child safeguarding that provokes this idea that it’s being transphobic? Or vice versa?’ It was only when the first referrals were old enough to have their care transferred to the adult service at St Colmcille’s Hospital in Loughlinstown that concerns were raised. To begin with, the extent of the GIDS’ involvement with the pressure groups Mermaids, GIRES and Gendered Intelligence right from the start is staggering. These are political campaign groups, two of which are run by parents, with very set ideas and beliefs based on the unscientific concept of innate gender identity. They are not politically impartial. As Mermaids became more politicised and extreme in their belief in gender identity ideology, so did the GIDS. In 2007, 50 kids a year had been referred to GIDS, but by 2020 there were around 5000. As a result, GIDS faced huge waiting lists, with junior shrinks having caseloads of 100, instead of 30 which would be the standard NHS practice. Many clinicians left.