The closure of a London clinic will help children who identify as trans

The war over transgender rights in Britain tends to be fought either loudly, on social media, or hidden from view, inside organisations. But official inquiries and the law courts are increasingly bringing rigorous public scrutiny to bear on these controversial issues. That scrutiny resulted in two victories this week for those who say self-proclaimed gender identity should not trump biological sex.

On July 28th the National Health Service (nhs) announced that it would close the Gender and Identity Development Service (gids) at the Tavistock foundation trust in London. England’s only specialist youth gender-identity clinic, gids was known globally as a centre for treating trans-identifying children up to the age of 18. It had seen a huge rise in numbers seeking help. More than 5,000 children were referred to specialist gender services in the year to April 2022. Some children had been waiting years to see a specialist.

The service has been hugely controversial. In 2020 the Tavistock was rated “inadequate” by inspectors, following concerns raised by whistleblowers. Critics alleged that clinicians at the Tavistock were following an affirmation-only policy, which involves affirming a child in the gender they say they are without exploring their personal history (a high percentage of trans-identifying children have other mental-health issues). This approach led to large numbers of children who said they identified as trans being put on puberty blockers and cross-sex hormones. Many went on to have surgery when they turned 18.

Last year the nhs commissioned Hilary Cass, a former head of the Royal College of Paediatrics, to review all of its child gender services. Her interim report, released in February, found that gids was “not a safe or viable long-term option” for treating gender-dysphoric children. nhs England has now said that the clinic will close early next year and that two new centres will be set up in London and Manchester.

These would be the first of up to eight regional centres in which gender services would be integrated with other mental-health services, to ensure other potential causes of trans-identification are assessed. nhs England will also implement “rapid” research on the use of puberty blockers by young people, after Dr Cass noted that there is currently insufficient evidence on their impact. The collection of long-term data on treatment outcomes will also be prioritised.

David Bell, a former consultant psychiatrist at gids who tried for years to flag his concerns, before retiring in 2020, welcomed the move. He thinks it will boost public opposition to the “ideological capture” of organisations by those who believe in affirmation-only policies, and will help prioritise therapy as the first method of treatment for trans-identifying children. “We are not anti-trans, we are anti-wrong-treatment for children,” he says.

The debate about ideological capture was at the heart of another decision a day earlier, this time at an employment tribunal in London. In 2018 Allison Bailey, a barrister, sent an email to colleagues arguing that her chambers, Garden Court, should not join the “diversity champions” scheme of Stonewall, a lobby group that argues a person’s self-identified gender should override biological sex. (gids was also a member of this influential scheme.) In it she accused Stonewall of “harassment, intimidation and threats” against anyone who opposed its viewpoint. This viewpoint holds, among other things, that self-identifying trans women should be able to use women’s bathrooms and play women’s sports.

Following her email, her chambers tweeted that complaints that she was transphobic would be investigated. Ms Bailey claimed that affected her income by costing her work.

The tribunal found that Garden Court had discriminated against Ms Bailey on the basis of her views. It ruled that Ms Bailey’s belief that Stonewall wanted to replace sex with gender identity, and her belief that the tone of Stonewall’s campaigns eroded women’s rights, were both protected under the Equality Act. She was unsuccessful in a separate suit against Stonewall, which she alleged had persuaded her chambers to discriminate against her. “I hope that women will now feel more confident in the workplace in stating their needs and rights, and employers will have to be more careful about discriminating against female employees who express these views,” says Stephanie Davies-Arai of Transgender Trend, a group critical of Stonewall’s influence.

Stonewall said it was pleased with the ruling on Ms Bailey, adding that “the case heard by the employment tribunal did not accurately reflect our intentions and our influence on organisations”. Reacting to the closure of gids, Stonewall says it was also pleased that the nhs had decided to act decisively to address unacceptable waiting times.

That puts a very brave face on it. The tide in Britain appears to be turning against groups who espouse the belief that gender identity trumps all else, and towards maintaining support for sex-based rights and evidence-based medicine. Public scrutiny is likely only to intensify. Mr Bell points out that the gids closure is only dealing with “downstream” issues. What needs to happen now, he says, is action on “upstream” issues, such as why so many children with mental-health problems are identifying as trans. That will only come when the government addresses “the ideological capture of schools and other public organisations”.■