How did the Tavistock carry on for so long?

The vicious culture of fear around trans issues silenced all concerns.

Fraser Myers

Fraser Myers
Deputy editor

Topics Identity Politics

How did we let this go on for so long? That is surely the question on everyone’s mind following the NHS’s announcement this week that it will shut down the Tavistock Centre, its specialist gender-identity clinic for children and young people.

This comes after the damning findings of paediatrician Dr Hilary Cass, whose interim report into the Tavistock was published earlier this year. Cass found that the Tavistock’s model of care is ‘not safe’ for children. This week a letter from Cass to NHS England was published with further advice on reforming Britain’s gender-identity services and on the potential harms of puberty blockers.

The Cass review confirmed much of what was already known – that clinicians at the Tavistock are under pressure to ‘affirm’ a child’s new gender identity, and that the puberty-blocking drugs that are prescribed to this end are largely experimental. But the deeper questions remain: why did so many adults go along with this and why were they so nonchalant about putting vulnerable children at risk?

After all, the alarm has been sounded repeatedly, over nearly two decades, through whistleblowers, reports, media investigations and lawsuits. And yet nothing ever seemed to change.

Concerns about the Tavistock stretch back at least 18 years. In 2004, mental-health nurse Susan Evans blew the whistle, after learning that a 16-year-old boy who thought he was a girl had been referred for hormone treatment after just four appointments. In 2005, a review by Dr David Taylor raised concerns about the speed with which children were being prescribed puberty blockers, the lack of evidence surrounding their use, and the troubled backgrounds of the children presenting with gender-identity issues.

In 2018, Dr David Bell, who had worked at the Tavistock since 1995, accused the clinic of fast-tracking young people down the trans pathway, without exploring their personal histories. He warned that many of the patients presenting as trans were often gay, on the autism spectrum or suffering from other conditions like anorexia. The review prompted Dr Marcus Evans, a Tavistock board member (and husband of Susan), to resign.

Even as the damning claims mounted, the volume of children treated by the clinic continued to balloon, from around 250 patients per year in 2011/12 to some 5,000 patients in 2021/22. According to the Telegraph, in the time between Susan Evans first blowing the whistle and this week’s announcement of the closure, some 20,000 children had been referred to the clinic.

We do not know how many of these children will have been prescribed puberty-blocking drugs, but from the Cass review and her letter this week we can say three things:

First, that staff at the Tavistock have been ‘under pressure to adopt an unquestioning affirmative approach’ to gender identity, which means children would likely be prescribed puberty blockers if they wanted them.

Second, there is no evidence that puberty blockers work as intended. Though they are often said to delay the onset of puberty to let children ‘pause’ and think before potentially transitioning to the opposite gender, Cass has found no evidence of this. As she wrote in the letter to NHS England, published this week, it is just as likely that these drugs ‘disrupt [the] decision-making process’, potentially making it more likely that young people will move on to cross-sex hormones.

And third, puberty blockers could be dangerous. As Cass puts it: ‘Brain maturation may be temporarily or permanently disrupted by puberty blockers, which could have a significant impact on the ability to make complex risk-laden decisions, as well as possible longer-term neuropsychological consequences.’

So why were so many children exposed to this harm? And why did no one put a stop to it? The simple explanation is that anyone who raised concerns was met with dismissal at best and venom at worst. As former clinician Dr Kirsty Entwistle noted in an open letter in 2019, concerns were not ‘sinking in’, leaving distressed colleagues with no option but to speak anonymously to the press. When the clinic’s child-safeguarding lead, Sonia Appleby, tried to report staff concerns to management, she was branded ‘hostile’ and accused of having an ‘agenda’.

The most common accusation thrown at those who blew the whistle was, of course, ‘transphobia’. An absurd smear, with its cruel implication that these practitioners must have hated the children in their care. The very children they were trying to protect from harm.

Of course, the accusation of transphobia not only appeared to discredit the concerns of the whistleblowers – it also made others afraid of voicing their own. Last year’s report by the Care Quality Commission into the Tavistock identified a culture of fear, in which ‘staff did not always feel able to raise concerns without fear of retribution’. As Marcus Evans put it when speaking to spiked in 2020: ‘The fear of [being accused of] transphobia has basically just immobilised people’s capacity to think critically.’

This lack of critical thinking and questioning opened the door to all kinds of strange and illogical views about gender. Over the years, many whistleblowers noticed the growing influence of trans lobby groups such as Stonewall and Mermaids. Mermaids promotes the idea that medical transitioning can be ‘life-affirming and life-saving’ for children. And Stonewall this weekend claimed that children as young as two years old can recognise their trans identity. The question of pre-school trans kids is not merely theoretical at the Tavistock – according to The Times, it has seen patients as young as three.

The cruel irony here is this extreme gender ideology purports to protect the most vulnerable. The ‘affirmation’ approach to gender transitioning is held to save the lives of those most in danger. In reality, it is the most vulnerable who are paying the price for this, such as children with body dysmorphia and complex mental-health issues. In recent years, the proportion of girls seeking gender reassignment has shot up exponentially – by some 5,000 per cent. And a vast proportion of children with gender-identity concerns grow up to be gay. Tavistock whistleblowers have compared the rushed medicalisation of children to a form of gay conversion therapy. A dark joke among staff had it that there would soon be ‘no gay people left’.

As these children grow up, many come to regret the path they were encouraged to take by this affirmation approach. So-called detransitioners, like Keira Bell, will bear the scars of these medical interventions for the rest of their lives.

This is the cost of silence. The cost of a culture of fear that tries to hush up difficult conversations. It ends with adults placing political correctness and woke ideologies above the welfare of children. With the demise of the Tavistock, this has got to change.

Fraser Myers is deputy editor at spiked and host of the spiked podcast. Follow him on Twitter: @FraserMyers.

Picture by: YouTube / BBC.

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Topics Identity Politics


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