News

Media enquiries

Topics related to gender identity - and issues that are relevant to many trans people's lives - have thankfully been receiving greater attention in the UK in recent years. This includes increasing interest in our service and what we do.

We welcome media enquiries about our work. Please contact our Trust’s dedicated press office who will be happy to help.

Our response in full to the ITV series Butterfly

The writer of the ITV series Butterfly, Tony Marchant, briefly met with two of our clinicians in 2017 to discuss the work of the Gender Identity Development Service. As part of the process, we were also given the opportunity to view a draft of the screenplay, although we had not viewed the final film at the time this response was drafted.

We frequently receive research requests for drama and documentary projects, and where possible we try to make our clinicians accessible, particularly to those creators who are approaching the issue with an interest in learning and not solely confirming previously held views.

Based on the story as presented in the scripts, we appreciate that Tony and the producers of Butterfly made a good faith effort to capture an understanding of work in this field. Raising awareness of the difficulties that young gender diverse people may face is important, as it can increase societal acceptance and decrease prejudice, and we support the show’s efforts to explore the experiences of the fictional family. However, we feel it is difficult for any single depiction to encompass the complexity and diversity of the journeys taken by the young people who come to our service. Consultation with young people and their families is a vehicle for talking about some of the complexities of the child’s feelings and any treatment decision they and their family wish to make: synthesising such a thoughtful and long term process in a few minutes of drama is difficult.

Given the diversity of the population of young people whom we see and the range of outcomes they may pursue with respect to identity and treatment, Butterfly tells only one version of a story of one young person’s journey, and every journey is different.

The first episode of the series includes an incident of self-harm. Tragically, there is a higher risk of self-harm and suicidal ideation or attempts found in LGBT communities compared to their cisgender or straight peers. Suicidality in young people attending the GIDS is similar to that of young people referred to child and adolescent mental health services. It is not helpful to suggest that suicidality is an inevitable part of this condition. Gender dysphoria is not a mental health condition in itself and we work hard with young people to ensure they can work out any issues they have around their gender identity while feeling supported. These might be internal issues around gender dysphoria, or external ones such as bullying or other adverse experiences they may have as a result of their gender identity. Our focus is on supporting young people to be resilient and positive and many of the young people we see are doing very well. It is important to note that it would be very unusual for younger children referred to the service to make suicidal attempts.

Increasing societal acceptance of gender diverse young people and decreasing gender-based prejudice may help prevent suicides. Suicide and suicide attempts are tragic and it is crucial to identify risk factors and develop interventions that address these. More positive narratives that reflect the evidence we have around risk are important.

Our waiting times and our therapeutic approach

With the continued increase in referrals to GIDS in 2017/18, we are aware that our waiting times have recently increased and that it can now take 14 to 18 months between having a referral accepted and being seen for a first assessment. We know that waiting to see someone at our service can be distressing for young people and their families, especially in a situation where the waiting time might increase. We are working hard to see everyone as quickly as possible.

We continue to work on innovative ways to deliver our service, both to reduce the waiting list and to support young people and their families while they are waiting. This includes running group sessions, and having a clinician rota available over the phone to respond to immediate concerns that may arise while on the waiting list.

In addition we are also working on improving the quality of referrals that come into our service to reduce delays before being added to the waiting list. Once a referral is accepted the original referral date is honoured, but it can take a lot of resources to get the information required to process referrals.

We remain true to our founding values and therapeutic aims – we provide a highly specialised service for children and adolescents who are experiencing gender dysphoria or need support to explore their gender identity.

We do this by fostering recognition and non-judgemental acceptance of diversity in gender identities and gender expression; providing support, advice and treatment to assist in reducing emotional, behavioural, and relationship difficulties and their effects; offering options for physical interventions as appropriate, and working with local services to prevent mental health problems such as anxiety, low mood, self-harm and suicidal thoughts. The service thinks about difficulties associated with gender identity development in the context of general developmental processes.

For families and professionals it can be difficult to know how to support young people with gender dysphoria as there are widely-differing strongly-held views – this social context and debate are moving faster than the evidence base. We are working hard to add to the evidence base and contribute to this changing field but understand that living with uncertainty is challenging.

As a service we need to remain thoughtful and work with young people and their families as individuals. Evidence shows that the physical interventions that some young people may choose to undergo can be tremendously beneficial. We also know that many young people who visit our service decide not to go ahead with any physical intervention.

We believe that individualised care is the best way forward – every young person is different and their needs and the best approach for them must be considered on a case-by-case basis. Many young people, given the space to explore their identity, are creating more varied pathways and understandings of gender, and find different things helpful in reducing their gender dysphoria.

New publication – read the practice review ‘Assessment and support of children and adolescents with gender dysphoria’ in the Archives of Disease in Childhood

There has been a large increase in the number of children and adolescents who question conventional gender expectations and seek recognition and acceptance of their gender diversity, wishing to develop a body that is congruent with their gender feelings. Professionals may be unsure how best to provide supportive care, how to access the national Gender Identity Development Service (GIDS) for children and adolescents, or how to deal with a transgender young person presenting with another clinical problem unrelated to their gender transition.

Faced with very distressed young people, they may feel under pressure to initiate physical intervention without consultation with psychosocial colleagues. It is important that all professionals are aware of the care pathway for transgender children that may be of relevance in a range of paediatric settings. The purpose of this practice review is to present an up-to-date perspective on the care of transgender children and adolescents to guide management and to enable the provision of a practical, evidence-based approach to their support.

Read ‘Assessment and support of children and adolescents with gender dysphoria’ on the BMJ website.