Here at GIDS we are always thinking about the best way to support all young people who come to our service. Some of this thinking includes contributing to or being involved in research studies. Other ways that GIDS and the clinicians who work here add to the evidence base is through papers in medical journals or presentations at conferences. Below are some projects that are underway, and some that are completed.

We have linked to the items that are published, but some might be behind a paywall depending on the journal in which they appear.

We wanted to understand the kinds of journeys that young people took through our service, to improve the care and support that we provide, so in 2020 we analysed key data on two different groups of young people, to understand the pathways that they took.

Read about the pathways they took

This study, published in February 2021 in the peer-reviewed journal PLOS ONE, looks at psychosocial functioning, quality of life and treatment pathways after GnRHa pubertal suppression in young adolescents with gender dysphoria.

The study shows that puberty blockers are a well-received intervention in carefully selected patients.

From the introduction to the study: “Pubertal suppression by means of gonadotropin-releasing hormone analogues (GnRHa) has gained increasing acceptance internationally as a recommended treatment option for young people of tanner stages two and over with gender dysphoria (GD), yet there is limited evidence of the psychosocial and physical outcomes of the treatment in this group. We prospectively evaluated the psychological, social and physical risks and benefits involved in pubertal suppression in a group of young people with gender dysphoria.”

Read more about the Early Intervention Study.

Read the paper on the PLOS ONE website.

The Tavistock and Portman NHS Foundation Trust has been awarded £1.3 million by the National Institute for Health Research (NIHR) to carry out an independent study that will inform better, more individualised care for young people and their families struggling with issues relating to gender identity.

This new Longitudinal Outcomes of Gender Identity in Children (LOGiC) study is innovative and will include both quantitative and qualitative approaches. Uniquely, an independent team of researchers will follow a whole group of volunteer young people. The young people will be recruited from among those who have been referred to the Gender Identity Development Service (GIDS). The study will follow these young people, whether they remain in contact with NHS services or not, regardless of their path. This will allow the independent researchers to compare and investigate outcomes for the entire cohort, including both those who go on to use physical interventions (such as hormone blockers) and those who do not. The findings generated from this research will enable services to provide better care for patients and their families.

Visit the LOGiC study website.

We recognise that puberty and the physical changes that it brings can be distressing for some people. Many, although not all, of the adolescents we see consider at some point having physical interventions (such as hormone blockers) through our service.  There are also many people who choose not to have physical interventions.

Learn more about puberty, and our approach to assessment and intervention here

Trajectories of transgender adolescents referred for endocrine intervention in England
Una Masic, Gary Butler, Paul Carruthers, Polly Carmichael
Archives of Disease in Childhood
https://adc.bmj.com/content/early/2022/07/28/archdischild-2022-324283.full

Discharge outcome analysis of 1089 transgender young people referred to paediatric endocrine clinics in England 2008–2021
Gary Butler, Kirpal Adu-Gyamfi, Kerry Clarkson, Ranna El Khairi, Sara Kleczewski, Alice Roberts, Terry Y Segal, Karththeepan Yogamanoharan, Sabah Alvi, Nadia Amin, Paul Carruthers, Stacey Dover, Joanna Eastman, Talat Mushtaq, Una Masic, Polly Carmichael
Archives of Disease in Childhood
https://adc.bmj.com/content/early/2022/07/18/archdischild-2022-324302

Supporting young people to manage gender-related distress using third-wave cognitive behavioural theory, ideas and practice
Canvin, L., Hawthorne, O., & Panting, H. (2022)
Clinical Child Psychology and Psychiatry, 1-17
https://doi.org/10.1177/13591045211068729

Service user engagement by ethnicity groups at a children’s gender identity service in the UK. Clinical Child Psychology and Psychiatry,
Manjra, I. I., Russell, I., Maninger, J. K., & Masic, U. (2022)
https://doi.org/10.1177/13591045221102650

Key socio-demographic characteristics of children and adolescents with gender dysphoria: a British Isles surveillance study
Khadr, S., Masic, U., Clarke, V., Lynn, R M., Holt V., Carmichael, P. (2022).
Clinical Child Psychology and Psychiatry
https://doi.org/10.1177/13591045221108840

1. Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK.
Carmichael, P., Butler, G., Masic, U., Cole, T. J., De Stavola, B. L., Davidson, S., … & Viner, R. M. (2021).
PLoS One, 16(2), e0243894. https://doi.org/10.1371/journal.pone.0243894

2. Gender identity development in children and young people: A systematic review of longitudinal studies.
Stynes, H., Lane, C., Pearson, B., Wright, T., Ranieri, V., Masic, U., & Kennedy, E. (2021).
Clinical Child Psychology and Psychiatry.
https://doi.org/10.1177/13591045211002620

3. How do mental health professionals describe their experiences of providing care for gender diverse adults? A systematic literature review.
Canvin, L., Twist, J., & Solomons, W. (2021).
Psychology & Sexuality.
https://doi.org/10.1080/19419899.2021.1916987

4. Gender diversity and autism spectrum conditions in children and adolescents: A narrative review of the methodologies used by quantitative studies
Manjra, I., & Masic, U. (2021).
Journal of Clinical Psychology, pp1-18
https://doi.org/10.1002/jclp.23249

6. Psychological Functioning in Non-binary Identifying Adolescents and Adults
De Graaf, N., Huisman, B., Cohen-Kettenis, P.T., Twist, T., Hage, K., Carmichael, P., Kreukels, B.P.C., & Steensma, T.D. (2021)
Journal of Sex & Marital Therapy
https://doi.org/10.1080/0092623X.2021.1950087

7. Longitudinal Outcomes of Gender Identity in Children (LOGIC): protocol for a prospective longitudinal cohort study of children referred to the UK gender identity development service.
Kennedy, E., Spinner, L., Lane, C., Stynes, H., Ranieri, V., Carmichael, P., … & King, M. (2021).  BMJ open, 11(9), e045628
https://bmjopen.bmj.com/content/11/9/e045628

1. Association of Media Coverage of Transgender and Gender Diverse Issues with Rates of Referral of Transgender Children and Adolescents to Specialist Gender Clinics in the UK and Australia.
Pang, K. C., De Graaf, N. M., Chew, D., Hoq, M., Keith, D. R., Carmichael, P., & Steensma, T. D. (2020).  JAMA Network Open, 3(7), e2011161-e2011161.
https://dx.doi.org/10.1001%2Fjamanetworkopen.2020.11161

2. Time trends in referrals to child and adolescent gender identity services: a study in four Nordic countries and in the UK.
Kaltiala, R., Bergman, H., Carmichael, P., De Graaf, N. M., Egebjerg Rischel, K., Frisén, L., … & Waehre, A. (2020).  Nordic Journal of Psychiatry, 74(1), 40-44
https://doi.org/10.1080/08039488.2019.1667429

3. Debate: You can’t take politics out of the debate on gender‐diverse children
Wren, B. (2020). . Child and Adolescent Mental Health, 25(1), 40-42.
https://doi.org/10.1111/camh.12350

4. Non-binary Lives: An Anthology of Intersecting Identities.
Smith, J. J., Jas, Y., Tolu, L., Tolu, M., McCarthy, K., Janib, A., … & Lord, E. (2020).  Edited by J. Twist. Jessica Kingsley Publishers.
https://uk.jkp.com/products/nonbinary-lives

5. A Longitudinal Study of Features Associated with Autism Spectrum in Clinic Referred, Gender Diverse Adolescents Accessing Puberty Suppression Treatment
Russell, I., Pearson, B., & Masic, U. (2020). . Journal of Autism and Developmental Disorders, 1-9.
https://doi.org/10.1007/s10803-020-04698-8

6. A psychological support group for parents in the care of families with gender diverse children and adolescents.
Caldarera, A., Davidson, S. Vitiello, B., & Baietto, C. (2020).
Clinical Child Psychology and Psychiatry
https://doi.org/10.1177/1359104520963372

We worked with the journal of Clinical Child Psychology and Psychiatry to create a Special Issue about ‘transgender identity’. The issue includes a group of papers that originated from our work. you can see links to many of the articles below.

• Langton, T., Wren, B., & Carmichael, P. (2018). Seeing the child in context: Supporting gender diverse children and their families in multiple ways–An introduction to this special edition. Clinical child psychology and psychiatry, 1359104518800143.
  https://doi.org/10.1177%2F1359104518800143
• Churcher Clarke, A., & Spiliadis, A. (2019). ‘Taking the lid off the box’: The value of extended clinical assessment for adolescents presenting with gender identity difficulties. Clinical child psychology and psychiatry, 1359104518825288.
  https://doi.org/10.1177%2F1359104518825288
• Matthews, T., Holt, V., Sahin, S., Taylor, A., & Griksaitis, D. (2019). Gender Dysphoria in looked-after and adopted young people in a gender identity development service. Clinical child psychology and psychiatry, 24(1), 112-128.
  https://doi.org/10.1177%2F1359104518791657
• Davidson, S., & Miller, A. (in press). Co-ordinating meaning within a gender identity development service – What can the theory of the Co-ordinated Management of meaning offer clinicians working with young people, and their families, exploring their gender identities. Clinical child psychology and psychiatry
• https://doi.org/10.1177%2F1359104519838313
• Davidson, S., Morrison, A., Skagerberg, E., Russell, I., & Hames, A. (2018). A therapeutic group for young people with diverse gender identifications. Clinical child psychology and psychiatry, 1359104518800165.
  https://doi.org/10.1177%2F1359104518800165
• Twist, Jos, and Nastasja M. de Graaf. (2018) Gender diversity and non-binary presentations in young people attending the United Kingdom’s National Gender Identity Development Service. Clinical child psychology and psychiatry, 1359104518804311.
  https://doi.org/10.1177%2F1359104518804311
• Mann, Georgina; Taylor, Amelia; Wren, Bernadette; De Graaf, Nastasja. (2018). Review of the literature on self-injurious thoughts and behaviours in gender-diverse children and young people in the United Kingdom.” Clinical child psychology and psychiatry, 1359104518812724
  https://doi.org/10.1177%2F1359104518812724
• De Graaf, Nastasja; Manjra, Ilham; Zitz, Claudia; Hames, Anna; (2018), Thinking about ethnicity and gender diversity in children and young people, Clinical Child Psychology and Psychiatry, 1359104518805801
  https://doi.org/10.1177%2F1359104518805801
• De Graaf, N. M., & Carmichael, P. (2018). Reflections on emerging trends in clinical work with gender diverse children and adolescents. Clinical child psychology and psychiatry, 1359104518812924.
  https://doi.org/10.1177%2F1359104518812924

• Tobin Joseph, Joanna Ting and Gary Butler*. The effect of GnRH analogue treatment on bone mineral density in young adolescents with gender dysphoria: findings from a large national cohort
  https://doi.org/10.1515/jpem-2019-0046
• Churcher Clarke, A., & Spiliadis, A. (2019). ‘Taking the lid off the box’: The value of extended clinical assessment for adolescents presenting with gender identity difficulties. Clinical child psychology and psychiatry
  https://doi.org/10.1177/1359104518825288
• Matthews, T., Holt, V., Sahin, S., Taylor, A., & Griksaitis, D. (2019). Gender Dysphoria in looked-after and adopted young people in a gender identity development service. Clinical child psychology and psychiatry, 24(1), 112-128.
  https://doi.org/10.1177%2F1359104518791657
• Davidson, S., & Miller, A. (in press). Co-ordinating meaning within a gender identity development service – What can the theory of the Co-ordinated Management of meaning offer clinicians working with young people, and their families, exploring their gender identities. Clinical child psychology and psychiatry
  https://doi.org/10.1177%2F1359104519838313

• Butler, Gary; De Graaf, Nastasja; Wren, Bernadette; Carmichael, Polly (2018) The assessment and support of children and adolescents with Gender Dysphoria, Arch Dis Child, 103.
  http://dx.doi.org/10.1136/archdischild-2018-314992
• Butler, G., Wren, B., & Carmichael, P. (2019). Puberty blocking in gender dysphoria: suitable for all? Archives of Disease in Childhood
  http://dx.doi.org/10.1136/archdischild-2018-315984
• De Graaf, Nastasja; Giovanardi, Guido; Zitz Claudia; Carmichael, Polly. (2018). Sex ratio in children and adolescents referred to the Gender Identity Development Service in the UK (2009–2016). Archives of Sexual Behavior, 47, pp. 1301-1304.
  https://doi.org/10.1007/s10508-018-1204-9
• Di Ceglie, D. (2018). The use of metaphors in understanding atypical gender identity development and its psychosocial impact. Journal of Child Psychotherapy, 44(1), 5-28.
  https://doi.org/10.1080/0075417X.2018.1443151
• Di Ceglie, D. (2018). Autonomy and decision-making in children and adolescents with gender dysphoria.
  https://doi.org/10.1017/9781108619554.018
• Bonfatto, M., & Crasnow, E. (2018). Gender/ed identities: an overview of our current work as child psychotherapists in the Gender Identity Development Service.
  Journal of Child Psychotherapy, 44(1), 29-46.
  https://doi.org/10.1080/0075417X.2018.1443150
• Tobin, J., Ting, J., & Butler,G (2018). The effect of GnRHa treatment on bone density in young adolescents with gender dysphoria: findings from a large national cohort
  https://doi.org/10.1530/endoabs.58.OC8.2

1. Twist, Jos (2017) Transitioning Together: Narratives of Sexuality and Intimacy in Partners of Trans People, Psychology of Sexualities Review, 8(2)
2. Twist, Jos; Barker Meg; Nel, Pieter; Horley, Nic (2017) Transitioning together: a narrative analysis of the support accessed by partners of trans people, Sexual and Relationship Therapy, 32(2), pp 227–243
3. Twist, J (2017). Pushing at the edges in uncertain places: Jos Twist in Conversation with Bernadette Wren, Psychology of Sexualities Review, Vol. 8, No. 1
4. De Graaf, Nastasja; Cohen-Kettenis, P.T; Carmichael, Polly; de Vries, A.L.C; Dhondt, K; Laridaen, J.; Pauli, D.; Ball, J.; Steensma, T.D. (2017) Psychological functioning in adolescents referred to specialist gender identity clinics across Europe: a clinical comparison study between four clinics (2018) European Child and Adolescent Psychiatry.

1. R. Costa, P. Carmichael, M. Colizzi (2016) To treat or not to treat: puberty suppression in childhood-onset gender dysphoria Nature Reviews Urology
2. D. Di Ceglie 2016 – Autonomy and Decision Making in Children and Adolescents with Gender Dysphoria” in the ‘ Lunch with the  expert’ session of the 18th ‘World Congress of Pediatric Adolescent Gynaecology’ (WCPAG) in Florence. June 2016.
3. D. Di Ceglie 2016 – Atypical Gender Identity Development: Current Views, at the Young European Scientists (Yes)-Meeting, Faculty of Medicine, Porto (Portugal). September 2016.
4. D. Di Ceglie 2016 – Book launch: Quagliata E., Di Ceglie D., Eds. “Lo sviluppo dell’identità sessuale e  l’identità di genere.” Casa Editrice: Astrolabio-     Ubaldini, Roma, at Palazzo San Macuto, Camera dei Deputati, Roma

1. Burns, J., & Zitz, C. (2015). Clinical Psychology. In The Palgrave Handbook of the Psychology of Sexuality and Gender (pp. 263-279). Palgrave Macmillan UK.
2. Costa, R., Dunsford, M., Skagerberg, E., Holt, V., Carmichael, P. & Colizzi, M. (2015). Psychological Support, Puberty Suppression, and Psychosocial Functioning in Adolescents with Gender Dysphoria. International Society for Sexual Medicine
3. Skagerberg, E., Di Ceglie, D. & Carmichael, P. (2015). Autistic Features in Children & Adolescents with Gender Dysphoria. Journal Autism Dev Disorder.
4. Webb, I. (2015). An exploration of the Body Image Scale in young people : a comparison of persons with features of gender dysphoria and control samples. (Doctoral dissertation, University of East London).
5. Wren, B. (2015) A clinical service for gender non-conforming young people: what can a liberation psychology perspective contribute? Liberation Psychology Perspective

1. Di Ceglie, D. (2014) “Gender dysphoria in young people” in “Clinical topics in child and adolescent psychiatry” (ed S. Huline-Dickens, Royal College of Psychiatrists Publications, London).
2. Di Ceglie, D., Skagerberg, E., Baron-Cohen, S. & Auyeung, B. (2014). Empathising and systemising in adolescents with gender dysphoria. Opticon1826, (16): 6, 1-8.
3. Gregor, C., Davidson, S. & Hingley-Jones, H. (2014). The experience of gender dysphoria for pre-pubescent children and their families: a review of the literature. Child & Family Social Work. doi:10.1111/cfs.12150.
4. Holt, V., Skagerberg, E. & Dunsford, M. (2014). Young people with features of gender dysphoria: Demographics and associated difficulties. Clinical Child Psychology and Psychiatry.
5. Wren, B. (2014). Thinking postmodern and practising in the Enlightenment: managing uncertainty in the treatment of children and adolescents. Feminism and Psychology. doi: 10.1177/0959353514526223.
6. Zitz, C., Burns, J. & Tacconelli, E. (2014). Trans men and friendships: A foucauldian discourse analysis. Feminism and Psychology. doi: 10.1177/0959353514526224.

1. Di Ceglie, D. (2013) “Care for gender-dysphoric children” in “Gender dysphoria and disorders of sex development: Progress in care and knowledge” (eds B.P.C. Kreukels et al New York: Springer).
2. Skagerberg, E., Davidson, S. & Carmichael, P. (2013). Internalising and externalising behaviours in a group of young people with gender dysphoria. International Journal of Transgenderism, 14, 105-112.
3. Skagerberg, E., Parkinson, R. & Carmichael, P. (2013). Self-harming thoughts and behaviours in a group of children and adolescents with gender dysphoria. International Journal of Transgenderism, 14, 86-92.
4. Khadr, S. N., Carmichael, P., Holt, V., Roche, E. F., & Viner, R. M. (2014). UK and Irish surveillance study of gender identity disorder (GID) in children and adolescents. Journal of Adolescent Health, 54(2), S56-S57.

1. Di Ceglie, D. (2012). Identity and inability to mourn in the skin I live in (2012). International Journal of Psychoanalysis, 93, 1308-1313.
2. Di Ceglie, D. (2012). Atypical gender identity development and autistic spectrum features. Neuropsychiatrie de l Enfance et de l Adolescence 60(5):S36-S37
3. Di Ceglie, D. (2012). Response to Alessandra Lemma – APP lecture research off the couch: revisiting the transsexual conundrum. Psychoanalytic Psychotherapy, 26, 290-293.

1. Jones, R. M., Wheelwright, S., Farrell, K., Martin, E., Green, R., Di Ceglie, D. & Baron-Cohen, S. (2011). Brief report: Female-to-male transsexual people and autistic traits. Journal of Autism and Developmental Disorders, 42 (2): 301-306.
2. Wiseman, M. & Davidson, S. (2011). Problems with binary gender discourse: Using context to promote flexibility and connection in gender identity. Clinical Child Psychology & Psychiatry, 13, 1-10.

1. Carmichael, P. & Davidson, S. (2009). A Gender Identity Development Service. The Psychologist: 22(11), 916-917.
2. Di Ceglie, D. (2009). Engaging young people with atypical gender identity development in therapeutic work: A developmental approach. Journal of Child Psychotherapy, 35, 3-12.
3. Eracleous, E. & Davidson, S. (2009). The gender identity development service: Examples of multi-agency working. Clinical Psychology Forum, 201, 46 – 50.
4. Holt, V. (2009). Atypical gender development in children and adolescents. In S.
5. Bailey & M. Shooter (Eds.), The young mind: An essential guide to mental health for young adults, parents and teachers.London: Transworld Publishers.

1. Di Ceglie, D. (2008). Working at the edge: Engaging in therapeutic work with young people with atypical gender identity development. Neuropsychiatrie de l’Enfance et de l’Adolescence, 56(6), 403-406.