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Closure of UK gender clinic does not mean change needed in Australia
An opinion piece written by Fiona Bisshop – AusPATH president
in SMH Sep 7th 2022The treatment of children and adolescents experiencing gender dysphoria is back in the news following the closure of a prominent gender clinic in the UK. This has led to much commentary about how to best help transgender youth, and whether this will affect how gender clinics operate in Australia.
The Gender and Identity Development Service (GIDS), run by the Tavistock and Portman NHS Trust – the only children’s gender clinic in the UK – was closed after it was criticised in an independent review led by paediatrician Dr Hilary Cass. The report found that the rapid increase in the number of children requiring support and the complex case-mix, including neurodiverse young people and those with mental health needs, meant that the current clinical model, with a single national provider, is not sustainable in the longer term.
The review also found the clinic did not have consistent data collection, which means it is not possible to accurately track the outcomes and pathways that children and young people take through the service; there was lack of open discussion amongst staff about the appropriate clinical response; and because the specialist service had evolved rapidly in response to demand, the clinical approach and overall service design had not been subjected to usual quality controls.
On face value, and without taking the time to read the review, it would be easy to interpret this as a condemnation of children’s gender clinics in general. However, I submit that this is not an accurate evaluation.
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Critics who are sceptical of providing gender-affirming care for
children portray young gender-diverse people as confused, and gender
affirmation as a negative thing which forces young people down a path to
transition. They use stories of people who regret their decision to
transition as evidence of the dangers of affirming therapy. But true
regret, whilst unfortunate, is rare.Critics who are sceptical of providing gender-affirming care for children portray young gender-diverse people as confused, and gender affirmation as a negative thing which forces young people down a path to transition. They use stories of people who regret their decision to transition as evidence of the dangers of affirming therapy. But true regret, whilst unfortunate, is rare.In fact, affirmation does not force anything on anyone. It does not push
blockers or hormones. It’s simply the process of supporting and
allowing a young person to express themselves and their gender identity
by using different names and pronouns, choosing how they dress, and
avoiding irreversible physical changes of puberty if they wish. In my
professional career, I’ve met many hundreds of older trans people who
were denied this opportunity as children, and have suffered throughout
their lives as a result.So, what are the implications of the Tavistock closure for Australia? Really, it just vindicates that the gender clinics here are on the right track, working towards changing their service model to better meet the needs of their patients.
There is no doubt – gender affirmation is not only evidence-based, it is vital, life-changing and life-saving.
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