A group of British psychologists has apologised for the role their profession played in harming children through so called gender-affirming care which has been condemned by the Cass report following the most extensive and thoroughgoing evidence-based review of the treatment for children experiencing gender distress ever undertaken.
Sixteen unnamed senior clinical psychologists wrote to The Observer newspaper following its editorial on the issue, saying that they are “ashamed of the role psychology played in gender care” in the UK.
Here’s the full letter:
We write as clinical psychologists with longstanding concerns about the scandal unfolding at Gender Identity Development Service (Gids) clinics. Some of us are former Gids clinicians. While welcoming your editorial stance, we would like to point out that it is not just the medical profession that has “much to reflect on.”
These were psychology-led services. Whether intentionally or not, and many were doing their best in an impossible situation, it was clinical psychologists who promoted an ideology that was almost impossible to challenge; who, as the Cass report found, largely failed to carry out proper assessments of troubled young people, and thus put many on an “irreversible medical pathway” that in most cases was inappropriate; and who failed in their most basic duty to keep proper records.
It is also our professional body, the British Psychological Society, that has failed (despite years of pressure) to produce guidelines for clinicians working with young people in this complex area; and that, forced into making an official response for the first time, now minimises its own role in events and calls for “more psychology” as the answer. We are ashamed of the role psychology has played.
What happened at Gids was a multi-factorial systemic failure, but when The Observer rightly calls for “accountability for the managers and clinicians who pursued such unethical practice and caused avoidable harm to young people”, we believe the role of our own profession should be fully examined.
Sixteen senior clinical psychologists
Names supplied
The Observer editorial reads in part:
‘They deserve very much better,” the distinguished paediatrician Hilary Cass concludes in the final report of her independent review of NHS gender identity services for children and young people.
Just how badly wrong things went at the Gender Identity Development Service (Gids) is evidenced in the fact that Cass felt she had to explicitly state that, while some people argue that clinical care for children should be based on a “social justice” model, “the NHS works in an evidence-based way”. That should never have been up for debate: as the British Medical Journal argued, it is deeply unethical to provide untested medical interventions for children that lack evidence of benefit, yet are life-altering and come with potentially very significant harms.
But that is exactly what has happened to a growing cohort of children seen by Gids, which has since been shut down. Disproportionately made up of girls and same-sex attracted children, many were put on an irreversible medical pathway without diagnostic criteria.
Because Gids failed to keep adequate data even on the children it was treating in this way, let alone keep track of their outcomes, it is impossible to know the scale of the harm that has been done to them, including how many have now detransitioned or experienced regret.
Looking forward, the most important priority for the NHS is delivering the quality of care children deserve yet have been denied by Gids. But there must also be accountability for the managers and clinicians who pursued such unethical practice and caused avoidable harm to young people. For the medical profession as a whole, there is much to reflect on: how did they look the other way as this travesty unfolded? How were adult belief systems allowed to drive healthcare for children, and how were campaigners from outside the NHS and medicine allowed to have so much influence? It is only by learning the lessons that a similar scandal can be avoided again.
