Content warning: Mentions of suicide, self-harm and child deaths. Transphobia and systematic workplace harassment.
Every time I speak to people working inside the NHS, I hear this line without fail: “I’m going to sound like a conspiracy theorist here.” But with every person I speak to, it always rings true. The stories alongside it are also shocking and highlight a culture of intimidation, fear, and silence.
When we report on past or future developments regarding gender services inside the NHS, no one is able to go on the record, and at a stretch, only under the guise of being “an anonymous source.” Every person I have spoken to has had their jobs threatened and their work systematically undermined to prop up the work of those seeking to make trans lives worse.
We spoke to two anonymous clinicians who worked at the Tavistock GIDS clinic about their experience of the culture of silence that was forced onto them.
“It was like watching a slow-motion car crash”
The discussion began with one of the clinicians saying, “Where do we start?” There was a lot to go through. This story goes all the way back to 2016. A story involving certain “Tavistock whistleblowers”, who weren’t the innocent victims that mainstream media had painted them as. According to our sources, there was a subset of Tavistock clinicians who had gender-critical views and held a lot of influence. Notably, they were known to parrot the term “transing the gay away”.
“Gender criticals claim they have been silenced, but they have been platformed in media and given words in articles, and space in interviews,” our source told us. “People who have no lived experience” were “given more space” than those who were more supportive.
We were told that these anti-trans clinicians encouraged a person on the board of governors at GIDS, David Bell, to write a report on their “concerns” about the clinic. He had, without approval from the trust, made a report that was “highly critical” and “verging on transphobic”, with a “lot of horrible stuff in there”. Internally, there was very little that staff could do to challenge it, largely because the main staff group did not have access to the report in the first place. As of the time of writing, it still has not been released publicly, despite having been shared with anti-trans journalists.
Things started advancing further from there. Anti-trans attacks in the media came against the clinic. Comparisons to “concentration camp experiments” were made. And Tavistock refused to speak out against it, even after challenges from staff members. No counter-narrative was being presented.
With media attention ramping up, “it was like watching a slow car crash.” Staff couldn’t even speak out against it, with Tavistock Trust Management claiming it would “pour fuel onto the fire” and shutting down any attempts, to the point that “staff weren’t allowed to publicly talk about trans issues”, as they just “got threatened with disciplinary action”, and the threat from HR “put in writing.” In meetings, management would “shut down on the concerns”, “turning off chat functions in Zoom meetings”, “scoffing, eye-rolling”.
Meanwhile, anti-trans narratives were building. The sources said that Tavistock was “repeatedly featured and misrepresented on Newsnight” and that “they [the mainstream media] were trying to incite a scandal.” Following that, “people would publicly say things that were gender critical in the drive of them knowing that there was no way for it to be challenged publicly. And would imply that if it weren’t answered, it would be true”.
A cruel cover-up
Time passed, and the book Time to Think by Hannah Barnes was published, a book that I was told was “full of fiction.” Anti-trans rhetoric was at a full-time high, with the Keira Bell case reaching its conclusion. A court order was placed to prevent new prescriptions of puberty blockers. And the order was implemented immediately.
In the follow-up to the ban, there were significant concerns raised by Clinical Staff in relation to the increased risk of deliberate self-harm and suicidal ideation for young trans people the staff were supporting. Over time, it became clear that staff were vindicated in raising these safety warnings, which were ignored by the Trust and NHSE. The true impact of this emerged over time.
I was told that “The Trust was trying to shut down the emerging evidence in relation to the increased deaths related to the service following the ban on Puberty Blockers.” By December 2023, the Trust advised staff that this number had reached 16 cases. The trust provided this statistic to the clinical staff, not by the staff themselves.
Yet, the Appleby report (A report that was commissioned to investigate the deaths relating to GIDS) downplayed the number of deaths relating to the GIDS service. I was told the report “was a shoddy bit of work” and that “there’s missing data.” and denied the 16 deaths reported by the Tavistock trust in the first place. In the end, I was told that the downplaying of the deaths was most likely “a coverup.”
The Cass Review began in 2020, and from the start, there was apprehension. “We were worried about the intention of the Cass review,” worried that “the conclusion had been made before the review was made.”
As the report progressed, I was told that “Hilary Cass came and reassured us that this wasn’t a hatchet job” and “she said she was not there to shut down the clinic.” But all that was for naught. While the report was in progress, there was “very limited interaction with Cass”. “GIDS only saw Cass 3 times in highly staged meetings” and very much gave the impression that “she did not have good faith”.
Silencing and litigation
Following the interim report from Cass, the announcement of the closure of GIDS came. No one was told. The staff discovered the closure on the same day as the press did. They were “told by the trust that the reason that it came out like that was because there was a threat that the information was going to be a leak to the public and wanted it to appear because it was because of the Cass review”. But in reality, it was decided that Tavistock would close before the Cass review.
Staff raised concerns about the closure, as they were worried there was no safe plan and handover of patients to the new services. They were told to keep things “business as usual” and that “no questions should be raised” Staff got the impression they were being “told to shut up”. Something which climaxed with an all-hands meeting where a “presentation came up with slides that stated that if we did not do as we were told, that they would litigate against us, that they would raise disciplinary actions against us, and notify the professional bodies that allow us to practice” Staff interpreted this as a “threat to their careers“.
We were told they would be offered jobs in the new service. However, “None of that happened.” Quite understandably, the affected staff “were in a state of shock” and “felt threatened” and contacted their trade unions. Alongside a closure like this, “there’s a redundancy situation, and the staff were made redundant.”
This escalated to the point of an open letter, signed by two-thirds of the staff at Tavistock, sharing their concerns about the service shutting down. Unfortunately, those who signed the form were threatened with job loss. Some people refrained from signing the form for fear of reprisal.
The staff told me, “There was no safe handover from the old service to the new service.” This wasn’t due to a lack of effort from the GIDS staff, especially as the trust knew 18 months before the closure date, while the staff knew 2 months before the closure.”
The shunning of experience
Following the closure of Tavistock, those with experience running these services were put out of a job and denied a place at the new service. “The new service has no one with that experience”. “The people the kids are going to see have no clinical experience. It is a disgrace.“ They discussed this comparison: “Would you send your kid to a dentist who has never pulled out a tooth before?”
At the moment, anti-trans clinicians seemed “to have influenced a lot of things including the new children and young people’s services, and spoken to politicians.” It was felt that anyone who was openly trans-positive would be at risk of having their careers ruined.
In the meantime, the training given to inexperienced new clinicians would be full of anti-trans sentiment, as we can see from the evidence from Trans Safety Network. It shows that anti-trans clinicians put together the materials for the new services, something “setting the scene for what healthcare will look like for the next 10 years.”
We barely need to point this out, but this is intensely bleak news. At the moment, with no one able to go on the record, these anti-trans narratives are allowed to fester. And even when they do try to communicate with mainstream outlets, “they don’t print it.” “It’s just out of greed”.
As we look to the future, our sources are “worried about parallel processes happening with what’s going on with adult services.” “There are echoes.” With all the misinformation going towards trans healthcare as a whole, we are deeply concerned that there could be a repeat of past indignities and discrimination within the very heart of a service that is vitally important to many young trans people and their parents.
If you have worked at an NHS gender clinic in England, Scotland, Wales or Northern Ireland and wish to share your story, please contact us using this link: Contact – What The Trans!?
