15 under-FOURS were referred to NHS Tavistock clinic to undergo gender care services

At least 15 children under the age of four were directed to the NHS’s transgender health service in England in the past two years.

A similar number of five-year-olds were referred between 2021-2022 to the highly-controversial Gender Identity Development Service (GIDS) at the Tavistock clinic, the country’s only gender identity service for children.

NHS documents state that, in total, over 5,000 children were referred to Tavistock’s service in the past two years, over concerns they were suffering from their gender identity not matching their biological sex. 

Only half of referrals were for children aged 15-plus.

The NHS data, unveiled among some new guidelines for how to treat children with gender dysphoria, only concerns referrals to the GIDS at Tavistock.

Not all of the patients would have been taken on for actual treatment, which can include puberty blockers and hormones that help change their bodies to align more with their gender identity. 

It is not known how many of the children aged five or under referred to GIDS went on to become patients. Any that did are unlikely to have been prescribed medication. 

But the figure is likely to cast even more questions over how children questioning their gender are directed to NHS care in England.

NHS England is cracking down on how children are referred to gender identity care in the future, in the wake of the Tavistock chaos which saw its GIDS service ruled unsafe following a review.

The figures were detailed in NHS England’s draft guidelines for how gender care will operate in two new centres due to open in the spring to replace the Gender Identity Development Service at Tavistock and Portman NHS foundation trust

Tavistock’s handling of children suffering a gender identity crisis has come under increasing focus in recent years. In 2020 former patient Keira Bell took the clinic to the High Court in claiming that she had not been challenged enough before being prescribed the drugs at 16

Other mental health issues were ‘overshadowed’ in favour of gender identity treatment, prompting accusations that staff rushed children onto powerful drugs. 

Under current guidelines, health and social service staff, teachers, and charities can refer a child they think is suffering from gender dysphoria to specialist NHS care. 

But under draft rules published yesterday, which could be enforced from the spring, referrals to NHS gender identity care would be restricted to just GPs and health service staff. 

Stella O’Malley, psychotherapist and director of campaign group Genspect said the fact children under the age of four were being referred for gender identity care, ‘shocking and concerning’.

‘Children up until the age of roughly seven or eight engage in magical thinking, for example they can believe that thinking about something can make it real,’ she said. 

‘Very young kids who are gender non conforming should be free to live as they please- nobody should be responding to gender non conformity as a problem to be treated.’

The NHS estimates this change would slash referrals to gender identify care by 5 per cent, or about 250 children based on the latest data. 

Other sections of the NHS draft outline that doctors must weigh up the risks of social transitioning for young children, which can include changing their pronouns and dressing as the opposite sex.

They also detail that puberty blockers should only be provided via an NHS research programme, and medics should consider safeguarding processes if children obtain such drugs online. 

Health authorities published draft guidelines for its new specialist gender dysphoria services children and young people yesterday for public feedback.

These services, one in London and one in the North West, would replace the GIDS at Tavistock when it eventually shuts it doors in the spring. 

The new clinics would, in theory, operate under the new draft guidelines.   

Current rules have been criticised by some experts who say they rush young people onto medication. 

They have also been attacked by patients who have complained that the service is not meeting fast-growing demand, with some having been on the waiting list for over four years.

The new London service will be run by a partnership between Great Ormond Street Hospital for Children and Evelina London Children’s Hospital.

In the North West, the service will be a partnership between Alder Hey Children’s NHS Foundation Trust and Royal Manchester Children’s Hospital.

After these initial two, a further six or seven similar services could be opened in other parts of the country.  

Patients currently being treated at Tavistock’s Gender Identity Development Service (GIDS) will have their care transferred to the new operators early next year.  

NHS England’s draft guidelines are in response to an ongoing review of GIDS by senior paediatrician Dr Hilary Cass, who warned the gender clinic was ‘not a safe or viable long-term option’.

She found other mental health issues were ‘overshadowed’ in favour of gender identity issues when children were referred to Tavistock.

The clinic had been accused of rushing children onto puberty blocking drugs by former patients who feel they weren’t challenged enough.

Dr Cass has called for ‘rapid’ research on the use of the drugs after she found ‘insufficient evidence’ on their benefits.

GIDS has found itself facing increasing scrutiny in recent years, with campaigners accusing it of rushing children onto puberty blocking drugs.   

Former patient Keira Bell took the clinic to the High Court in 2020, claiming that she had not been challenged enough when she was prescribed the drugs at age 16.

Feedback on the NHS’s draft guidelines closes on 4 December.