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Tavistock to face possible clinical negligence claims over gender identity service

BMJ 2022; 378 doi: https://doi.org/10.1136/bmj.o2016 (Published 12 August 2022) Cite this as: BMJ 2022;378:o2016
  1. Clare Dyer
  1. The BMJ

Tavistock and Portman NHS Foundation Trust in London is facing possible clinical negligence claims by former patients of its Gender Identity Development Service (GIDS) for children and adolescents.

The law firm Pogust Goodhead hopes to bring a group action and has called for former patients of the service, which treats young people with gender dysphoria, to come forward.

GIDS is the sole service in England providing the treatment. Former staff have accused it of being too ready to prescribe puberty blocking hormones to young people who question their gender identity and are reluctant to consider other options.

After an interim report from an independent review by Hilary Cass, a former president of the Royal College of Paediatrics and Child Health, GIDS is to be closed, and services will in future be provided through regional hubs with multidisciplinary teams and thorough assessment.1

The GIDS model requires it to decide whether young people with gender dysphoria should receive puberty blockers and, later, cross sex hormones and, if so, to refer them to paediatric endocrinologists to deliver the treatment.

The Cass review found that at GIDS the “clinical approach and overall service design has not been subjected to some of the normal quality controls that are typically applied when new or innovative treatments are introduced.” In future, it said, “children and young people with gender incongruence or dysphoria must receive the same standards of clinical care, assessment and treatment as every other child or young person accessing health services.”2

In November 2020 the Care Quality Commission took enforcement action after an inspection that rated GIDS overall as “inadequate,” highlighting overwhelming caseloads, deficient record keeping, and poor leadership.

Pogust Goodhead is an international litigation firm that specialises in corporate wrongdoing and harm. Its global managing partner, Tom Goodhead, said, “Children and young adolescents were rushed into treatment without the appropriate therapy and involvement of the right clinicians, meaning that they were misdiagnosed and started on a treatment pathway that was not right for them.

“These children have suffered life changing and in some cases irreversible effects of the treatment they received, which has resulted in long term physical and psychological consequences for them. We must not shut down debate on account of a fear of discussing gender identity, and those responsible must be held accountable.”

His colleague Lisa Lunt, the firm’s head of product liability, said, “We support the findings of the Cass review interim report and believe there has been a real level of harm that has been perpetrated towards patients who were rushed into taking life altering puberty blockers without adequate consideration or proper diagnosis.”

A spokesman for the firm said it was also considering suing NHS England as commissioner of the services.

GIDS’s figures show that around 1000 young people have been referred to endocrinology teams in the past decade, out of some 19 000 referrals. A spokesman for the Tavistock trust said it had worked with every young person on a case by case basis, “with no expectation of what might be the right pathway for them, and only the minority of young people who are seen in our service access any physical treatments while with us.”

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