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Gender Identity Development Service
The Gender Identity Development Service (GIDS) was a nationally operated health clinic in the United Kingdom that specialised in working with transgender and gender diverse youth, including those with gender dysphoria. Launched in 1989, GIDS was commissioned by NHS England and took referrals from across the UK, although it was operated at a Tavistock and Portman NHS Foundation Trust site. GIDS was the only gender identity clinic for people under 18 in England and Wales and was the subject of much debate.
In the late 2010s, the GIDS became controversial because of growing public attention on trans issues and concerns about the service, including a huge increase in patients and a lack of longitudinal evidence to support the treatments it gave. Some of its most prominent critics were gender-critical psychotherapists and psychoanalysts who argued against gender-affirming care for minors altogether.
By 2020, a large increase in referrals led to waiting lists in excess of two years. Between 2020 and 2021, GIDS stopped offering hormonal treatments to youth following the judgement in Bell v Tavistock, until the decision was overturned on appeal. In July 2022, the NHS decided to close GIDS and replace it with regional healthcare centres, following the release of the interim report of the Cass Review, in order to reduce waiting lists and provide better quality care to young people. The service closed in March 2024.
GIDS was a service provided by the Tavistock Clinic. Originally located at Tavistock Square in London, the clinic specialised in psychiatric care. The Tavistock Clinic treated both adults and children, with their first patient being a child. It mainly focused on military psychology, including shell-shock, now termed PTSD. In 1948, with the creation of the NHS, the Tavistock Clinic launched its children's department, which developed many works by James Robertson and John Bowlby on attachment theory. In 1959, it opened an adolescent department and in 1967 it was absorbed into the London Child Guidance Clinic.
The Gender Identity Development Clinic was founded in 1989 by Dr Domenico Di Ceglie, a child and adolescent psychiatrist. It was one of the first child gender services in the world. After its opening, "it got two referrals over the whole year". It was initially based at St George's Hospital before moving to the Tavistock and Portman NHS Foundation Trust in 1994. The clinic saw 12 patients that year, increasing to 24 two years later. The last word of the clinic's name varied over time, shifting to Unit before being standardised in the late 2000s as Service.
In its early years, the service took a primarily psychoanalytic approach reflecting object relations theory, drawing from Di Ceglie's training. Di Ceglie described the children referred to the clinic as suffering from "atypical gender identity organization". In the early 2000s, some of Di Ceglie's colleagues at Tavistock published articles in The Guardian arguing that medical transition was a form of "mutilation" and that rights won in the European Court of Human Rights for transgender people were a "a victory of fantasy over reality".
Di Ceglie estimated in 1993 that only 5% of his patients would "commit themselves to a change of gender". Puberty blockers were considered a usable option by the end of the 1990s but only for patients aged 16 or over who had first tried extensive therapy. In 2000, a retrospective audit led by David Freeman looked at the records of 124 patients the service had seen since opening. The audit showed it was very rare (2.5% of the sample) for young people referred to GIDS to have no associated problems, that children do not "grow out of it" and that problems increase with the onset of puberty.
In 2009, Dr Polly Carmichael, a consultant clinical psychologist, succeeded Di Ceglie as the clinic's director. In that same year, GIDS became a nationally commissioned NHS service.
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Gender Identity Development Service
The Gender Identity Development Service (GIDS) was a nationally operated health clinic in the United Kingdom that specialised in working with transgender and gender diverse youth, including those with gender dysphoria. Launched in 1989, GIDS was commissioned by NHS England and took referrals from across the UK, although it was operated at a Tavistock and Portman NHS Foundation Trust site. GIDS was the only gender identity clinic for people under 18 in England and Wales and was the subject of much debate.
In the late 2010s, the GIDS became controversial because of growing public attention on trans issues and concerns about the service, including a huge increase in patients and a lack of longitudinal evidence to support the treatments it gave. Some of its most prominent critics were gender-critical psychotherapists and psychoanalysts who argued against gender-affirming care for minors altogether.
By 2020, a large increase in referrals led to waiting lists in excess of two years. Between 2020 and 2021, GIDS stopped offering hormonal treatments to youth following the judgement in Bell v Tavistock, until the decision was overturned on appeal. In July 2022, the NHS decided to close GIDS and replace it with regional healthcare centres, following the release of the interim report of the Cass Review, in order to reduce waiting lists and provide better quality care to young people. The service closed in March 2024.
GIDS was a service provided by the Tavistock Clinic. Originally located at Tavistock Square in London, the clinic specialised in psychiatric care. The Tavistock Clinic treated both adults and children, with their first patient being a child. It mainly focused on military psychology, including shell-shock, now termed PTSD. In 1948, with the creation of the NHS, the Tavistock Clinic launched its children's department, which developed many works by James Robertson and John Bowlby on attachment theory. In 1959, it opened an adolescent department and in 1967 it was absorbed into the London Child Guidance Clinic.
The Gender Identity Development Clinic was founded in 1989 by Dr Domenico Di Ceglie, a child and adolescent psychiatrist. It was one of the first child gender services in the world. After its opening, "it got two referrals over the whole year". It was initially based at St George's Hospital before moving to the Tavistock and Portman NHS Foundation Trust in 1994. The clinic saw 12 patients that year, increasing to 24 two years later. The last word of the clinic's name varied over time, shifting to Unit before being standardised in the late 2000s as Service.
In its early years, the service took a primarily psychoanalytic approach reflecting object relations theory, drawing from Di Ceglie's training. Di Ceglie described the children referred to the clinic as suffering from "atypical gender identity organization". In the early 2000s, some of Di Ceglie's colleagues at Tavistock published articles in The Guardian arguing that medical transition was a form of "mutilation" and that rights won in the European Court of Human Rights for transgender people were a "a victory of fantasy over reality".
Di Ceglie estimated in 1993 that only 5% of his patients would "commit themselves to a change of gender". Puberty blockers were considered a usable option by the end of the 1990s but only for patients aged 16 or over who had first tried extensive therapy. In 2000, a retrospective audit led by David Freeman looked at the records of 124 patients the service had seen since opening. The audit showed it was very rare (2.5% of the sample) for young people referred to GIDS to have no associated problems, that children do not "grow out of it" and that problems increase with the onset of puberty.
In 2009, Dr Polly Carmichael, a consultant clinical psychologist, succeeded Di Ceglie as the clinic's director. In that same year, GIDS became a nationally commissioned NHS service.