‘Secretive’ gender clinics back down over puberty blocker data

Adult NHS gender clinics have bowed to pressure to share missing data on the outcomes of 9,000 patients who were treated as children at the Tavistock clinic.

Six NHS Trusts thwarted a landmark review published by Dr Hilary Cass this week by refusing to co-operate with research into the long-term impact of prescribing puberty blockers and sex hormones.

Cass had commissioned a team at the University of York to examine how thousands of trans children fared after being transferred to adult NHS services from the age of 16.

But the research had to be abandoned after six of the seven NHS adult clinics refused to participate, with some expressing unfounded concerns over “interference from government ministers”. Cass described their failure to share data as “co-ordinated” and “ideologically driven”.

Victoria Atkins, the health secretary, was informed on Thursday night that the adult clinics have now backed down and agreed to comply, after she ordered them to end a “culture of secrecy and ideology”.

Gender clinic leaders who had led opposition to the research provided assurances that they will co-operate, after being threatened with “mandatory direction” from NHS bosses.

It means the world-leading study of the consequences of medical interventions for trans children will be able to proceed, with the NHS due to set out further details early next week. The research will track the fate of the 9,000 children who were under the care of the Gender Identity Development Service (Gids) at the Tavistock and Portman NHS Trust between 2009 and 2020.

An NHS spokesman said: “Ahead of the publication of the Cass review’s final report, NHS England wrote to all seven providers of adult gender dysphoria clinics setting out our expectation of full participation with the data linkage study, and have now received assurances that the group intend to do so.”

Six adult NHS gender clinics, in Leeds, Newcastle, Northampton, Nottingham, Sheffield and the Gids clinic at the Tavistock centre in north London, refused to take part in the study. A seventh adult clinic, in Exeter, was the only unit to agree to supply evidence.

A document, buried in Cass’s report, lays bare the alleged reasons for the clinics’ refusal to participate, including that the “study may not be fully independent”. It said the six clinics claimed the study “may suffer from interference by NHS England, the Cass review team and government ministers” whose interests “do not align” with theirs and those of the patients.

The clinics are also said to have complained that the “unintended outcome of the study is likely to be a high-profile national report that will be misinterpreted, misrepresented or actively used to harm patients”.

Some clinics felt obliged to contact all eligible patients directly to inform them of the study, the document said, providing another roadblock to participation.

• Nine key findings from the Cass report

The document also reveals how the clinics conceded that changes to NHS numbers, postcodes and gender “would make record linkage between Gids and adult clinics extremely challenging”.

This is despite a legislative change ordered by the former health secretary Sajid Javid in 2022, to allow pre and post-transition NHS numbers to be linked, so that the study could proceed.

Campaigners are calling for the leaders of the adult clinics to be held accountable. In a letter to Atkins, the charity Sex Matters said: “Public-sector bodies deliberately withholding information is disgraceful and a dereliction of duty.

“The research they obstructed is needed by clinicians, policy-makers, the general public and, most importantly, future patients and their families, so they can understand the risks and the effectiveness of puberty blockers and cross-sex hormones.”

The NHS’s most senior adviser on transgender health was among the adult clinic leaders who refused to co-operate with Cass’s review. Dr Derek Glidden, clinical director of the Nottingham Centre for Transgender Health, refused to share data despite being chairman of the NHS England clinical reference group on gender dysphoria. The Nottingham clinic has been key to the rollout of a new wave of experimental trans services being set up across the country.

The Leeds Gender Identity Clinic, which is led by Dr Laura Charlton, also refused to share data with the review. Charlton, who worked at Gids from 2014 to 2020, was the organiser of a letter sent to the Association of Clinical Psychologists UK in 2022 defending the use of medical interventions in children.

A spokesman for the Leeds Gender Identity Service said: “We fully support the research into young people’s gender services, and we co-operated as fully as we could with the Cass review. The Leeds Gender Identity Service is named as a primary data source within the report.

“We look forward to engaging with the forthcoming review of adult services as we have a lot to share in terms of clinical expertise and the lived experience of our service users.”

The other NHS trusts did not respond to requests for comment.