Tavistock whistleblower ‘had no alternative’ but to raise concerns

Dr David Bell spoke out ahead of the final report by the Cass Review into gender identity services for children and young people.

The Gender identity service at the Tavistock Trust closed at the end of March (Aaron Chown/PA) (PA Archive)

A whistleblower at the Tavistock Trust said he is “pleased I didn’t turn away” when colleagues raised concerns to him several years ago about the children’s gender service which closed last month.

Dr David Bell spoke ahead of the publication of the final report into the Independent Review of Gender Identity Services for Children and Young People.

The review, led by Dr Hilary Cass, was commissioned in 2020, two years after Dr Bell had compiled a report detailing concerns some staff had raised with him about how the Gender Identity Development Service (Gids) at the Tavistock and Portman NHS Foundation Trust was operating.

I am pleased that I didn’t turn away and I am pleased that the concerns I raised in my report have been borne out, and more

Dr David Bell

Dr Bell, who worked at the trust as a consultant psychiatrist for 25 years before retiring in 2021, told the PA news agency he feels his report was “a very important part of that chain of events” that led to a decision by NHS England to commission the Cass Review.

He said his report had laid out concerns that children were being “rushed through” the Gids service and set on a medical pathway to address their gender distress but not given the care needed for other issues such as anxiety and depression.

His comments come as it was reported the final Cass report, to be published on Wednesday, will warn children could face psychological consequences if they are allowed to “socially transition”, whereby they change names, pronouns or clothing.

This has not been confirmed by the team behind the review, but the interim report previously stated that social transition is “an active intervention because it may have significant effects on the child or young person in terms of their psychological functioning”.

Gids was the only service available in England for children and young people with gender dysphoria, but the review’s interim report in 2022 stated that a “fundamentally different service model” was needed, and that a sole provider of such services was “not a safe or viable long-term option” amid rapidly rising referrals.

A few months later, the NHS announced Gids would close and be replaced with a regional network of clinics for children and young people.

Two new hubs – led by London’s Great Ormond Street Hospital and Alder Hey Children’s Hospital in Liverpool – opened at the beginning of April.

Dr Bell welcomed the use of the phrase “diagnostic overshadowing” in the interim report, which noted that “many of the children and young people presenting have complex needs, but once they are identified as having gender-related distress, other important healthcare issues that would normally be managed by local services can sometimes be overlooked”.

Describing the review’s launch almost four years ago as “extremely welcome”, Dr Bell said it is “the most detailed, most thorough and most extensive review of the treatment of gender disturbance in children undertaken anywhere in the world at any time”.

He has not been involved in or seen the Cass Review’s final report, but asked about his role in getting to this point, he said he feels he “didn’t have an alternative” but to raise the concerns he did.

“I am pleased that I didn’t turn away and I am pleased that the concerns I raised in my report have been borne out, and more,” he said.

“What I feel terrible about is all the children who have suffered unnecessarily and been damaged by the wrong treatment.”

On his hopes for the final report, he said he would like adolescent services to take over the management of 17-25 year-olds “as is recognised elsewhere in the NHS they are still a very vulnerable group and they should not be seen within adult services.”

The interim report said “further consideration will be needed regarding the age of transfer to adult services”, noting that while children currently move to adult gender services at aged 17 and 18, “young people with neurodiversity often remain under children’s services until age 19 and some other clinical services continue to mid-20s”.

Dr Cass has previously acknowledged the at-times “very toxic” debate on the subject of gender, saying people are “afraid to talk openly” and appealing for them to “put the animosity aside to come to a shared consensus”.

While Dr Bell is not on social media, he has “heard it said that I’m transphobic or that I hate trans people”.

Asked for his response to this, he said: “I’d asked them what they mean by this term?  Are they saying that I’m opposed to trans adults being able to live their lives? If that’s the case I’d say they are wrong and they haven’t listened to what I’ve said because I’ve never said anything of that nature.

“If they mean to stand up for children to be given the right treatment and the right help, and not to be given the wrong help and to be damaged, I don’t see how they can call that anti-trans. That seems to be just protecting the rights of the child.”

Mermaids, a transgender youth support charity, has previously said it is concerned that young people’s “voices and experiences have been dismissed in what has become a heavily politicised process”.