Trans madness: former governor of gender affirmation center warns of 'tragic consequences' for rushing minor into treatment

The UK's National Health Service (NHS) is reforming its Gender Identity Development Service (GIDS) at the Tavistock Centre in London following the findings of an independent report that alleged that its practices "were not safe" for children and young people. The center has been under investigation since psychotherapist Marcus Evans, a former member of the Board of Governors, resigned in 2019 claiming that the minors needed "more therapy and not just 'affirmation' and medication."

In an article published in Spiked, Evans echoes the results of Dr. Hilary Cass' independent study from February of last year. She recommended a radical change in GIDS methodology. Following the publication of the report, the NHS announced that it would close the Tavistock Centre and that other regional centers would be created to "ensure that the holistic needs" of patients are fully addressed, following the study's recommendations.

8,000 minors awaiting gender affirmation treatment

One of the main points, already criticized by Evans in an earlier article in Quilette explaining his resignation, is the abusive use of puberty blockers, with hardly any follow-up and prior study of the patients. Both Cass and Evans insist that the use of these drugs does not have enough of an experimental basis to ensure that their benefits outweigh the harmful effects they cause in the long term. In fact, another major complaint is the lack of long-term follow-ups in patients, especially when they are no longer teenagers and have to come to terms with the consequences of a sex change.

The number of minors and young people requesting to undergo gender affirmation or sex change procedures has multiplied exponentially in recent years. In 2019, Evans stated that the number of appointment requests had increased by 400% since 2014. Currently, the psychotherapist, who criticizes the Tavistock Centre for remaining open and operating under the same protocols a year after the report was published, says that there are about 8,000 people on the waiting list.

Pressure on therapists

In 2019, Evans resigned as a governor of the center due to pressure on therapists to prescribe drugs and to identify minors by the gender identity they claim to have, without further inquiry into their family, physical or psychological situation or even whether they had any other type of previous psychiatric pathologies. Evans left his position after the center's management decided to ignore letters from several parents complaining that their children had been fast-tracked through GIDS without any serious psychological evaluation. He also said that the center disregarded a doctor's report who expressed having serious ethical issues with the center's procedures in this regard.

Pressure on patients to undergo surgery

In Dr. Bell's letter, the expert criticized "inadequate clinical assessments, patients being pushed through for early medical interventions, and GIDS’ failure to stand up to pressure from trans activists." These complaints were raised in 2005 by former center employee, and Marcus' wife, Susan Evans, who was concerned about the speed with which children were being referred to the medical track. The way in which the center's management ignored these complaints led the psychotherapist to resign in protest.

Tavistock is still open with the same protocols

Evans said this did not change the Tavistock management's understanding of the gender dysphoria situation or the way they dealt with it. According to the expert, the main problem with GIDS is that "Many of those at GIDS remain committed to a shared set of beliefs about gender and identity, which define how they see themselves in relation to the rest of the world. They believe themselves to be part of a progressive group with virtuous principles. And they are determined to hold on to these beliefs, even in the face of evidence that challenges them."

Judicial setbacks haven't made the center reconsider its practices. They have made it clear that Tavistock does not follow up with children who have undergone gender reassignment treatment, not even those who have undergone gender reassignment surgery. There hasn't been any additional research on the long-term effects. Also, at the request of the court, they were forced to acknowledge that they do not perform studies on patients that would reveal other possible previous conditions such as those within the autism spectrum.

Therapists fear they'll be accused of being transphobic

Evans believes this is because "GIDS feared what the research and follow-up might have revealed. From my own experience, I know that many who undergo gender reassignment can endure significant subsequent struggles."

According to the psychotherapist, this is not a simple mistake, but a problem of imposing ideological beliefs on a group that won't question them. In fact, Evans points out that, although many experts share his views, they refuse to come forward for fear of being labeled bigots or transphobes and being attacked for violating human rights. This is something that some physician groups, such as the American Pediatric Association, have helped to promote by encouraging physicians to recognize the sex that minors identify with.

Increase in suicide attempts among patients with regrets

However, in his extensive professional experience, Evans stated that "young people presenting with gender dysphoria – a sense that there’s a mismatch between their biological sex and their gender identity – usually have complex comorbid difficulties. They could, for example, also be on the autistic spectrum, suffer from anxiety disorders, have a history of trauma or of physical problems," says the specialist, who claims "it is dangerous to focus solely on gender identity issues."

This is so dangerous that, during his time evaluating people who had attempted to take their own lives or had suicidal gestures, he discovered that many of them reached that point after regretting having undergone a sex change. "A number of my patients had gone through gender-reassignment surgery, and often were angry at the loss of their biological sexual functioning. They also were aggrieved with psychiatric professionals, who, they believed, had failed to adequately investigate the underlying psychological difficulties associated with gender dysphoria," Evans said.

Desire to fix their existential problems with surgery

Many of these people, Evans insists, want to believe that all their feelings of doubt, conflict and confusion stem from gender dysphoria and have a medical solution: sex change. Evans radically disagrees with this and warns therapists to study patients carefully: "But a child’s certainty about suffering from gender dysphoria does not justify putting said child on a medical pathway. On the contrary, an individual [who is] highly certain about needing a specific medical intervention – and one with such long-term consequences – should be seen as a red flag."

Young people "do not need gender services"

Something that has not been taken into account in GIDS, according to Evans is the following: "I would argue that the model of care on offer at GIDS does not meet young people’s needs. They don’t need gender services; they need good children and adolescent mental health services (CAMHS). These services take a holistic approach. They look at the individual in the broadest possible sense and assess his or her psychological state, including comorbid conditions and family dynamics."

Evans criticizes therapists who impose "their idea of what is “normal” on a patient who believes he or she is trans." According to the expert, the therapist "must resist the temptation to suspend curiosity, uncritically accept the patient’s presentation at face value, and then act as an “affirming” cheerleader for life-changing acts of transition." Evans also stated that "the goal of exploratory therapy should be to understand the meaning behind a patient’s presentation in order to help them develop an understanding of themselves, including the desires and conflicts that drive their identity and choices."

"Tragic long-term consequences"

In fact, Evans said that gender-affirming therapies will eventually lead to an "opioid-like" crisis due to physicians who only say "yes" to patients instead of helping them and saying "no" if necessary.