However you dress it up, it’s what’s underneath that matters.

Plenty of digital ink has been expended on the Care Quality Commission’s (CQC) inspection of the Gender Identity Development Service (GIDS) at The Tavistock Centre: the UK’s only service handling children with gender dysphoria.

Much of the press coverage focused on the report’s “inadequate” rating – admittedly, the worst a Trust can get – and specific findings such as poor record keeping and long waiting times.

But while journalists seized on the negative elements of the CQC report, they missed a far greater danger to patients in what the CQC found praiseworthy.

The CQC was impressed that the culture and ethos of GIDS was shared through the organisation. This sounds positive, but it’s completely at odds with the fact that GIDS has been haemorrhaging staff, many of whom have become whistleblowers.

Young people are being given hormones that disrupt or delay a healthy puberty

These include Susan Evans, a psychotherapist who worked at GIDS, who initially took the lead in the judicial review brought by Keira Bell, which ruled that it was extremely unlikely that a child could give truly informed consent for interventions likely to leave them sterile and permanently damaged. Kirsty Entwistle, a former clinician at GIDS Leeds branch, wrote an open letter to Polly Carmichael, formerly lead clinician at GIDS, saying: “I think it is a problem that GIDS clinicians are making decisions that will have a major impact on children and young people’s bodies and on their lives, potentially the rest of their lives, without a robust evidence base.”

Marcus Evans, husband of Susan and former Tavistock governor has been interviewed many times and has been clear and consistent in his criticism. Sonia Appleby, the safeguarding lead at The Tavistock and Portman NHS Trust, is taking her employer to court claiming she was prevented from doing her job properly.

Most recently Dr David Bell, a former staff governor at The Tavistock, appeared on Channel 4 News just two days after his retirement warning: “This is a very highly politicized area and leaders of movements with a very powerful ideological commitment have managed to capture policy both medically [and] professionally in the media and in government with no evidence base.”

It is this political dimension which has led to the harms described by Dr Bell and the Trust’s critics.

This is what has driven the values and ethos at GIDS, praised by CQC as known and understood, and reported thus: “the values and ethos of the service focused on promoting non-judgemental acceptance of gender identities.”

This culture is otherwise known as the “gender affirming model of treatment” (GAMT).

In recent years, the Tavistock Centre has denied that it promotes GAMT; it has also denied that GAMT is harmful. It seems something very disturbing is going on behind those doors; something GIDS is too ashamed or alarmed to admit.

The CQC also says that, “Staff referred young people to other providers for medical treatments that was in line with good practice.”

However, there is no description in the CQC report as to what they consider to be good practice. Again, a casual observer will notice that young people are being given hormones that disrupt or delay a healthy puberty, and that patients are referred for wholly unnecessary operations which remove healthy, functioning organs. Who decided this practice is “good”? No one knows.

While the Tavistock may not perform unnecessary bilateral mastectomies, it refers patients to hospitals that do

The same goes for the organisational culture, which is often difficult to ascertain. Organisations espouse values (what it says its culture is) and actual values (what it does behind closed doors) and perceived values (how the outside world sees it). For the Tavistock Centre, the espoused values are that they are neutral towards gender ideology (the belief that everyone has a gender identity). Its actual values, as evidenced by whistleblowers’ and the CQC’s reports, show it to be an enthusiastic promoter of this ideology.

Little wonder that the perceived culture is one of avoidance and denial. It’s worth remembering that these were the words used to describe the culture that allowed rogue surgeon Ian Paterson to needlessly amputate more than 1,000 women’s breasts. And while the Tavistock may not perform unnecessary bilateral mastectomies, it refers patients onwards to hospitals that do.

In response to the “inadequate” rating issued by the CQC in its report, the Tavistock announced it was disbanding the GIDS management team and instituting “a new Interim GIDS Management Board, chaired by the Divisional Director for Gender. This will replace existing senior management structures in GIDS and will provide a single point of accountability for both improvement programmes and existing service delivery.”

This board will be accountable to a new GIDS Oversight Committee chaired by Tavistock CEO Paul Jenkins. This seems little more than a rearrangement of deckchairs while the ship continues its slow and certain descent.

If we want to understand why so many thousands of children have been subjected to controversial, non-peer reviewed treatments, we need to look at what’s going on beneath the surface.

For people pretending to be the opposite sex, validation is like crack cocaine

In September 2020, Liz Truss, Minister for Women and Equalities announced the government’s decision following its review of the Gender Recognition Act. Perhaps to counter the howls from the genderist lobby at the shelving of self-ID, the government reduced the charge for a Gender Recognition Certificate from £140 to a nominal amount (it is now £10) and announced the opening of three new gender clinics.

These “new” gender clinics were in fact already being trialled as part of a pilot scheme, bringing the total number in England to ten. At the time of writing two — one in Dean St London and one in Manchester, Indigo — seem to be fully up and running.

The Indigo Gender Service website sets off more alarms than an earthquake in a Los Angeles car park and is worth quoting in full:

We are a new NHS adult gender service in Greater Manchester, which has been commissioned to provide care that is local, timely and easier to access. Indigo is a partnership between gtd healthcare and LGBT Foundation, delivering a service which has been designed by and for trans communities in Greater Manchester.

Our service is an innovative model of trans healthcare which is based in primary care. This means our clinical services are delivered by experienced GPs in practices across Greater Manchester, with additional services being delivered in community settings.

The website goes on to say: “We know that trans and non-binary people are the experts of their own experience, and that is why this service has been developed by and for trans communities. Our services are trans and non-binary led, with trans and non-binary people guiding and feeding into them at all levels.”

Let’s get one thing straight. If you are in denial about the reality of your sex, if you think that taking opposite sex hormones, and maybe lopping off a body part will solve any problem you might have about who you are, then you are not an expert of your own experience: you are deluded and, frankly, a danger to yourself.

A service “designed by and for trans communities” is like having a drugs rehabilitation clinic “designed by and for junkies and dealers”.

How did we get here? I can answer in a single word: validation.

Validation, in this context, is the confirmation of a person’s deeply held beliefs about themselves. The word pervades and pollutes the whole discourse of gender identity.

Take Lui Asquith, spokesperson for the Mermaids charity, who countered criticism of the Tavistock by saying: “it is all about creating a system in which everyone feels validated.”

For people pretending to be the opposite sex, validation is like crack cocaine.

This is the culture in NHS England: Transgenderism is cool and it shall be promoted

Take a look at the Indigo website. It is a shop window, with transgenderism as the product. The banner image is of a beaming “transman”, complete with the beginnings of a beard, showing how happy she is to have undergone the removal of her breasts. There is no recognition that believing oneself to be transgender is indicative of a malaise that needs evidence-based treatment.

This is the culture in NHS England: Transgenderism is cool and it shall be promoted.

This is the reason the CQC could not find anything wrong with the gender affirming culture at The Tavistock. There are members of the team at The Tavistock who believe in gender identity, including at least one who pretends to be the opposite sex. That is a clear conflict of interest when there is a craving to be validated.

Our young people have been sold a lie that they will pay for with their bodies. The taxpayer will be picking up the bill for years to come. The bill from ongoing hormone prescriptions, to dealing with the catastrophic side effects (see the East German women athletes doped with testosterone in the Eighties for a vision of what’s to come), and the cost of trying to repair the physical damage wrought by unnecessary and regretted surgeries.

Parents always knew that GIDS was inadequate; there would have been an outcry had that not been the verdict of the CQC. What we need to understand is that the CQC itself is inadequate, since it has signally failed to question the appropriateness of the practice or culture within GIDS. NHS England is inadequate – it should not accept experimental gender “medicine” with such alarming enthusiasm.

We must look to Keira Bell, victor at the High Court over The Tavistock, for context: “This judgment is not political; it is about the protection of vulnerable children. Please read it carefully: it exposes a complacent and dangerous culture at the heart of the national centre responsible for treating children and young people with gender dysphoria.”

Dr Hilary Cass has been invited to review gender medicine in England. The Cass Review has announced its terms of reference and started a Twitter account.

It’s difficult to see how this review can reach meaningful conclusions while clinicians and politicians cling onto the unscientific, ideological belief in gender identity, and that the best treatment for gender dysphoria is to drug and mutilate young people into a facsimile of the sex they say they want to be.

There is no evidence that opposite-sex imitation is an effective and worthwhile treatment for adolescent feelings of dissatisfaction with one’s sexed body. There is no randomised controlled trial. We do not know if happy transitioners would be happier had they not transitioned.

There needs to be a moratorium on such treatments in the NHS. The next fifteen years can provide the control group for the last fifteen years of uncontrolled experimentation. Only when there is a deep and broad body of quality research should the idea of medicalising gender identity be looked at again. Dress it up as being “by trans, for trans”, but what lies beneath is irreparable harm: something that no society should countenance, let alone validate.