Two Cambridge academics were among 19 consultant psychiatrists who wrote a letter in The Times last week (23/02) calling on the government to enable a study into the outcomes of patients at the now closed Tavistock gender clinic.

The letter was signed by the head of the Department of Psychiatry, Prof Tamsin Ford, as well as another senior child and adolescent psychiatrist, Prof Isobel Heyman.

Progress towards their demands was made last Thursday (26/02), when Health Secretary Wes Streeting introduced legislation to facilitate such a study, due to come into effect on 20 March.

The letter comes after the UK medicines watchdog ordered the pausing of a trial designed to investigate the risks and benefits of puberty blockers for minors experiencing gender dysphoria on 20 February. The regulator expressed “concerns related to the wellbeing” of the 220 children participating in the trial.

The authors stressed that this puberty blocker trial “was only one of the recommendations made by Dr Hilary Cass” in a 2024 report into child gender services in the UK. “We would urge the government and research community to now pursue the suggested tracing and follow-up study,” they added.

This study aims to link data on 9,000 children and young people who received care at the Tavistock gender clinic with data about the same individuals as adults. It was due to be completed as part of the Cass Review, but most of the adult gender clinics chose not to collaborate.

The psychiatrists commented: “It was alarming to learn that NHS adult clinics refused to co-operate with the research team who were tasked with this follow-up study, and we would hope that a reinvigorated effort would now be undertaken. There will be a lot we can learn from this cohort and this should now be the priority.”

The new legislation allows the disclosure of data otherwise protected under the Gender Recognition Act 2004 for the sole purposes of the study. It also updates the list of organisations contributing to the study, and reflects the fact that NHS England took over responsibility for the research in January 2024.

The study is still awaiting research and ethics approval, and the new legislation does not compel the adult gender clinics to cooperate. However, Streeting said there was a “clear expectation that all relevant organisations will now provide the data required to complete this study”.

Prof Heyman told Varsity: “One reason for undertaking this follow up study without further delay is that there will be a long wait to see how children treated with puberty blockers in a new trial are doing as young adults. We would be waiting 10-15 years. The data on people now in their 20s who were treated at the Tavistock are available now – there is a real opportunity to find out about, for example, education, employment, identity, and health care.”

She added: “Our opinion on this is based not so much on being particular specialists in the field of gender medicine. Rather, it is imperative that when we offer assessments and interventions to young people with any condition we should do our very best to gather data about the difficulties, measure outcomes and follow up into the future as far as is possible. This is to determine both benefits and any potential harms.”

Tavistock was opened in 1989, and until it closed in March 2024, the centre was the UK’s only dedicated gender identity clinic for children and young people. In 2020, the clinic was rated “inadequate” by inspectors following concerns raised by whistleblowers.

This led to Dr Cass, a retired consultant paediatrician, being appointed to write a review into the care offered by the clinic. The interim report, published in March 2022, led to the closure of the centre two years later, and its replacement by two regional hubs linked to the Great Ormond Street and Alder Hey children’s hospitals.

The final report was published in April 2024 and offered 32 recommendations. Cass concluded that the evidence for using puberty blockers was inconclusive, leading to a UK-wide ban on the drugs for minors experiencing gender dysphoria, except for in clinical trials.

While the report was welcomed by many UK medical associations and the major political parties, its methodology received criticism from LGBTQ+ advocacy groups and international health organisations. The British Medical Association voted to “publicly critique the Cass Review” and called for its implementation to be paused while it carried out its own evaluation.

Announcing the new legislation, Streeting described the study as “another step to achieving our manifesto commitment to implement recommendations of the independent Cass Review”.

Heyman called the study “a unique opportunity to help with optimising the care of young people, in exactly the way one would do for any other question in medicine”.