NHS England Adult Clinics Post Cass Review

Protest Parliament Square, London, 20th April, 2024: leaflet being displayed linked to Anticapitalistresistance.org

Dear PITT reader,

In an August 12, 2022 essay for PITT entitled, ‘Jubilation as the Walls Begin to Crumble’ I wrote about the closing of the Gender Identity Development Service (GIDS) at the Tavistock clinic in the U.K.

The story of GIDS was extensively covered in the 2023 award-winning book by the investigative journalist Hannah Barnes, "'Time to Think’: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children".

Now, in the recently released Cass Review, Dr. Cass has used scientific rigor to demonstrate that UK adult gender clinics are also a woefully inadequate service. The Telegraph headlined it this way: "Top NHS advisor on trans health failed to cooperate with Cass Review”.  Dr. Derek Glidden of the Nottingham Centre for Transgender Health in England refused to share patient data with Cass’ team.  Dr. Cass said that efforts to track the journeys of approximately 9,000 children who were seen by adult services were “thwarted” because the clinics refused to cooperate. Six of seven clinics (including Nottingham) refused to comply with the request for data.  Dr. Derek Glidden chairs the NHS England Clinical Reference Group on gender dysphoria. 

This same Dr. Derek Glidden was also responsible for the roll-out of the pilot clinics; these clinics sign off on cross-sex hormones and surgeries to primarily the 17-25 year age group about which Dr. Cass expressed grave concern and has suggested that ‘extreme caution’ should be undertaken going forwards. 

The Telegraph also exposed another one of the Reference Group’s five members, Dr. Laura Charlton, for refusing to participate in the research. Dr. Laura Charlton, the clinical lead at Leeds Gender Identity Clinic who worked at GIDS from 2014-2020, has previously defended the now disgraced and defunct GIDS.

Before the Cass Review was released, I wrote to Amanda Pritchard, Chief Executive for NHS England on 9th April.  I asked if in response to the exposé on WPATH (‘The WPATH Files’ by Mia Hughes for Michael Shellenberger of Environmental Progress), did NHS England now consider WPATH to be discredited?

The WPATH Files are a brilliant, shocking and deeply disturbing piece of journalism.  They expose information uncovered through whistleblowing and reveal thoughts through conversations between gender clinicians and lobbyists / activists.  WPATH is systematically allowing non-clinicians to specify clinical approaches. WPATH (The World Professional Association for Transgender Health) will not surrender their status easily, but the evidence of their modus operandi is now in plain sight.  One example is evidence of a discussion regarding extreme body-modification surgeries such as removing genital organs entirely or creating a neovagina alongside a penis, with no medical justification.  In other words, Frankenstein surgeries.

These previously designated “pilot” clinics are now full adult clinics and were signed off by Dr. Derek Glidden, operating in accordance with WPATH standards of care. 

Dr. Walter Pierre Bouman, a former president of WPATH and a senior doctor at the Nottingham Centre for Transgender Health and honorary professor at the University of Nottingham’s School of Medicine, has embarrassed and disgraced himself - to put it mildly - with his criticism of the Cass Review.  How did he do this?  Michael Searles, Health Correspondent for The Telegraph reported on April 30th, 2024, that Dr. Bouman said Dr. Cass’ Review had been “poorly reasoned” and, in a lengthy LinkedIn post, claimed there was a “a fine line between naivety, narcissism and psychopathy”.

The Telegraph also revealed on Apr 12, 2024, that it had seen unredacted screenshots of the leaked messages that identified Professor Arcelus, the Nottingham clinic’s Medical Director and a professor in mental health and transgender health at the University of Nottingham, as "among those discussing and endorsing controversial procedures which are currently not allowed on the NHS”.

Dr Cass was highly critical of WPATH saying that while it had been “highly influential in directing international practice”, its “guidelines were found by the University of York appraisal process to lack developmental rigour”.

In WPATH’s Standards of Care Version 8, Professor Arcelus, as co-chair of the guidelines, oversaw a chapter on eunuchs. You read that right - eunuchs. This document claims that baby boys can be born with a ‘eunuch gender identity’.

On the eve of publication of the Cass Review, NHS England’s national director of specialised commissioning, John Stewart, wrote the following in a letter seen by the Telegraph, “The study relied upon your organisations fully cooperating with the University of York in support of the research.  However, despite the best efforts of the research team, the necessary cooperation from the clinical leads within the Gender Dysphoria Clinics was not forthcoming, despite - and contrary to - positive assurances from CMOs”.  CMOs are Chief Medical Officers and the senior tier of the National Health Service.  It continues, “If left this way, it would represent a missed opportunity for the NHS to lead the way internationally in gathering high quality evidence that can, for the first time, present a better understanding of the longer-term outcomes for individuals who have received clinical or medical intervention for gender dysphoria / gender incongruence in childhood or adolescence”.  These so-called professionals should be hanging their heads in shame. 

From my position, the lunatics had indeed taken over the asylum and those within the adult service are still on the loose. 

Medical evidence has kowtowed to ‘lived experienced’ in this area of ‘healthcare’.  Many 'key stakeholders' who contribute to consultations have medically transitioned themselves or are in the process of doing so. They have driven the treatment pathway without any evidence regarding who benefits and who does not when choosing to medically transition.  Future quality of life is not considered.  How can an immature brain give informed consent?  Unfortunately stakeholders may also include those who have an interest in medically transitioning others.  The stakeholders who are trans rights activists have blindsided medical ethics.  Activist stakeholders repeatedly churn out the same poor studies to put fear into anyone daring to question their narrative.  I wonder how long it will be before the full and true extent of the “shaky foundations” described by Dr. Cass are uncovered?

The letter, written by John Stewart continued that NHS England would, “review the use of gender-affirming hormones through a process of updated evidence review and public consultation, similar to the rigorous process that was followed to review the use of puberty suppressing hormones”.  Pray how long are we meant to wait for this? 

On 20th March 2024, a mere 21 days before the release of the Cass Review, the Chelsea Centre for Gender Surgery (CCGS) in West London listed on its website that “Chelsea and Westminster Hospital NHS Foundation Trust has been commissioned to provide masculinising surgery for transmasculine and nonbinary patients.  The Trust is proud to be the first NHS hospital site to perform this life-saving operation.” 

“Miss Tina Rashid will lead on feminising genital surgery and Miss Victoria Rose will lead on masculinising chest surgery, with both surgeons contributing to the commencement of masculinising genital surgery (phalloplasty)”.  The website goes on to highlight, ‘What We Did” as part of Transgender Awareness Week on the November 16, 2023.  A webinar was hosted entitled, “How Do We Achieve Excellence in Trans Healthcare?’

Various people spoke at this webinar including Skye Davies, Peer Support Worker at TransPlus and Giuseppe DiTaranto, Consultant Plastic Surgeon. Dr. DiTaranto presented on "the incredible ground-breaking work of the CCGS team as the only team in the UK to provide single stage masculinizing lower surgery”.  Heather, a service user of TransPlus, shared her own personal story of how the Trust has influenced their life for the better over the past three years. Apparently, it is very moving to hear Heather’s story as she explains, ’The Trust actually trusts their patients and are empathetic to their needs… it is the empathy and thoughtfulness that has truly made a difference”.   Roger Chinn, Chief Medical Officer, then thanked the speakers for being such great ambassadors for the service. Chelsea and Westminster NHS Trust awarded TransPlus the runner-up CEO Award in 2021 for Research, Innovation and Quality Improvement.

A Freedom of Information Request highlighted that Chelsea and Westminster NHS Trust planned to provide 20 surgical procedures in the financial year 2022/23, while in the initial stage of training, followed by 80 procedures in Year 2, 160 in Year 3 and then 220-280 in subsequent years. This information is for just one NHS Trust on a new service. 

Do we have to wait for a review of the adult clinics in the UK with all that is known?  NHS, not just in England but throughout the United Kingdom, is failing the 17-25 year olds and I can only hope legal cases now start to put momentum behind the destruction of this pernicious ideology.  For those over 25, such as Ritchie Herron and Sinead Watson, I hope the courts will see that vulnerability continues into adulthood and medical negligence has occurred.  I hope the courts not only give appropriate compensation - and how does one measure that with such devastating consequences - but that criminal proceedings can be conducted too.  The Hippocratic Oath states, "First do no harm".  On the Nottingham Centre for Transgender Health website on May 9th, 2024, it states, “Some transwomen decide that they want to have surgery to permanently alter their anatomy, however not all trans feminine people choose to have surgery.  All referrals are done via the gender identity clinic and the surgery and immediate follow-up care is handled by the Gender Dysphoria National Referral Support Service (GDNRSS).  Patients may be referred to the district nurse or GP if they require wound care in the days following the operation.  Patients will remain under the care of the GDNRSS for a year, after which time any ongoing care will be discharged back to the GP”.

The word ‘wound’ jumps out.  It is not a neo-vagina that has been created it is a wound which has been inflicted on a health body but not a healthy mind - this is why the lunatics have taken over the asylum. Frankenstein-medicine is not ‘healthcare’ and has no place in healthcare unless you choose to support the + at the end of the alphabet soup.

Dr Cass’ Review has clearly demonstrated that the model for ‘gender affirmative care’ is deeply flawed. I think the words of Allison Pearson in The Telegraph on her ‘comment’ piece hit the nail on the head, “The Cass report lays bare what we all knew about the trans brainwashing cult.  The indoctrination of impressionable youngsters by dangerous cranks has been revealed thanks to this landmark review”.  Here, here, Allison.

It is my mission to one day shake Dr Cass by the hand. I hope one my day my son will thank her for all she has done.  My husband and I were interviewed by Dr. Cass.  Sadly our son was not.  Dr Cass’ Review commenced before my son even believed he was ’trans’.  I was not, and am still not, openly supported in my concerns for my son by any single adult within education or healthcare apart from Dr. Cass.  I am never backing down, truth and justice will prevail.

This piece was written in memory of a son the same age as mine.  He will never be forgotten.