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Time to Think: The Inside Story of the Collapse of the World's Largest Gender Service for Children
Time to Think goes behind the headlines to reveal the truth about the NHS’s flagship gender service for children.
The Gender Identity Development Service (GIDS), based at the Tavistock and Portman Trust in North London, was set up initially to provide ― for the most part ― talking therapies to young people who were questioning their gender identity. But in the last decade GIDS has referred more than a thousand children, some as young as nine years old, for medication to block their puberty. In the same period, the number of referrals has exploded, increasing thirty-fold, while the profile of the patients has changed, from largely pre-pubescent boys to mostly adolescent girls, who are often contending with other difficulties.
Why had the patients changed so dramatically? Were all these distressed young people actually best served by taking puberty blockers and cross-sex hormones? While some young people appeared to thrive after taking the blocker, many seemed to become worse. Was there enough clinical evidence to justify such profound medical interventions in the lives of young people who had so much else to contend with?
This urgent, scrupulous and dramatic book explains how, in the words of some former staff, GIDS has been the site of a serious medical scandal, in which ideological concerns took priority over clinical practice. Award-winning journalist Hannah Barnes has had unprecedented access to thousands of pages of documents, including internal emails and unpublished reports, and over a hundred hours of personal testimony, to write a disturbing and gripping parable of our times.
The Gender Identity Development Service (GIDS), based at the Tavistock and Portman Trust in North London, was set up initially to provide ― for the most part ― talking therapies to young people who were questioning their gender identity. But in the last decade GIDS has referred more than a thousand children, some as young as nine years old, for medication to block their puberty. In the same period, the number of referrals has exploded, increasing thirty-fold, while the profile of the patients has changed, from largely pre-pubescent boys to mostly adolescent girls, who are often contending with other difficulties.
Why had the patients changed so dramatically? Were all these distressed young people actually best served by taking puberty blockers and cross-sex hormones? While some young people appeared to thrive after taking the blocker, many seemed to become worse. Was there enough clinical evidence to justify such profound medical interventions in the lives of young people who had so much else to contend with?
This urgent, scrupulous and dramatic book explains how, in the words of some former staff, GIDS has been the site of a serious medical scandal, in which ideological concerns took priority over clinical practice. Award-winning journalist Hannah Barnes has had unprecedented access to thousands of pages of documents, including internal emails and unpublished reports, and over a hundred hours of personal testimony, to write a disturbing and gripping parable of our times.
500 pages, Paperback
First published February 23, 2023
224 people are currently reading
2820 people want to read
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Displaying 1 - 30 of 206 reviews
February 26, 2023
This is not an easy book to read - but it's important that it was written and published. Hannah Barnes strikes a balanced, journalistic tone throughout the sorry tale of a pioneering NHS unit becoming ensnared in a crisis not wholly of its own making, but then doubling-down on idealogical grounds and creating the potential for very great harm to children and young people in the process.
No matter what you might read about this book elsewhere, Barnes gives voice to young people who had both positive and negative experiences at the Tavistock & Portman NHS Foundation Trust, and has clearly sought the views of staff, trustees and managers across the service. The result is a picture of a service spiralling out of control, bewildered at the sudden dramatic increase in referrals, and ensnared by fraught relationships with pressure groups who were just a little too close for comfort to the clinical leadership.
The most affecting and troubling parts of the book are the stories of young people who came to the service in distress, confusion and despair, and left far too often with a prescription for life-altering drugs which were meant to buy time - but in fact appear to have locked them into a pathway which many eventually have not followed. The longer-term effects remain largely unknown.
This is a brave book which dares to challenge the contemporary view that anything relating to a minority group is beyond critical consideration. It is braver still because it dares to do so without becoming an evisceration of 'the other side'
No matter what you might read about this book elsewhere, Barnes gives voice to young people who had both positive and negative experiences at the Tavistock & Portman NHS Foundation Trust, and has clearly sought the views of staff, trustees and managers across the service. The result is a picture of a service spiralling out of control, bewildered at the sudden dramatic increase in referrals, and ensnared by fraught relationships with pressure groups who were just a little too close for comfort to the clinical leadership.
The most affecting and troubling parts of the book are the stories of young people who came to the service in distress, confusion and despair, and left far too often with a prescription for life-altering drugs which were meant to buy time - but in fact appear to have locked them into a pathway which many eventually have not followed. The longer-term effects remain largely unknown.
This is a brave book which dares to challenge the contemporary view that anything relating to a minority group is beyond critical consideration. It is braver still because it dares to do so without becoming an evisceration of 'the other side'
December 27, 2023
A one sided view which fails to take sufficient account of the voices of transgender people. It is purely looking to follow an anti transgender and gender critical view point.
Edit: to those saying the book is based on first hand experiences. The book interviews four people. Just four out of the thousands and thousands successfully treated. Do we base the success of a place on four people or the many thousands?
It is all too easy to try and form a narrative around those who the system didn’t work for.
Edit: to those saying the book is based on first hand experiences. The book interviews four people. Just four out of the thousands and thousands successfully treated. Do we base the success of a place on four people or the many thousands?
It is all too easy to try and form a narrative around those who the system didn’t work for.
March 4, 2023
Gripping exposé on the unfolding scandal at GIDS. Reveals an incredible defensiveness to criticism at the top of a service delivering experimental treatments, with life-changing effects, to children with often complex issues. Shocking wilful blindness to the potential harms being caused. Cavalier attitude to sending children on an unproven medical pathway likely to mean they can never have an orgasm as an adult. Everyone should read this book.
June 1, 2023
Time to Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for Children” is a very thorough and well-researched book about the dangers which can accommodate such a rare and specialized health service - especially one being provided to young people, with no clinical research data or studies of patients over the years (unlike every other health service) to assess and assist in the treatments they were continually undertaking and to make changes and/or improvements on the current model of treatment.
First of all, it’s shocking to me on a number of levels. The first being that it is somehow “anti-trans” to suggest that the former GIDS clinicians, the author, and many other members of the public, clearly had a valid point when observing how GIDS’s treatment model only promoted one side of the gender dysphoric equation (the “pro-physical intervention” model), at the expense of the other side (the “let’s look more into reasons children may be feeling this way”/more exploratory model, which considered things like family trauma, sexual trauma, homophobia, etc. as reasons why a young person may mistakenly believe they are trans).
This was very obviously due to a horrible organizational and management structure - giving extremely complex and high caseloads to clinicians, with the only option being to refer them to puberty blockers - which rather than gives them “time to think” as it is constantly argued, instead halts their entire thinking process - setting them up to then remain on the medical pathway. These young people often don’t realize they’ve made a mistake until years after taking the blockers, the cross-sex hormones, or some/all of the reassignment surgery itself.
It is stressed repeatedly throughout the book that many senior clinicians who desperately tried to raise concerns with management and executive members were not only being repeatedly ignored or silenced, but were also very often - if subtly - being told their view was wrong and if they couldn’t get on board with what GIDS was doing, perhaps they should look for another job.
To make this clear, we are not referring to anyone who is in the least bit “transphobic.” Rather, these clinicians feel the insane increase in referral numbers of trans children over the years needs to be examined more closely as to , rather than simply ignoring the problem. It’s unbelievable to me that the most vulnerable members of our population, children (sometimes as young as 3 or 4!) are being put onto a pathway which clearly isn’t right for them and at times when they clearly aren’t struggling with gender identity itself, but rather homosexuality, and often puberty and the awkwardness that EVERY child goes through at its onset.
Not only is this pathway wrong, but unlike claims made to the contrary, it almost certainly is hurting children and we simply aren’t hearing enough of the detransition/regret stories (and neither are they) because it has turned into a bizarre political and ideological battle, where instead of encouraging free thinking, doctors and providers are being forced to STOP thinking and prescribe to the status quo, or find somewhere else to work.
Kudos to all the brave clinicians who continued to work there despite the negative effects it was having on their mental health, in order to do everything they could to help these at-risk kids, and have their concerns taken seriously by someone. I only have a little more to say on this and will try to finish tomorrow.
If not, the only thing I will add is that it was a great (yet shocking and sad read), it was often mired in too many repetitive and/or boring details that didn’t really serve to further the point which had already been made. Some of the grammar and spelling mistakes were a bit much at times, but hopefully that will improve upon further editions. From what I understand as well, the author had to consult with over 20 publishers before finally finding one who would publish this book! So I suppose the cannot necessarily be faulted for some editing errors when just getting it published itself was an uphill battle.
Well worth the time and thought for those who are proponents of medical treatment for trans kids, those who are somewhere in the middle, as well as those who are utterly against the concept. Barnes deals with all the issues in the fairest way possible, always making sure to get the story (or as much of it as possible) from both sides of the coin, and always allowing a statement or rebuttal to be included against a person who was, for example, said to be a senior management executive that ignored the complaints and concerns of technicians. Bravo, Barnes. Bravo.
First of all, it’s shocking to me on a number of levels. The first being that it is somehow “anti-trans” to suggest that the former GIDS clinicians, the author, and many other members of the public, clearly had a valid point when observing how GIDS’s treatment model only promoted one side of the gender dysphoric equation (the “pro-physical intervention” model), at the expense of the other side (the “let’s look more into reasons children may be feeling this way”/more exploratory model, which considered things like family trauma, sexual trauma, homophobia, etc. as reasons why a young person may mistakenly believe they are trans).
This was very obviously due to a horrible organizational and management structure - giving extremely complex and high caseloads to clinicians, with the only option being to refer them to puberty blockers - which rather than gives them “time to think” as it is constantly argued, instead halts their entire thinking process - setting them up to then remain on the medical pathway. These young people often don’t realize they’ve made a mistake until years after taking the blockers, the cross-sex hormones, or some/all of the reassignment surgery itself.
It is stressed repeatedly throughout the book that many senior clinicians who desperately tried to raise concerns with management and executive members were not only being repeatedly ignored or silenced, but were also very often - if subtly - being told their view was wrong and if they couldn’t get on board with what GIDS was doing, perhaps they should look for another job.
To make this clear, we are not referring to anyone who is in the least bit “transphobic.” Rather, these clinicians feel the insane increase in referral numbers of trans children over the years needs to be examined more closely as to , rather than simply ignoring the problem. It’s unbelievable to me that the most vulnerable members of our population, children (sometimes as young as 3 or 4!) are being put onto a pathway which clearly isn’t right for them and at times when they clearly aren’t struggling with gender identity itself, but rather homosexuality, and often puberty and the awkwardness that EVERY child goes through at its onset.
Not only is this pathway wrong, but unlike claims made to the contrary, it almost certainly is hurting children and we simply aren’t hearing enough of the detransition/regret stories (and neither are they) because it has turned into a bizarre political and ideological battle, where instead of encouraging free thinking, doctors and providers are being forced to STOP thinking and prescribe to the status quo, or find somewhere else to work.
Kudos to all the brave clinicians who continued to work there despite the negative effects it was having on their mental health, in order to do everything they could to help these at-risk kids, and have their concerns taken seriously by someone. I only have a little more to say on this and will try to finish tomorrow.
If not, the only thing I will add is that it was a great (yet shocking and sad read), it was often mired in too many repetitive and/or boring details that didn’t really serve to further the point which had already been made. Some of the grammar and spelling mistakes were a bit much at times, but hopefully that will improve upon further editions. From what I understand as well, the author had to consult with over 20 publishers before finally finding one who would publish this book! So I suppose the cannot necessarily be faulted for some editing errors when just getting it published itself was an uphill battle.
Well worth the time and thought for those who are proponents of medical treatment for trans kids, those who are somewhere in the middle, as well as those who are utterly against the concept. Barnes deals with all the issues in the fairest way possible, always making sure to get the story (or as much of it as possible) from both sides of the coin, and always allowing a statement or rebuttal to be included against a person who was, for example, said to be a senior management executive that ignored the complaints and concerns of technicians. Bravo, Barnes. Bravo.
August 24, 2023
The book focuses on the current moral panic around the treatment and/or transition of gender dysphoric children, with the focal point being the UK-based Tavistock Trust's Gender Service for Children (GIDS). Barnes writes compellingly on the risks of quick referrals to puberty blockers after insufficient assessments; the potential long term health risks of puberty blockers & hormone treatment; the worry whether same sex attracted children are seeking transition instead of coming out; poor data collection on patients and their outcomes; and the safeguarding threats to children that a disorganised service poses. Barnes writes about these concerns, relying on interviews with staff and several review reports and court cases.
The book though suffers from something which it critiques GIDS for, a lack of data on whether these threats are in fact leading to poor outcomes for children accessing GIDS. When the book does focus on data - like for example a 2022 paper on patients referred to medical intervention by the service - it finds that 5.3% of patents stopped puberty blockers or hormonal treatment and just 2.9% of patients had stopped identifying as gender variant. Barnes doesn't seem to place much weight on this study, perhaps because it suggests that the service for the most part was correctly identifying dysphoric patients who continue to seek medical treatment, even if the process in doing so was poor and presented risk.
The lack of data on both sides does lead one to conclude that much of the support or criticism of GIDS is rooted in ideology; a starting position, neither evidenced by data, of either affirmation at all costs or skepticism towards medical treatment of dysphoria in children.
The book is overwhelming sourced by people critical of the service. It is unclear why the majority of service staffers, who appear to be happy with their work at GIDS, did not trust Barnes sufficiently to go on the record and be interviewed. Some did provide written responses to questions. As a result, one cannot help but feel that they are only getting a specific perspective on the service and in my opinion this weakens the book.
The book though suffers from something which it critiques GIDS for, a lack of data on whether these threats are in fact leading to poor outcomes for children accessing GIDS. When the book does focus on data - like for example a 2022 paper on patients referred to medical intervention by the service - it finds that 5.3% of patents stopped puberty blockers or hormonal treatment and just 2.9% of patients had stopped identifying as gender variant. Barnes doesn't seem to place much weight on this study, perhaps because it suggests that the service for the most part was correctly identifying dysphoric patients who continue to seek medical treatment, even if the process in doing so was poor and presented risk.
The lack of data on both sides does lead one to conclude that much of the support or criticism of GIDS is rooted in ideology; a starting position, neither evidenced by data, of either affirmation at all costs or skepticism towards medical treatment of dysphoria in children.
The book is overwhelming sourced by people critical of the service. It is unclear why the majority of service staffers, who appear to be happy with their work at GIDS, did not trust Barnes sufficiently to go on the record and be interviewed. Some did provide written responses to questions. As a result, one cannot help but feel that they are only getting a specific perspective on the service and in my opinion this weakens the book.
March 5, 2023
This book makes it clear that it is reporting on the charity/organisation and how it was run. There are narratives there that show that the organisation has helped many individuals who are/identify as trans. Alongside this, are also narratives that imply that the organisation is potentially harming those very same individuals by not exploring thoroughly enough what the individuals are/were feeling. Hannah Barnes has provided a volume of references to support the statements and views contained in this book.
March 10, 2023
A fascinating insight into the operation of GIDS.
It is clearly an extremely well-researched book. However, I did feel as if there was a fair amount of repetition in terms of detailing the views of those interviewed, and their concerns. As a result I felt the book was somewhat longer than necessary.
It is clearly an extremely well-researched book. However, I did feel as if there was a fair amount of repetition in terms of detailing the views of those interviewed, and their concerns. As a result I felt the book was somewhat longer than necessary.
March 8, 2023
a must read
this book is essential for people trying to understand gender ideology and it's fall out. It is well-researched and necessary. I
this book is essential for people trying to understand gender ideology and it's fall out. It is well-researched and necessary. I
February 13, 2023
The story of what happened at the Tavistock clinic and why it was shut down is one of the most important of our times. That it happened at all should shock everyone in our society. That Hannah Barnes couldn't find a publisher for this book for the longest time should shock us even more.
We are emerging now from a crazy time, one in which women's rights were starting to be sacrificed on the altar of a strange ideology that wants to obliterate biological sex altogether. It is only down to the courage of people like Hannah Barnes (and Helen Joyce and Kathleen Stock) that women are being given the tools to fight back against this oppression.
We are emerging now from a crazy time, one in which women's rights were starting to be sacrificed on the altar of a strange ideology that wants to obliterate biological sex altogether. It is only down to the courage of people like Hannah Barnes (and Helen Joyce and Kathleen Stock) that women are being given the tools to fight back against this oppression.
Read
May 3, 2025The more I sit on this book in my head I just got to say horrible things have happened with good intentions. Studies that are purposefully failing due to the right to control women’s reproductive rights is not new. People are purposely trying to manipulate and cause harm to well meaning professionals that can’t do the same job as the Duch study 📚. Due to that mentally ill like schizophrenia or disabled or LGBTQ 🏳️🌈 people have always been used in history to do
Horrible things to themselves due to the advise and adverse treatments available for a hidden agenda to control women’s reproductive rights.
It’s a sad day when books are used as entertainment rather than propaganda. That the either or fallacy’s or the confirmation bias or the spotlight bias or the bystandard bias are arbitrary and discombobulated from any truth to peddling words in this statement book synopsis the title does brush at it yet cognito lacking the propaganda tool to see governments controlling harm or lack of accountability in adverse treatments is….
A sad 😔 reasoning is the purpose is…. For the synopsis is lacking for a thesis or for Francis Bacon to have a hypothesis. Is a brush is entertainment not propaganda or an adequate segueing, dissent in academia. It’s left opening to “control” any and all in it’s hard hobbling to answer
To a purpose or reasoning to governments controlling harm, for causing harm.
Where the passiveness to the book. être m’io ordre
Ou toute m’io mot
I wondered how much of this book is to get an agenda in your stop puberty blockers and stop birth control for women and stop abortions when abortion is illegal or birth control illegal.
Seeing what’s done in the states I could understand. The conservative party I used to be a part of as a moderate and sign petitions for early MLA. Something about punching pregnant women the men should get life imprisonment when the baby died. It’s an absolute hidden agenda on ending abortion and stopping birth control for women.
I’ve never heard of men punching pregnant women in stomach while pregnant. Except when abortion is illegal and men raising not their own children come into the picture.
And even then it’s rarity where I don’t think it happens very often or be in the news. Something like that would be in the news like nonstop.
I had a concussion those days, and I never realized that an agenda.
So I think liberal is only political party that actually recognizes LGBTQ or women’s rights more frequently and some things. GOVT should not have control over.
And that’s women’s autonomy, and LGBTQ 🏳️🌈
The Dutch study has never been replicated. They argued either because the English don’t have the healthcare like the Dutch or maternity or education like they do in as the Dutch.
But it’s argued it can’t be replicated.
My terminology of duchy is was different than the terminology of duchy in the book 📕 but honestly an effort to understand the book 📕 and duchy study, so far 16% through is only study available in the book.
Cambridge dictionary says it’s. Yet that’s still different than what I thought it was.
the area of land owned or ruled by a duke or duchess. Synonym. dukedom.
I’m unsure what the mermaid group and some other names are…. But I’m sure I’m wrong about those names and meanings also… lots explaining on terminology in the book. 📕
The duchy study has never been replicated in England.
Goes on to say a lot of autism. The figure is diagnosed in transgender therapy and they wanna know what the numbers are Or kids that are gay or lesbian who had one incident with each other intimately would get bullied into abuse of the transgender therapy.
l've come to the conclusion of the book at 76% done ✅ is that puberty is a hard age for anybody. But harder for people with transgendered therapy.
How do I think about puberty blockers is… the book reinforces the segues too this and that for peddling words
The book makes an argument that kids that went through transition are sicker than before, book is saying it wonders how much of this is done maliciously from malediction of unknown or by missionaries for a causes of belief to be barred for pronatalism.
Either way the book is meant to be a struggle on these points saying things are homophobia or against trans people when any and all care is given to these children. That most these children are abused by trauma be it sexual or drug trauma or alcohol trauma. At 3% the general population which it emphasis that they couldn’t ask deeply or pursue asking questions in those matters.
Making it impossible to find, and support groups that didn’t encourage hormone blockers or hormone replacement treatments were often kicked out of the discussion.
Doctors 🥼 who did surgery on adults were actually kids… who are adults… it gets confusing 🫤
Where support therapy was done from adults who never went through therapy coaching and grooming kids for this therapy.
The book does lots of segues that publicly difficult to Acquiescence to the problem. Like everyone working there simply had their regret get walked on for other experiences to either have the same regret of the youth living on older people’s regret for getting experience.
For there boundaries or morals after the virtue of trans 🏳️⚧️ therapy.
I’m sorry 😞 but was my struggle read, an academia English teacher challenge me to read this book so I picked it up. Said it took her a while to get through. Took me near a month to finish….
Had to keep on ending it and going back to it, ending it and going back to it to get finish it…
It is a hard listen 🎧 and a struggle read if your up for the challenge. But I do think people should try and read it for helping your Society your in or culture figure out these issues and maybe grow yourself into knowledgeable problem.
A well thought of synopsis for a book 📕
I choose not to rate it due to its a children book 📕 about children with problems. I don’t think k the books quite rateable?!?!
What’s my next read… this book nearly stopped my reading 📖 interest intake
Read 80% of the book 📕 and I’m already feeling the synopsis is redundant and meta analysis 🧐 to deviate from victimizing the entire audience for people to crowd out of stats and into the trauma filled life’s of transgenderism 🏳️⚧️
A bits of anxiously long book
Just seemed like my life baggage was evening unpacked and looked at and I was was getting blamed for unpacking it.
Sort of deal, like some hidden repressions when I don’t look at it that way, more like fail to unpack trauma.
Feels like my purpose is to have people public acquiescing over hard things in my life. And I often wonder if the young people will see their believing to becoming CEO’s.
It’s as if young people and living on older peoples experiences regret for boundaries and to get morals
And to feel like they don’t want to grow up
To be like
Me.
So basically anxious 😬
It’s a course of ethnomethodology, in breaching and bracketing Durkheim aphorisms. If you look up what Durkheim aphorism are….
It’s not that some one would do that to
Me is the phenomenon is how come history makes me anxiously wait out my problems lined up or outing my problems in that don’t align with who I am
Today
History seems to be written by winners,
And the the triumphant of the loser mean the utter most suppression.
So basically bad things in history have happened with good intentions.
“ I’m just saying as an older person perhaps the bad people are also always saying who the bad people are.”
-the poets
Horrible things to themselves due to the advise and adverse treatments available for a hidden agenda to control women’s reproductive rights.
It’s a sad day when books are used as entertainment rather than propaganda. That the either or fallacy’s or the confirmation bias or the spotlight bias or the bystandard bias are arbitrary and discombobulated from any truth to peddling words in this statement book synopsis the title does brush at it yet cognito lacking the propaganda tool to see governments controlling harm or lack of accountability in adverse treatments is….
A sad 😔 reasoning is the purpose is…. For the synopsis is lacking for a thesis or for Francis Bacon to have a hypothesis. Is a brush is entertainment not propaganda or an adequate segueing, dissent in academia. It’s left opening to “control” any and all in it’s hard hobbling to answer
To a purpose or reasoning to governments controlling harm, for causing harm.
Where the passiveness to the book. être m’io ordre
Ou toute m’io mot
I wondered how much of this book is to get an agenda in your stop puberty blockers and stop birth control for women and stop abortions when abortion is illegal or birth control illegal.
Seeing what’s done in the states I could understand. The conservative party I used to be a part of as a moderate and sign petitions for early MLA. Something about punching pregnant women the men should get life imprisonment when the baby died. It’s an absolute hidden agenda on ending abortion and stopping birth control for women.
I’ve never heard of men punching pregnant women in stomach while pregnant. Except when abortion is illegal and men raising not their own children come into the picture.
And even then it’s rarity where I don’t think it happens very often or be in the news. Something like that would be in the news like nonstop.
I had a concussion those days, and I never realized that an agenda.
So I think liberal is only political party that actually recognizes LGBTQ or women’s rights more frequently and some things. GOVT should not have control over.
And that’s women’s autonomy, and LGBTQ 🏳️🌈
The Dutch study has never been replicated. They argued either because the English don’t have the healthcare like the Dutch or maternity or education like they do in as the Dutch.
But it’s argued it can’t be replicated.
My terminology of duchy is was different than the terminology of duchy in the book 📕 but honestly an effort to understand the book 📕 and duchy study, so far 16% through is only study available in the book.
Cambridge dictionary says it’s. Yet that’s still different than what I thought it was.
the area of land owned or ruled by a duke or duchess. Synonym. dukedom.
I’m unsure what the mermaid group and some other names are…. But I’m sure I’m wrong about those names and meanings also… lots explaining on terminology in the book. 📕
The duchy study has never been replicated in England.
Goes on to say a lot of autism. The figure is diagnosed in transgender therapy and they wanna know what the numbers are Or kids that are gay or lesbian who had one incident with each other intimately would get bullied into abuse of the transgender therapy.
l've come to the conclusion of the book at 76% done ✅ is that puberty is a hard age for anybody. But harder for people with transgendered therapy.
How do I think about puberty blockers is… the book reinforces the segues too this and that for peddling words
The book makes an argument that kids that went through transition are sicker than before, book is saying it wonders how much of this is done maliciously from malediction of unknown or by missionaries for a causes of belief to be barred for pronatalism.
Either way the book is meant to be a struggle on these points saying things are homophobia or against trans people when any and all care is given to these children. That most these children are abused by trauma be it sexual or drug trauma or alcohol trauma. At 3% the general population which it emphasis that they couldn’t ask deeply or pursue asking questions in those matters.
Making it impossible to find, and support groups that didn’t encourage hormone blockers or hormone replacement treatments were often kicked out of the discussion.
Doctors 🥼 who did surgery on adults were actually kids… who are adults… it gets confusing 🫤
Where support therapy was done from adults who never went through therapy coaching and grooming kids for this therapy.
The book does lots of segues that publicly difficult to Acquiescence to the problem. Like everyone working there simply had their regret get walked on for other experiences to either have the same regret of the youth living on older people’s regret for getting experience.
For there boundaries or morals after the virtue of trans 🏳️⚧️ therapy.
I’m sorry 😞 but was my struggle read, an academia English teacher challenge me to read this book so I picked it up. Said it took her a while to get through. Took me near a month to finish….
Had to keep on ending it and going back to it, ending it and going back to it to get finish it…
It is a hard listen 🎧 and a struggle read if your up for the challenge. But I do think people should try and read it for helping your Society your in or culture figure out these issues and maybe grow yourself into knowledgeable problem.
A well thought of synopsis for a book 📕
I choose not to rate it due to its a children book 📕 about children with problems. I don’t think k the books quite rateable?!?!
What’s my next read… this book nearly stopped my reading 📖 interest intake
Read 80% of the book 📕 and I’m already feeling the synopsis is redundant and meta analysis 🧐 to deviate from victimizing the entire audience for people to crowd out of stats and into the trauma filled life’s of transgenderism 🏳️⚧️
A bits of anxiously long book
Just seemed like my life baggage was evening unpacked and looked at and I was was getting blamed for unpacking it.
Sort of deal, like some hidden repressions when I don’t look at it that way, more like fail to unpack trauma.
Feels like my purpose is to have people public acquiescing over hard things in my life. And I often wonder if the young people will see their believing to becoming CEO’s.
It’s as if young people and living on older peoples experiences regret for boundaries and to get morals
And to feel like they don’t want to grow up
To be like
Me.
So basically anxious 😬
It’s a course of ethnomethodology, in breaching and bracketing Durkheim aphorisms. If you look up what Durkheim aphorism are….
It’s not that some one would do that to
Me is the phenomenon is how come history makes me anxiously wait out my problems lined up or outing my problems in that don’t align with who I am
Today
History seems to be written by winners,
And the the triumphant of the loser mean the utter most suppression.
So basically bad things in history have happened with good intentions.
“ I’m just saying as an older person perhaps the bad people are also always saying who the bad people are.”
-the poets
June 29, 2023
A very important book on the topic of transgender children. Something you can barely discuss without being branded a transphobe these days. However, from a medical point of view it is important to note that the full extent of side effects of hormonal treatments are unknown. Among them is osteoporosis. Hormone blockers are not necessarily reversible and children put on these invariably proceed to sex hormone treatment. Puberty blockers do not give these children “time to think”, it sets them on a path that they are not capable of fully assessing. Another point is that many of the children who claimed they were transgender have a host of other mental issues. There has been a huge rise of girls want to become boys. Why? And what does it say about society when assigned gender is felt like such a constraint that changing sex seems like a viable option? Everyone should feel free to express themselves on these sliding scales, rather than to try to pass and thus squeeze into another pigeon hole.
The book gives many examples of how misgivings were not heard and patients rushed through and into treatment rather than to wait and explore options.
The book gives many examples of how misgivings were not heard and patients rushed through and into treatment rather than to wait and explore options.
April 21, 2023
Super interesting, but it's about twice as long as it needs to be in my opinion, after about halfway through it felt like I was just reading the same ideas I'd read up to that point. It's interesting to think about gender identity and ways to help people who experience gender dysphoria, but what really stood out to me was the breakdown of the whistleblowing process. It was honestly mindblowing that the systems that are supposed to support this process were this dysfunctional, even when when it came to people reporting essentially institutionalised malpractice on children.
October 18, 2025
Really well-researched and written, thoughtful and sensitive. Also makes me very paranoid about the lack of record-keeping that could be going on elsewhere in the health system too though… because good grief, that institutional failure was very alarming, and seems so basic when compared with the difficult and contentious ethical issues being covered here.
February 16, 2023
Thrilled beyond words that this book has been published.
February 14, 2023
What happened at the Tavistock was a travesty. Thrilled someone has written a book about it. This is a story the world needs to hear.
March 13, 2023
The frankly shocking story of the biggest medical scandal in recent years - one whose full impact won’t known for many years.
Barnes is an incredible investigative journalist. She meticulously unpicks the entire issue from well meaning beginning through the numerous internal investigations and whistleblowers to the ignoble collapse of a once world class clinic.
Encouraging findings at a Dutch clinic of giving puberty blockers to a very specific cohort of young people while they received extensive counselling should have been great news.
That it should end up giving the same medication after fewer and fewer assessments to a very different cohort with multiple comorbidities - with no tracking, no follow up and the forcing out of anyone who raises concerns - is a betrayal of the young people and their families, the devoted clinicians and the founding principles behind the Tavistock.
Heads should roll, but I am no sure they will
Barnes is an incredible investigative journalist. She meticulously unpicks the entire issue from well meaning beginning through the numerous internal investigations and whistleblowers to the ignoble collapse of a once world class clinic.
Encouraging findings at a Dutch clinic of giving puberty blockers to a very specific cohort of young people while they received extensive counselling should have been great news.
That it should end up giving the same medication after fewer and fewer assessments to a very different cohort with multiple comorbidities - with no tracking, no follow up and the forcing out of anyone who raises concerns - is a betrayal of the young people and their families, the devoted clinicians and the founding principles behind the Tavistock.
Heads should roll, but I am no sure they will
May 14, 2023
This book was so so good. It really takes you behind the scenes of the Tavistock Controversy which has lead to over 1,000 lawsuits for the harming of children in the United Kingdom in the name of Gender Ideology. It follows the organizations that partner with the Tavistock and all of the changes to the policy and law as the clinic developed. For a period of time it focuses on the comorbidities that lead many kids to see a therapist and how those comorbidities are intentionally overlooked for gender transition because it is much more profitable. Over 30% of referred adolescents were on the Autism Spectrum while in the general population only 2% of them are which clearly illustrates that Autistic Kids are more susceptible to gender indoctrination.
If you are someone who opposes gender ideology and the social harms it inflicts, this is a book for you.
If you are someone who opposes gender ideology and the social harms it inflicts, this is a book for you.
March 20, 2023
All health and social care professionals who work with children and young people should read this book.
July 3, 2023
A good case study showing how basic child safeguarding, medical ethics and common sense and logic can be suspended and l how supposedly professional and independent clinicians can become emotionally captured and exhibit cliquish behavior, careless disregard for the consequences (you don't have to worry about what you don't document or track, after all), produce misleading word salads passing as official public statements (an example, p314: "The tribunal found that 'both in emails and in answers to questions in the tribunal, Dr Carmichael was often both verbose and imprecise') and fail, at absolutely all levels, to take any responsibility, lest one be branded as a child harming transphobe. Oh, it helps that affected children are mostly the very vulnerable and therefore marginalized.
Unsurprisingly, it's always the principled few who push against the current and take all kinds of risks to get the word out.
Unsurprisingly, it's always the principled few who push against the current and take all kinds of risks to get the word out.
UCLH paediatric endocrinologist Gary Butler has previously told the High Court that
"the decisions at UCLH and Leeds do not automatically follow on from those made at the GIDS Tavistock. They are a reassessment of physical maturity and cognitive capacity in their own right. They may be at odds with the Tavistock formulation (an infrequent event) and thus would be returned to the Tavistock MDT for reconsideration."
However, when asked by the court for the number of young people who had been assessed to be suitable for puberty blockers by GIDS but then not prescribed them because they were considered not to be competent to make the decision, the Tavistock’s legal team ‘could not produce any statistics on whether this situation had ever arisen.' A July 2022 academic paper from the UCLH and Leeds endocrinologists revealed that one young person, out of 1,089, was judged to lack capacity to consent to treatment. They were 16 years old.
Director of GIDS Polly Carmichael confirmed this to the Tavistock’s medical director in 2018, telling him that the GIDS team was ‘very close knit, very committed... it has been like a family’.” And it did feel like that to many. When people did challenge, it was taken very badly, Matt Bristow says, ‘as a personal affront rather than people raising legitimate professional concerns’. He and others recount how executive members of staff would become tearful when criticisms of the service were raised. It would then be made known among the team that ‘this has made Polly cry’, Bristow says. I don't think that’s appropriate as a management style.’
Even some of those fiercely critical of GIDS seem to be desperately uncomfortable admitting the weaknesses of management. And this helps explain why change was so hard to force through. It was difficult to voice legitimate concerns when these were construed as a personal attack on people you cared for and admired. Clinicians have told me how defensive some members of the Executive would be whenever the service was criticised. It’s understandable, perhaps, given how long all of them had worked there. As Anna Hutchinson explained during the GIDS Review, it would be ‘quite intolerable to think about’ any potential harm if you have been putting children on to a ‘medical pathway’ which might include infertility and ‘significant surgery’ for more than a decade. ‘A lot of people would struggle to say, “I was wrong or maybe that was not [the] best thing for all of those kids.”' Nonetheless, this defensiveness was not conducive to either the airing of or acting upon concerns. It was not always the leadership who would be defensive: other members of staff would ‘jump in’ because they wouldn't want to see the Executive upset, I’m told. Some clinicians also say this sense of family explains why they stayed so long at GIDS. It made it much harder to leave.
She agrees that what evidence GIDS did have applied ‘largely to a very different cohort to the one which was presenting’, and that she ‘wouldn’t have much confidence in cross-reading any of that evidence to the current demographic’. But, she says, there are lots of areas in medicine, ‘especially in paediatrics, where we've got no idea at all about the long-term follow-up’. Like what, I ask? But she could not think of an example.
December 26, 2023
This is a long, complicated book about a single small service in England's National Health Service, but it does a good job of describing many of the problems of practicing medicine in the twenty-first century, in England or any other country with a highly-developed medical service. Yes, it is about gender dysphoria and the medical aspects of transitioning, but it is also about many other things: the role of hierarchy and bureaucracy in stifling good medical judgement, the effect of politics and interest groups on physicians practicing in sensitive areas of medicine, the difficulty of speaking up and challenging orthodoxy, and even the role of financial incentives for health care executives and physicians. When practitioners consistently describe what is going on in their practice as "mad", feel pressure to prescribe a treatment with a limited evidence base, and lose sleep over whether they are causing long-term harm to children under their care, there is clearly something seriously wrong. This book would have benefitted from some editing, and it feels repetitive and endless at times. But the individual patient stories help to reinforce what is at stake, and it is an important and tragic story.
Here is a link to a US public radio station's interview with the author:
https://www.wbur.org/onpoint/2023/03/...
Here is a link to a US public radio station's interview with the author:
https://www.wbur.org/onpoint/2023/03/...
Read
August 19, 2023Meticulous, difficult, essential; three words I’d use to begin to describe this text. It will take some work to square up the repercussions of the information in the detailed documentation of the fall of GIDS, the UKs only gender specialist unit, with my continued and determined belief in Trans rights. I’m embarrassed to say I knew absolutely none of it prior to reading this and on finishing it I’m incredulous that I knew nothing.
Once again I am reminded that the truth resists simplicity. I believe this book brings the truth, but it is certainly not a simple black and white tale.
Once again I am reminded that the truth resists simplicity. I believe this book brings the truth, but it is certainly not a simple black and white tale.
March 10, 2023
A devastating account of the medical scandal which unfolded at the UK's only publicly funded Gender Identity Disorder Clinic for minors, GIDS. What began as a (relatively) even minded clinic aiming to square various circles became a one-size-fits-all medicalised approach to clients with complex and multiple conditions. They ended up handing out puberty blockers, an entirely experimental and permanently life-changing drug, like smarties to children as young as 11. They were listening to ideologues and lobby groups over medical evidence (of which they had precious little). They went after whistleblowers who were concerned with safeguarding.
Hannah Barnes lays bare the whole appalling business in a clinical and forensic fashion. She is fair-minded - she speaks to young people who avow that they were helped by the service, as well as those who were irretrievably damaged. She uncovers a truly appalling management culture, and lays the blame very much with the leadership, although she does not impugn motive (there's some speculation here but no conclusion).
Worth reading as a cautionary tale of how contemporary society is not immune to the kind of medical wrongdoing which litters the past.
Hannah Barnes lays bare the whole appalling business in a clinical and forensic fashion. She is fair-minded - she speaks to young people who avow that they were helped by the service, as well as those who were irretrievably damaged. She uncovers a truly appalling management culture, and lays the blame very much with the leadership, although she does not impugn motive (there's some speculation here but no conclusion).
Worth reading as a cautionary tale of how contemporary society is not immune to the kind of medical wrongdoing which litters the past.
February 21, 2024
More accurate rating: 8.5/10.
I found this account of (to put it simply): "what went wrong with the GIDS at the Tavistock Clinic" a very thorough, engaging, worrying and thought-provoking piece of investigative journalism. Full of compassion, and a deep desire to understand, as well.
It obviously asks a lot of questions regarding the aetiology, and more importantly safety and ethics of the currently dominant, affirmative and medicalising model of treatment for gender/sex dysphoria in children and adolescents. And I'll add, for my part, that I think it's a disgrace the 'political' climate around this topic, this issue, has become so fraught the author struggled to find a publisher for her genuinely curious and caring inquiry.
But beyond the fact this book certainly adds to society's ongoing conversation, debate, fight, whatever you want to call it, regarding the problems with gender identity ideology, it is also, without a doubt, an account of the limitations of, and fuck-ups these can lead to in broader psychiatric care. In medical care as a whole, really. What happened with GIDS isn't just a story about (potentially mis-) treating gender dysphoria in minors. It is a story about what happens to the most vulnerable of patients, of distressed individuals, when medical institutions lack proper mechanisms of oversight, safeguarding... and freaking data-gathering. Honestly, that's one of the things that shocked me the most, by far: the fact GIDS or the Tavistock just... didn't carry out any kind of proper data gathering and analysis. Christ.
It is also a story about what happens when medical treatments aren't properly presented as being experimental – because they lack a solid base of actual evidence. And about what happens when socialised healthcare lacks the necessary funding to function optimally and, crucially, in the best interest of all patients. For fuck's sake, if there is one thing that should not experience budget cuts, it's freaking healthcare!
So yes, I found this an important piece of journalism, not just because I'm a gender-critical feminist, but because I am someone who has had extensive experience with under-funded, overloaded, and also 'ideologically-captured' (by, in my case, Freudo-Lacanian psychoanalysis) mental health care – and suffered harm as a result.
I found this account of (to put it simply): "what went wrong with the GIDS at the Tavistock Clinic" a very thorough, engaging, worrying and thought-provoking piece of investigative journalism. Full of compassion, and a deep desire to understand, as well.
It obviously asks a lot of questions regarding the aetiology, and more importantly safety and ethics of the currently dominant, affirmative and medicalising model of treatment for gender/sex dysphoria in children and adolescents. And I'll add, for my part, that I think it's a disgrace the 'political' climate around this topic, this issue, has become so fraught the author struggled to find a publisher for her genuinely curious and caring inquiry.
But beyond the fact this book certainly adds to society's ongoing conversation, debate, fight, whatever you want to call it, regarding the problems with gender identity ideology, it is also, without a doubt, an account of the limitations of, and fuck-ups these can lead to in broader psychiatric care. In medical care as a whole, really. What happened with GIDS isn't just a story about (potentially mis-) treating gender dysphoria in minors. It is a story about what happens to the most vulnerable of patients, of distressed individuals, when medical institutions lack proper mechanisms of oversight, safeguarding... and freaking data-gathering. Honestly, that's one of the things that shocked me the most, by far: the fact GIDS or the Tavistock just... didn't carry out any kind of proper data gathering and analysis. Christ.
It is also a story about what happens when medical treatments aren't properly presented as being experimental – because they lack a solid base of actual evidence. And about what happens when socialised healthcare lacks the necessary funding to function optimally and, crucially, in the best interest of all patients. For fuck's sake, if there is one thing that should not experience budget cuts, it's freaking healthcare!
So yes, I found this an important piece of journalism, not just because I'm a gender-critical feminist, but because I am someone who has had extensive experience with under-funded, overloaded, and also 'ideologically-captured' (by, in my case, Freudo-Lacanian psychoanalysis) mental health care – and suffered harm as a result.
March 10, 2023
An absolute must read for anyone who has heard anything or been involved in the transgender debate.
Barnes should absolutely be commended for her work here in going over what happened at the Tavistock leading to it's soon to happen closure. The truth is this probably could have happened at least 7 years earlier as an external consultant had recommended a rethink on what they should be doing but that was ignored. As were a whole bunch of other worries...
I did not go for a full 5 stars as I found it a touch odd that the history of gender ideology was not touched on at the start along with the infamous John Money - those involved in GIDS should absolutely been aware of what could go wrong based on what happened with Money and the Reimar twins which makes the lack of worry displayed by the senior management at GIDS absolutely baffling.
Barnes should absolutely be commended for her work here in going over what happened at the Tavistock leading to it's soon to happen closure. The truth is this probably could have happened at least 7 years earlier as an external consultant had recommended a rethink on what they should be doing but that was ignored. As were a whole bunch of other worries...
I did not go for a full 5 stars as I found it a touch odd that the history of gender ideology was not touched on at the start along with the infamous John Money - those involved in GIDS should absolutely been aware of what could go wrong based on what happened with Money and the Reimar twins which makes the lack of worry displayed by the senior management at GIDS absolutely baffling.
March 16, 2023
The book is a heavy read because it sets out the reality of weak leadership at both levels of the head of and an important section of an organization. Its failure to tackle acknowledged problems with a management which considered criticism as a personal attack and failed to stand up to pressure from outside groups. A one size fits all treatment that did not take into consideration other health issues that patients presented with nor was backed up with medical research. All this compounded by the fact that it involved the medical treatment of children.
April 26, 2024
This book is forensic and serious. You often get the sense that every word is chosen extremely carefully, and that this is by necessity. It's not really an enjoyable book but it's a vital one for our times. It feels extremely repetitive: at times, it seems that the phrase 'concerns were raised by [Clinician's Name]' appears on almost every other page. The purpose of this is to make the point that the concerns constantly being raised were routinely ignored. Sometimes, a Tavistock clinician's concerns were discussed performatively in a group setting, to show that they were being listened to, then they were yet again routinely ignored with no action resulting from the discussion. For some individuals on staff, victimization followed.
I can quite appreciate why the author takes a clinical tone in this book. Because once you've actually finished reading the tome and stepped back from it, what it all adds up to is a bunch of quacks conducting life-changing medical experiments on children. The author has to be highly meticulous with her evidence. If everything in this book is true, and it's all from primary sources, then we're talking about child neglect and abuse on a significant scale. It may be that some of the leadership at GIDS thought they were doing the right thing, but if that's the case, then it would prove the maxim about the road to hell being paved with good intentions.
The monotony of the chapters that catalogue the seemingly hunderds of times clinicians of all disciplines raised safeguarding and mental health concerns about the children in the care of the Gender Identity Development Service (GIDS) at the Tavistock is somewhat eased by chapters containing patient case studies. The case studies deal with both people who feel GIDS was helpful, and those who feel GIDS neglected them in some important ways. The one thing all have in common is that the puberty blockers seemed to be offered freely once they reached the relevant age (under GIDS's peculiar standards), sometimes after only two-three sessions of therapy. These sessions usually did not address the overall context of the child's life.
The results for those who realise that they are happy with their natal sex after all: the theft of their puberty and all that goes with it (first crushes included) through hormone blockers, lifelong infertility, and increased risk of other medical complications later in life. Children with ASD (35% of GIDS patients, as opposed to 2% of the general population), ADHD, and what parents deemed to be gender non-conforming behaviour often ended up at GIDS with complex issues that may have resolved once they grew into their natal gender as puberty progressed.
A disproportionate amount of children who ended up at GIDS were in care, had recent parental bereavements, had experienced sexual abuse, and a host of other issues, and GIDS often ignored the context of their lives and referred them for puberty blockers.
One of the many alarming aspects of this book is the disclosure that whistleblowers described GIDS clinicians there as often confirming children's internalized homphobia, picked up from being bullied at home or school. Astoundingly, it also seems that a proportion of parents in the world would rather have a trans child than a gay child. Yes, you read that correctly. There are parents in the world who would rather their child took life-altering drugs rendering them infertile for life, and had parts of their bodies removed, than accept that their child might be gay. There were, according to insiders, definite cases of transition being used as thinly diguised 'gay conversion therapy.'
If a child has some of the minor gender non-conforming attributes that gay children can sometimes (but not always) possess, they would be happier to transition them than to accept their child's sexual orientation and let the child know that they are loved in all their gayness - a phenomenon that we know occurs in nature across all mammals.
Once a child is put on puberty blockers, the chances of their dysphoria resolving during teen years decreases dramatically. It has been shown time and again that this pathway is usually self-fulfilling. GIDS staff who raised concerns about all of this were labelled 'negative', 'gender critical', and 'transphobic'. This was even the case for the staff who believed some children did need to transition, but wondered about the context of the exponential rise in numbers, particularly of girls claiming to be trans boys. In one case study, Harriet, who thought she was trans for a period but returned to her natal sex, describes her interest in computers being seen as a 'male' pursuit by GIDS clinicians. We're back to old-fashioned misogyny and homphobia here, and children are suffering at a massive rate because of this ignorance.
There are many children who have been collateral damage due to the GIDS culture of silencing and their too-close relationship with pressure groups like Mermaids and Gender Intelligence. Further collateral damage is scores of former staff from the GIDS unit at the Tavistock who suffer moral injury over their time there, to this day.
A therapist called Matt Bristow relates what happened when people tried to raise concerns, which suggests the place had a cult-like atmosphere: 'He and others recount how executive members of staff would become teary when criticisms of the service were raised. It would then be made known among the team that "this has made Polly cry", Bristow says. 'I don't think that's appropriate as a management style."' This refers to GIDS director Dr Polly Carmichael, a person many of the sources in the book seem to have been afraid of crossing.
We've all seen situations where conscientious people who try to raise ethical concerns are silenced, and indeed false allegations of bullying against those raising ethical concerns is a recognized form of bullying in itself. It's clear that the leadership of the Tavistock were the ones who were not up to the job, but it took two decades and a massive scandal for the NHS to figure this out. What a tragedy for all of those who have been damaged by this organization and its toxic ideology.
I don't doubt that there is a small proportion of the population who are trans and need to present as such in order to live a fulfilled life. I genuinely wish them well; it takes courage to make this decision and follow through. However, there is an ideology around this issue that has bypassed rationality in recent years, and spilled over into the dangerous and destructive. Where children are being urged to embark on a pathway that will alter their lives fundamentally before they are even deemed eligible to vote, drink, or drive, we have to ask ourselves if we have lost sight of basic common sense in the name of serving an ideological agenda.
I can quite appreciate why the author takes a clinical tone in this book. Because once you've actually finished reading the tome and stepped back from it, what it all adds up to is a bunch of quacks conducting life-changing medical experiments on children. The author has to be highly meticulous with her evidence. If everything in this book is true, and it's all from primary sources, then we're talking about child neglect and abuse on a significant scale. It may be that some of the leadership at GIDS thought they were doing the right thing, but if that's the case, then it would prove the maxim about the road to hell being paved with good intentions.
The monotony of the chapters that catalogue the seemingly hunderds of times clinicians of all disciplines raised safeguarding and mental health concerns about the children in the care of the Gender Identity Development Service (GIDS) at the Tavistock is somewhat eased by chapters containing patient case studies. The case studies deal with both people who feel GIDS was helpful, and those who feel GIDS neglected them in some important ways. The one thing all have in common is that the puberty blockers seemed to be offered freely once they reached the relevant age (under GIDS's peculiar standards), sometimes after only two-three sessions of therapy. These sessions usually did not address the overall context of the child's life.
The results for those who realise that they are happy with their natal sex after all: the theft of their puberty and all that goes with it (first crushes included) through hormone blockers, lifelong infertility, and increased risk of other medical complications later in life. Children with ASD (35% of GIDS patients, as opposed to 2% of the general population), ADHD, and what parents deemed to be gender non-conforming behaviour often ended up at GIDS with complex issues that may have resolved once they grew into their natal gender as puberty progressed.
A disproportionate amount of children who ended up at GIDS were in care, had recent parental bereavements, had experienced sexual abuse, and a host of other issues, and GIDS often ignored the context of their lives and referred them for puberty blockers.
One of the many alarming aspects of this book is the disclosure that whistleblowers described GIDS clinicians there as often confirming children's internalized homphobia, picked up from being bullied at home or school. Astoundingly, it also seems that a proportion of parents in the world would rather have a trans child than a gay child. Yes, you read that correctly. There are parents in the world who would rather their child took life-altering drugs rendering them infertile for life, and had parts of their bodies removed, than accept that their child might be gay. There were, according to insiders, definite cases of transition being used as thinly diguised 'gay conversion therapy.'
If a child has some of the minor gender non-conforming attributes that gay children can sometimes (but not always) possess, they would be happier to transition them than to accept their child's sexual orientation and let the child know that they are loved in all their gayness - a phenomenon that we know occurs in nature across all mammals.
Once a child is put on puberty blockers, the chances of their dysphoria resolving during teen years decreases dramatically. It has been shown time and again that this pathway is usually self-fulfilling. GIDS staff who raised concerns about all of this were labelled 'negative', 'gender critical', and 'transphobic'. This was even the case for the staff who believed some children did need to transition, but wondered about the context of the exponential rise in numbers, particularly of girls claiming to be trans boys. In one case study, Harriet, who thought she was trans for a period but returned to her natal sex, describes her interest in computers being seen as a 'male' pursuit by GIDS clinicians. We're back to old-fashioned misogyny and homphobia here, and children are suffering at a massive rate because of this ignorance.
There are many children who have been collateral damage due to the GIDS culture of silencing and their too-close relationship with pressure groups like Mermaids and Gender Intelligence. Further collateral damage is scores of former staff from the GIDS unit at the Tavistock who suffer moral injury over their time there, to this day.
A therapist called Matt Bristow relates what happened when people tried to raise concerns, which suggests the place had a cult-like atmosphere: 'He and others recount how executive members of staff would become teary when criticisms of the service were raised. It would then be made known among the team that "this has made Polly cry", Bristow says. 'I don't think that's appropriate as a management style."' This refers to GIDS director Dr Polly Carmichael, a person many of the sources in the book seem to have been afraid of crossing.
We've all seen situations where conscientious people who try to raise ethical concerns are silenced, and indeed false allegations of bullying against those raising ethical concerns is a recognized form of bullying in itself. It's clear that the leadership of the Tavistock were the ones who were not up to the job, but it took two decades and a massive scandal for the NHS to figure this out. What a tragedy for all of those who have been damaged by this organization and its toxic ideology.
I don't doubt that there is a small proportion of the population who are trans and need to present as such in order to live a fulfilled life. I genuinely wish them well; it takes courage to make this decision and follow through. However, there is an ideology around this issue that has bypassed rationality in recent years, and spilled over into the dangerous and destructive. Where children are being urged to embark on a pathway that will alter their lives fundamentally before they are even deemed eligible to vote, drink, or drive, we have to ask ourselves if we have lost sight of basic common sense in the name of serving an ideological agenda.
![Profile Image for [Name Redacted].](/_next/image?url=https%3A%2F%2Fi.gr-assets.com%2Fimages%2FS%2Fcompressed.photo.goodreads.com%2Fusers%2F1347082397i%2F287915._UY200_CR0%2C0%2C200%2C200_.jpg&w=128&q=75)
May 16, 2025
"
Price Tag
"
by Sleater-Kinney
The bells go off
The buzzer coughs
The traffic starts to buzz
The clothes are stiff
The fabrics itch
The fit's a little rough
But I suck it in
To every stitch
Try to fit inside the glove
I scramble eggs
For little legs
The day's off in a rush
It's 9 am
We must clock in
The system waits for us
I stock the shelves
I work the rows
The product's all light up
If I could flip the switch
The system fix
I could move us to the top
The numbers roll
It's time to go
But never fast enough
We never really checked
We never checked the price tag
When the cost comes in
It's gonna be high
We love our bargains
We love the prices so low
With the good jobs gone
It's gonna be rough
In the market
The kids are starving
They reach for the good stuff
Let's stay off the label
Just till we're able
To save a little up
The next big win
The ship comes in
No more worry for us
Just keep moving
The wheels keep turning
It's time to go pay up
We never really checked
We never checked the price tag
When the cost comes in
It's gonna be high
We love our bargains
We love the prices so low
With the good jobs gone
It's gonna be rough
I was lured by the devil
I was lured by the cost
I was lured by the fear
That all we had was lost
I was blind by the money
I was numb from the greed
I'll take God when I'm ready
I'll choose sin till I leave
We never really checked
We never checked the price tag
When the cost comes in
It's gonna be high
We love our bargains
We love the prices so low
With the good jobs gone
It's gonna be rough
by Sleater-Kinney
The bells go off
The buzzer coughs
The traffic starts to buzz
The clothes are stiff
The fabrics itch
The fit's a little rough
But I suck it in
To every stitch
Try to fit inside the glove
I scramble eggs
For little legs
The day's off in a rush
It's 9 am
We must clock in
The system waits for us
I stock the shelves
I work the rows
The product's all light up
If I could flip the switch
The system fix
I could move us to the top
The numbers roll
It's time to go
But never fast enough
We never really checked
We never checked the price tag
When the cost comes in
It's gonna be high
We love our bargains
We love the prices so low
With the good jobs gone
It's gonna be rough
In the market
The kids are starving
They reach for the good stuff
Let's stay off the label
Just till we're able
To save a little up
The next big win
The ship comes in
No more worry for us
Just keep moving
The wheels keep turning
It's time to go pay up
We never really checked
We never checked the price tag
When the cost comes in
It's gonna be high
We love our bargains
We love the prices so low
With the good jobs gone
It's gonna be rough
I was lured by the devil
I was lured by the cost
I was lured by the fear
That all we had was lost
I was blind by the money
I was numb from the greed
I'll take God when I'm ready
I'll choose sin till I leave
We never really checked
We never checked the price tag
When the cost comes in
It's gonna be high
We love our bargains
We love the prices so low
With the good jobs gone
It's gonna be rough
March 14, 2023
Such a considered and thoughtful discussion of the topic.
Sensitively discussed and I really feel Ms Barnes has offered a balanced examination.
I found it both fascinating and disturbing. I would recommend it to anyone who wants to understand more fully how things have progressed to the point at which the Gids service at the Tavistock had to be closed. I honestly believe this is such an important read and that a lack of knowledge and understanding surrounding this issue is making this situation so much more difficult for all involved.
Sensitively discussed and I really feel Ms Barnes has offered a balanced examination.
I found it both fascinating and disturbing. I would recommend it to anyone who wants to understand more fully how things have progressed to the point at which the Gids service at the Tavistock had to be closed. I honestly believe this is such an important read and that a lack of knowledge and understanding surrounding this issue is making this situation so much more difficult for all involved.
This entire review has been hidden because of spoilers.
March 31, 2023
Time to Think : The Inside Story of the Collapse of the Tavistock’s Gender Service for Children (2023) by Hannah Barnes is a truly excellent book that details what occurred at the Tavistock’s Gender Identity Discovery Service (GIDS). Barnes is an Oxford educated BBC journalist.
There is an excellent interview with Barnes on Andrew Sullivan’s podcast ‘The Dishcast’ and there is a good review of this book in New Statesman. The book is remarkable because despite Barnes’ pedigree as a well known journalist the book was knocked back by over twenty publishers in the UK according to The Economist.
The book is not transphobic. At no point does Barnes question that many people are happier being trans and that those people should be treated well.
The book proceeds chronologically from the start of the trust in 1989 in its years seeing a fairly small number of children in the 1990s. In the 1990s puberty blockers began to be used to slow puberty in transgender youth. This was an off label use for drugs that were used to delay puberty in children. There was little known about the effects of these drugs in the long term.
In the late 2000s and 2010s there was a dramatic rise in the number of children who had gender dysphoria. In 2009-10 GIDS saw 97 children, by 2015-16 this had increased to 1419 children. The rise in female at birth patients went from 32 to in 2009/10 to 1981 in 2019/20.
In the book Barnes quotes many people who worked at GIDS who had serious concerns that the service was putting too many children on puberty blockers and that the vast majority of these children would then go on to hormone therapy. Many of these children had mental health issues and other serious life issues. From the book :
“about 70 per cent of the sample had more than five ‘associated features’ – a long list that includes those already mentioned as well as physical abuse, anxiety, school attendance issues and many more”
Barnes mixes the stories of people working at GIDS with stories of children who have been through the clinic. There are some de-transitioners and some who had issues with the clinic.
Barnes speaks to many former employees including Sonia Appleby, who was the ‘professional for safeguarding children’ at the centre for before she was dismissed. She was awarded compensation for wrongful dismissal. Interestingly some of the other people Barnes talks to were gay and believed that there was homophobia at GIDS. Some parents were also described as homophobic.
The trans rights group Mermaids is described as having put some pressure on GIDS and at times to have had a say in hiring decisions.
The book charts the course of concerns being raise about the service. This started in 2005 with an internal review. There were then recommendations that the number of people who could be seen be capped in 2014. After that in 2018 the Bell Report was written that deemed GIDS ‘not fit for purpose’. In 2021 the Care Quality Commision (CQC) rated GIDS as ‘Inadequate’, the lowest rating. Finally GIDS was closed in 2022 and that regional centres in children’s hospitals would be used that emphasized mental health more.
Remarkably it became clear that despite the novel treatment often offered at GIDS the record keeping and following up long term on patients referred was severely lacking.
The book has a narrow focus on GIDS and does not comment about the way in which the number of children with gender dysphoria increased so dramatically. This is to the book’s credit. The narrow focus on the exposition of events at GIDS in such a careful way is very impressive.
Time to Think is a remarkable book that carefully describes what happened at GIDS. Barnes has done a fantastic job in interviewing many people for the book and putting forward their statements.
There is an excellent interview with Barnes on Andrew Sullivan’s podcast ‘The Dishcast’ and there is a good review of this book in New Statesman. The book is remarkable because despite Barnes’ pedigree as a well known journalist the book was knocked back by over twenty publishers in the UK according to The Economist.
The book is not transphobic. At no point does Barnes question that many people are happier being trans and that those people should be treated well.
The book proceeds chronologically from the start of the trust in 1989 in its years seeing a fairly small number of children in the 1990s. In the 1990s puberty blockers began to be used to slow puberty in transgender youth. This was an off label use for drugs that were used to delay puberty in children. There was little known about the effects of these drugs in the long term.
In the late 2000s and 2010s there was a dramatic rise in the number of children who had gender dysphoria. In 2009-10 GIDS saw 97 children, by 2015-16 this had increased to 1419 children. The rise in female at birth patients went from 32 to in 2009/10 to 1981 in 2019/20.
In the book Barnes quotes many people who worked at GIDS who had serious concerns that the service was putting too many children on puberty blockers and that the vast majority of these children would then go on to hormone therapy. Many of these children had mental health issues and other serious life issues. From the book :
“about 70 per cent of the sample had more than five ‘associated features’ – a long list that includes those already mentioned as well as physical abuse, anxiety, school attendance issues and many more”
Barnes mixes the stories of people working at GIDS with stories of children who have been through the clinic. There are some de-transitioners and some who had issues with the clinic.
Barnes speaks to many former employees including Sonia Appleby, who was the ‘professional for safeguarding children’ at the centre for before she was dismissed. She was awarded compensation for wrongful dismissal. Interestingly some of the other people Barnes talks to were gay and believed that there was homophobia at GIDS. Some parents were also described as homophobic.
The trans rights group Mermaids is described as having put some pressure on GIDS and at times to have had a say in hiring decisions.
The book charts the course of concerns being raise about the service. This started in 2005 with an internal review. There were then recommendations that the number of people who could be seen be capped in 2014. After that in 2018 the Bell Report was written that deemed GIDS ‘not fit for purpose’. In 2021 the Care Quality Commision (CQC) rated GIDS as ‘Inadequate’, the lowest rating. Finally GIDS was closed in 2022 and that regional centres in children’s hospitals would be used that emphasized mental health more.
Remarkably it became clear that despite the novel treatment often offered at GIDS the record keeping and following up long term on patients referred was severely lacking.
The book has a narrow focus on GIDS and does not comment about the way in which the number of children with gender dysphoria increased so dramatically. This is to the book’s credit. The narrow focus on the exposition of events at GIDS in such a careful way is very impressive.
Time to Think is a remarkable book that carefully describes what happened at GIDS. Barnes has done a fantastic job in interviewing many people for the book and putting forward their statements.
December 8, 2023
The trend in Europe has been towards an increasingly more cautious approach to gender affirming services for kids, with several nations pulling back from the use of puberty blockers and other hormonal interventions. The UK recently dismantled its Tavistock Clinic - the NHS's primary center for pediatric gender affirming care- due to concerns the Clinic was harming kids with treatments having weak scientific support.
The problem, as this book lays it out, was that no one had any time to think. The kids were not given space to think. The clinicians didn't have time to question. Everyone assumed that someone else had done the research and found the evidence. Add on the heavy pressure from activists to deviate from clinical norms, and you've got a serious healthcare ethics problem.
This British author demonstrates how Europeans are taking a less dramatic approach to this issue than are Americans. in fact, I found it to be a bit boring at times. But it is a good call that we need to structure our organizations to provide time for people to think and reflect - a rarity these days.
The problem, as this book lays it out, was that no one had any time to think. The kids were not given space to think. The clinicians didn't have time to question. Everyone assumed that someone else had done the research and found the evidence. Add on the heavy pressure from activists to deviate from clinical norms, and you've got a serious healthcare ethics problem.
This British author demonstrates how Europeans are taking a less dramatic approach to this issue than are Americans. in fact, I found it to be a bit boring at times. But it is a good call that we need to structure our organizations to provide time for people to think and reflect - a rarity these days.
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