The Gender Identity Development Service (GIDS)

What is the Gender Identity Development Service (GIDS)?

Gender identity care for children and young people under 18 is provided within the NHS by the Gender Identity Development Service (GIDS). GIDS is a highly specialised clinic for young people who experience difficulties with their gender identity. It is based at the Tavistock and Portman NHS Foundation Trust and commissioned by NHS England. The service has clinics in London, Leeds, Bristol and Birmingham. To be seen by a specialist team at the GIDS, a young person usually needs to be referred by their GP or a local Child and Adolescent Mental Health Service (CAMHS). However, some people we spoke to talked about their young person being referred via school, or a charity. The service has a waiting list meaning that people who get referred have to wait to be seen. The waiting time for the first appointment varies, but with high demand can take a long time. To find out the current waiting time you see the GIDs website (GIDS, 2020).

Support offered by GIDS

Interaction with GIDS starts with a psychosocial assessment, which usually takes between 3 and 6 appointments, and is done by one or two mental health professionals from the GIDS team. The aim of the assessment is ‘to explore and understand the child or young person’s past and current gender identification, as well as their development across a number of areas of their life.’* What happens after the assessment depends on a number of factors including the ‘young person’s age, gender experiences and the support they and the family are already receiving.’ Depending on the young person’s age and their experiences, GIDS may arrange a meeting with a paediatric endocrinologist in the GIDS team. These specialists will ‘discuss the child’s feelings around the physical changes of puberty and order a range of physical tests to look at the young person’s pubertal status, and their hormonal and chromosomal characteristics.’ If appropriate, they can then clear the young person for hormone blockers. The young person can continue to meet with the GIDS clinicians after their assessment and receive support and guidance from GIDS until they are 18 years old.*
In our interviews, parents and carers shared a range of experiences with GIDS. In this section, you can find out more about these. Some of the things that parents/carers talked about included:
The first appointment at GIDS;
  • What happens in the GIDS appointments;
  • What happens between appointments;
  • Importance of trust and continuity;
  • Cost and time; and
  • Fears and hopes for future appointments.

The first appointment at GIDS

The parents and carers we spoke to shared their experiences of going to the first appointment at GIDS with their young person. They also talked about what happened in that first appointment and how they and their young person felt about it.
In our interviews, people shared mixed experiences of going to see GIDS for the first time. For some, the first appointment was positive, informative and reassuring, whilst others felt disappointed. Many parents had researched and looked for information about the existing pathways and support available to their family. This meant that there was often a lot of anticipation and eagerness to get input and help from the service, but at times also a lot of anxiety and uncertainly about how that experience would be.

Richard found the GIDS clinicians to be amazingly supportive and understanding’ of his family.

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I’m aware that not everyone has had as positive experiences we have as a family. The two people that we see regularly have been amazingly supportive and understanding and informative and we feel really grateful that we have had the opportunity to speak to people that were so understanding and empathic to our family in the individuals and as a collective.

How was that first meeting? You mentioned that was the first time you remember?

Yeah, so, it was, it was the first time that I’d really sat down with my ex-wife and daughter in that, in a situation like that where we were talking about us as a family and as a marriage breaking up and our daughter and how that might have affected her. I hadn’t really had a formal conversation like that before. And then for future meetings, our daughter would be in the meeting with us for half of it and then a second half or the first half with one of the people that we would speak to, so she could do a time-line on her experiences and talk about things which she might find embarrassing talking about in front of me or her mum or both of us and able to talk perhaps more openly without us being there for the whole meeting. And it also gave me and her mum the opportunity to talk and listen to each other’s perspective and view on what happened and what we think is happening and what we may expect to happen in the future.

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Depending on the age of their child and their needs, parents and carers had varying expectations towards the service. This point was emphasised by one parent who said, ‘I think the important thing to say is that the experience with GIDS is really dependent on who you get as your therapists and what your child’s needs are. So that, you know, it is kind of really, you know, unique, I suppose and a mixture of those things’ (Adele).
For many parents and carers, the first appointment would come at an end of a very long wait during which they would have had many conversations with their child about how their child felt about their gender, as well as about the service and what they wanted to get from it.

Adele talks about her son’s first appointment at the Gender Identity Development Service.

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So when we actually had our first GIDS appointment was about a week after he’d actually come out at school. So, he made that social transition and actually was already feeling quite a lot better about things and we’d had huge amounts of very in-depth conversations at home. And we went to the appointment and you know, it was positive. We kind of had been given a few ideas of what to expect and understandably the first appointment is really very much information gathering from them. And it’s kind of bizarre, because you’ve been talking about it so much at home and you feel like you’re completely almost talked out about it. You know, talking with your child, you’re talking with you know, family members about it. You are kind of constantly going over all of these things in your head and it’s just becomes this all encompassing thing that you’re going through. And then when you end up, you know, going to his first appointment and you then have to almost go back, right back to the beginning and talk about their childhood and when you were a baby and this that and the other. And you almost expect them to know it by that, because you’ve talked about it so much, it’s not news to you. it’s not new. But it’s all, understandably, looking back of course they need to understand the context, because they really need to understand the foundations that they’re you know, that they’re working from. But it does feel a little bit like, right, we’re here, we want things to start happening and you then have to put the brakes on and go, no, actually we need to kind of like go back again and we need to revisit. All of those kind of conversations and thought processes that we’ve been going through over the last few months.

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Some had very practical expectations, such as Andrew who had hoped his daughter’s hormone therapy, for which the family was paying privately, could be taken over by the NHS. He was disappointed to be told that was not an option. He shared: ‘after about two years on the waiting list, we eventually got to see two [specialist at GIDS], But, they couldn’t help us. We waited two years to see them and when we got to see them, there was nothing they could do, apart from psycho-social support, because she’s not [an] adult, yet.’ Andrew felt the NHS did not want to ‘get it wrong’ when it comes to young people. He emphasised: ‘They [the NHS] have to make sure that… trans kids have time to really figure out what it is they want. And then once they’re eighteen they can make a choice and then the NHS will, will help them.’ Other parents like Oonagh also believed that the service takes a wait and watch approach with the young people.
One parent felt that GIDS was not able to help his child, who needed hormone therapy but was under 18. He felt that he wanted more than ‘friendly chats over the table’ and wanted more help especially ‘when theres depression’ and dysphoric feelings.
The way people felt about the service sometimes changed. Parents spoke of negative first impressions, but an improvement in how they felt about the service over time. Whilst some parents and carers, felt the appointments started well, but with time, they found themselves questioning how helpful it was for their child to go to GIDS. In some instances, parents and carers asked to change the therapists their child was seeing at first, which people like Georgina felt improved the care their child was receiving.

Josie had positive first impressions of the Gender Identity Development Service but that changed with time.

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So that wait was really difficult and then we went and the first appointment, first little bit they were really helpful, because they kind of they, they asked her what name and pronouns she wanted, which, you know, we hadnt, that hadn’t really even crossed our mind to do that. And so they were the, probably the first people to start using it, apart from her friends, but you know, the first adults anyway. But as time went on, yeah and she, she very quickly had a, you know, that they made a diagnosis of gender dysphoria and, and so on. And we had several sessions where we were with one practitioner and she was with another practitioner. But as time went on, the sessions just started to distress her more and more. And it was, it was really clear that she wasnt really, her way of dealing with that in the first instance was she sort of kind of withdrew herself from it a bit really. And we started to have concerns as well, because it was really, we couldnt really understand what they were doing. So the first bit was really clear. Nobody actually told us, but it was pretty clear that what was happening was that she, that they were gonna make a diagnosis and say, you know, whether she. But once they had done that and the sessions just kept going and kept going and kept going, we couldnt understand what they were doing. We thought they were doing therapy, but then they actually said, oh no, this isnt therapy, but it wasnt really an assessment either.

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Georgina was disappointed with the first appointment at the GIDS, but felt more positive when her son got a new therapist.

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We had a yeah, we, we had our first appointment which was a complete disappointment. It was, we were gutted when we came out of there. I’m not totally sure what I expected, even though I joined the support group. Lots of people talk about their appointments at GIDS and things like that and discuss what’s said and whether they think that’s right or wrong and all that kind of thing. So I think I thought it would be a bit of a getting to know you session. I think I thought that they would ask what youve asked, you know, what’s your journey so far. And that theyd be interested I guess. But our first appointment really wasnt like that at all. And we came out feeling like one of the people that we saw particularly just didnt believe us, basically. They didnt ask anything about any history, family history our son’s journey, or anything. He wanted [participant’s child’s name] to speak which I thought was crazy given that there were two clinicians there that he didnt know, plus me and my husband and my ex husband was also in the room and I had made it perfectly clear that I would not be able to speak freely in front of my ex husband. And obviously my ex husband and my new husband are not friends. So, to make us be in it—I asked for a split appointment so that we didnt have to speak all together. I didnt think my ex would speak freely either. And I knew [participant’s child’s name] wouldn’t speak freely in front of my ex, because at the time things were very fraught between them. So, Id asked if we could have a split appointment so that everybody could speak. And they didnt do that. And tried to make us all speak in front of each other which I knew wouldn’t work. It was a complete waste of time. We drove for an hour to the appointment spent an hour sat there talking about stuff that was really very irrelevant, nothing to do with my son. I mean they asked us what we expected from the service, but I did think that that was a really silly question, because we waited nine months [laughs] for a gender clinic. I mean, what do you expect from heart surgery [laughs] you know. Just seemed really stupid. So I just, apparently that’s a very common question. I just thought it was really patronising and ridiculous. So yeah, we came out really disappointed and after a couple of months of umming and arring and talking to various different people including a couple of social workers who were in the family and stuff. They said that that particular practitioner sounded really incompetent. He kept sort of writing notes and then putting his clip board to his chest and sucking his teeth and sort of being really negative about whatever it was wed said. I mean I cant remember the conversation exactly, but it was just, he was just so disbelieving and patronising so yeah, we changed the clinician in the end. I tried not to get him into trouble as such. We didnt exactly, we didnt lodge a complaint. But we said that we felt he was unprofessional and wasnt listening to us. But the other clinician that was there, [participant’s child’s name] really wanted to. So we said that it, we were happy to stick with him completely, because it’s important that [participant’s child’s name] can speak to whoever he’s speaking to. And we felt like he would speak to him.

And the new person that we have is also lovely, but I will say, I think weve been for probably, think about this, over four years I think weve had appointments three monthly or something like that. I think weve had like six, yeah six appointments now over four years. Which isnt, I don’t think that’s enough for them to get to know somebody, especially a child whose gonna reluctantly talk about something so private and embarrassing potentially. They need to build a rapport and they need to see them more often, I think. Anyway, she’s lovely, but they still havent asked us what the journey is. I know a lot of people get these questionnaires and stuff and they find them really daunting and theyre a real pain in the bum. We havent had one. I don’t know if that’s a good thing or a bad thing, but I feel like they don’t know anything about [participant’s child’s name], so how can they make an assessment. Does that make sense?

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Often parents and carers did research on other people’s experiences with the service. One mother whose child was waiting for their first appointment at GIDS observed that she was trying to take stories of other people’s negative experiences with the service ‘with a pinch of salt.’ She said ‘people often repeat the bad stories if they’ve had a bad experience. And, so, I think some people have had a bad experience with individual clinicians that they’ve seen that they’ve not been happy with. But, you know, everybody is after something different and everybody gets on differently with different people.’

What happens in the GIDS appointments?

In our interviews, we asked parents and carers about what happens in the GIDS appointments. They talked about the therapeutic and assessment processes and how they and their young person felt about it. Many spoke about the kind of questions that the GIDS team would ask them and their child.
Georgina shared: ‘They …ask how things are going. And how were doing and, and if anything… significant has happened.’ Other parents described being asked about their family history and relationships. For example, Lisa emphasised: ‘we were asked lots of questions about our history, our family composition about our experiences, our individual experiences, the people who surround my son and their experiences and their relationships with him.’ While Mel said, ‘And we were all waiting for puberty. It’s like, that’s it, you know, they’ve gone through all the different options, all the psycho, psycho analysis. All the assessments and they still go every month and have consultations, which I haven’t attended any. I’ve been, I could but normally the days that they do them I’m working or it’s just not organised that way. But my husband and his ex-wife always go. Granma’s gone sometimes. Sister’s gone. But always report back on how things went, so that’s great. They’ve been fully involved in that process.‚Äù
Because young people can be referred at any age, the timing of getting to GIDS played a large role in affecting what happened in the appointments and also how people felt about their care. Parents and carers of young people who were going through puberty, stressed that there was a sense of urgency to get seen by the service and subsequently be able to access hormone blockers. Parents and carers felt the appointments and processes were a lot to ask from a young person who was expected to open up about very private and intimate details of their life, whilst knowing that they are being assessed to access the help they desperately need.
Other parents emphasised that they understood the cautious approach the service was taking ‘clearing’ their young person for medical interventions, while also sympathising with their child, who desperately needed them and was going through unwanted puberty.

Ali talks about her daughter’s experiences with the GIDS. She felt that she understood why the process was slow, but also why her daughter found it frustrating with time slipping away rapidly.

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I would say that the therapist was very good about getting her to come to terms with herself and how her appearance would, would be. That, you know, there wasnt going to be a magic wand. But on the other hand, it was very slow and it was very frustrating for her, because there was a degree of hesitation taking seriously how she felt, I had the same reservations, I didnt know whether it was going to be this how she feels just now, is she going to be certain about things. And, she keeps things, she’s always kept things very bottled up. So, I’m never very sure just how strongly she feels about something and really up until that point she had been talking to me. So Id had a fair idea of how strongly, strongly she felt about things. But, I know she didnt convey that to the therapist, and it’s only because I had that personal knowledge of it, obviously it’s my daughter. And it, [sighs] yeah. So, I did have the opportunity to email into the therapist and say that, you know, she does feel strongly about this. And, you know, she’s desperate about this and, you know, what are the options? Is there any way to move on quicker?

Yeah, that was very much with the therapist that she had to, in that small window she had to make, you know, any concerns that she had, she had to bring up there and then. She had to restate and state again how she felt and what she wanted to go and where she wanted to be. And any expression that she had of doubt would then have to be examined again and gone over again and shed have—it was almost like you go forward two steps and back one and then forward two steps and back one each time with each session. I can understand that with, yeah, psychologists want to make sure that everything was sorted out as far as possible. But it’s very difficult for a young person who sees time slipping away rapidly to come into a session and get through everything and take on board the help that’s given and, and also try and push forward for what they want. So, it’s frustrating.

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Lisa describes what happens in the GIDS appointments and how her son feels about the process.

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it’s like it’s a therapeutic, well it’s an assessment session, but it feels like a therapeutic session, so, we were asked lots of questions about our history, our family composition about our experiences, our individual experiences, the people who surround my son and their experiences and their relationships with him. Initially, we had appointments altogether. Then they separated us off, so my son would go with one of the therapists and then his dad and I would stay with the other. it’s just been a mixture, really. it’s clinician led. So, if they say they want separate appointments then provided that’s okay with my son then we don’t, we go our separate ways. We don’t, know what my son says in his appointments. Obviously, we’ve seen the, we’ve seen the interim report. My son’s response to it. I took him through it. He’s very articulate and intelligent. His response to it was, I don’t think they really get it. He said, They’ve made the big things little and the little things they’ve made so much of and I don’t really understand. There were some factual errors in there, which I didn’t think given the, given the number of time we had talked about specific issues, I thought they were pretty silly mistakes to make.

What were they emphasising, so when he said they made little things big things?

There was a great deal of focus on the family environment. It was basically a summary of what we had told them about our family and our life. There was no focus on the actual assessment of my son, his experiences related to his gender identity. There was no, there was nothing in relation to diagnosis. There was no interim conclusion. There were no there, there were no recommendations for future assessment or, you know, where do we get—it was just, I could have written that document in half an hour, an hour, let’s say. It was just the info, it contained the information that we had given to them. And all the big things, all the reasons why my son felt that he was there seemed to be missing. So from his perspective, the big things were the things that he thought he was there to sort out and to be supported by, and they were completely absent from the document. Whereas all the silly little things, as far as he was concerned, you know, who’s in my family? How do they relate to me? Who am I close to? You know, those aren’t big things to him. it’s just his life. it’s kind of, you know, that’s how it is.

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Importance of trust and continuity

Parents and carers we spoke to emphasised the importance of trust and good rapport with the specialist team. Many spoke about the fact that it takes time for the young person to feel they can trust someone with sensitive and private issues, in particular in the context of being assessed. Leigh shared about her foster son: ‘When he attended [GIDS] he went monthly for assessments with his therapist who has remained his therapist throughout, he has had that constant and hes managed to build up a really good relationship with his therapist, Finally, maybe a year or so ago, [he] started opening up about other stuff. So, in that way, hes been supported with them. Thats, thats been quite good.’
For some people we spoke to, it felt like building trust was hindered by frequent staff changes at the service. Ross spoke about how his child’s therapeutic team changed several times and how he and his child felt that there was no sense of continuity to the therapeutic relationship as a result of staff changes. Lisa also shared that her son’s two therapists ‘left within a month of one another.’ For Lisa this felt like a setback. She shared ‘we’re now not quite starting from the beginning, but this new therapist has to reassess my son… [and] we haven’t been given a timescale for that assessment.’

Ross speaks about his child’s appointments and the frequent changes of therapists that left his child feeling disillusioned with the GIDS.

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So we did keep finding different teams each time. Various people would leave the service. So wed have another fresh team and wed cover the same ground. It was almost like they were treading water, which in hindsight is possibly because the blockers were refused and [GIDS] other than give you blockers cant really do a lot. They cant issue you testosterone until you’re over 18 which is beyond their remit, because they only take until 16, 17 years old. So it did feel like I say a waste of time, but we didnt really gain anything. I would take a day off work. [Name of participant’s child] would take a day off work. We travel up to north [name of city] with cost of travel and wed sit and talk about stuff that we talked about six weeks ago to a different individual. We kept getting different teams. May have been just our situation was unfortunate. Wed one team where two of the three people in our team fell pregnant at the same time. And both left the services for their maternity leave. So then we got another team. We went right back to the very beginning and started covering all the ground that we felt wed already covered. They were, their follow up notes passed on, but each one of them wanted to hear it from the horse’s mouth. So we would just cover the same things over and over and over, which my child got quite disillusioned with [GIDS]. Initially, were looking forward to appointments, because they were being listened to and taken seriously. But then towards the end it was kind of well, were not gonna get anything. Were just gonna go and sit and chat in a room for twenty minutes and we both gotta take a day off work. Weve both gotta lose money earnings and weve gotta pay out money for travel. We go all the way up there. The highlight was going into Subway and having a sandwich afterwards was kind of the big benefit was oh well were in [name of city] so well got to a museum and well do something after the appointment. The appointments didnt really gain much.

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A point many parents and carers raised was how they felt the appointments were too infrequent and brief. Ali observed that she wanted ‘to talk things over with … the therapist … [but] because its only an hour appointment and its only … every four to six weeks [there] just wasnt the time to do it.’ Georgina felt that the three-monthly appointments her son was going to did not feel like enough. She emphasised, ‘I dont think thats enough for them to get to know somebody, especially a child whose gonna reluctantly talk about something so private and embarrassing potentially. They need to build a rapport and they need to see them more often, I think’.

Cost and time getting to appointments and taking time off school

Another common theme was the cost of travelling to the appointments and the time it took to get to a clinic, which was often not close to where they lived. Many parents and carers emphasised that it was both expensive (because of the travel costs) and time-consuming to attend the appointments. It was not uncommon for parents and carers to have to take annual leave to get to the appointments. For example, Lisa shared: ‘I don’t get paid if I don’t go to work. My son’s father has a limited amount of leave, so he’s now in the realms of taking unpaid leave. We have to go down to [GIDS] from where we live and in terms of lost income, every appointment costs us hundreds …of pounds’. Parents and carers also spoke about their child missing school to travel to the appointments.

Richard talks about the cost of getting to the appointments, and how they can be quite enjoyable’ but also draining.

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I mean, it costs a lot of money. No-one’s ever considered or it doesn’t feel like no-one’s considered, if I have to take a day off work, once a month and then I have to a hospital in [name of city] and back and essentially it’s gonna cost me a couple of hundred pounds every time I do it. My work said, no, they wouldn’t pay for that. They wouldn’t pay, they wouldn’t give me a day off. I have to take that as a holiday. That reduces my holiday time. And actually, I’ve tried to work after going to [name of city], but by the time I’ve actually gone to [name of city] and come back and it’s actually more emotional than I am expecting, generally, because it’s, as I say, they make it quite enjoyable and it’s really nice as an experience going to the [GIDS]. But actually, psychologically, I think it’s quite draining.

Why is it draining?

Because I feel quite different to a day when I am not doing that. To describe it is probably quite hard because it’s, it’s a kind of subconscious tiredness. A lot of sort of searching sort of through my own emotions and searching through how I discuss something which I don’t discuss very often when we go to [GIDS] and possibly conversations here or there in between. My daughter doesn’t really want to talk about it much because the conversations have happened from her perspective. She’s just being as patient as possible before she has the blockers.

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Mel felt the appointments were going well for her step-daughter but also stressed the cost of getting to the appointments.

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I mean, it’s been fairly mixed, I think. One thing I know they really struggle with, the fact that they have to travel to [city]. it’s a huge effort they, my husband has to come from here and pick them up, where they live, in [name of a county] and then they all have to go on masse to [name of city]. It means missing school. Then often really early in the morning, it’s a lot of money for them all to go. You know, they have to find a lot of money for it in petrol and food and so on and so forth.

I think they feel that the overall experience has been a positive one and that she has been heard.

I know that they recently there was, they had an appointment with someone who was trying to explain to her what happens in terms of if she does decide to have surgery. You know, what happens, you know. And, but they were very course about it. And I know my husband he was really quite upset about that. And, she didn’t like it either. But normally I think the people that they deal with, they’ve been dealing with the same people, which really helps. Someone who knows the journey and someone that you build a rapport with over a period of time. So that’s been really, really good for them. Yeah, the sister’s gone as I said and grandma has gone as well. Just trying to think. Yeah, I mean, it’s, so far so good. They’ve not come back and said, It was terrible and blah, blah, blah. I feel that they feel that they’re understood when, when he comes back and talks to me about it. And, you know, she was able to come back and really explain to me, cos I asked her you had the appointment and what does it mean, hormone blockers?’ And she just explained it to me. She doesn’t talk about it all the time. But, you know, it’s strange I think when they’re going through what she goes through. People often have questions and then you’re really private personal stuff is just open for debate. And I don’t think any child really wants to talk about. I remember, when I was a kid, I started my period when I was ten. I was mortified. I had breasts and pubic hair when I was at junior school. I was just like, mmm. It was horrible. And I never wanted to talk about it. And I never wanted anyone to know and so, although they’re not the same, it’s still like a focus on you that don’t really wanna have on you, but it’s necessary. it’s necessary, I think.

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What happens between appointments?

Some parents we spoke to felt that there was not enough communication with and support between appointments at GIDS.
Lisa said that it had been difficult to contact their new therapist and to have the appointments confirmed. She said, ‘We last had our, an appointment in September, we were supposed to have an appointment sent to us for December. I still haven’t had it. I’ve chased the appointment. I still haven’t heard anything.’ At the same time, many parents and carers acknowledged that the service is overstretched and struggling to respond to the increased demand and felt more resources should be put into it.

Georgina felt nervous about her son’s assessment at the GIDS. She also felt she had no way of communicating with her son’s therapists between the appointments.

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I have almost no question whatsoever in my head that [participant’s child’s name] is, he is trans. But if they don’t see that then I’m, I don’t know what to do. I’m really nervous that theyre not researching him enough. Does that make sense?

Do you have an opportunity to discuss this with the people who are in charge of that treatment of these meetings with your son?

Kind of. I mean, I guess I could just randomly bring it all up and, and say, but I don’t feel, I don’t know, I mean, obviously their questions are still important to read, to talk about what they ask as well and I don’t wanna just take over the appointment. But I, theyre nice enough for me to be able to say that and I should say that. I think it’s got to the stage where I was thinking that at six appointments. I, we would have some sort of feedback in some way or another, even if it was, he’s too young to diagnose right now But there was nothing so on my next appointment I maybe would. But again, even in that way with the communication, because our appointments are now split, because after the marker of the first appointment I rang them, and I did say these appointments must be separate. It cannot work any other way. You know, we all have to take time off work and it’s not you know, it needs to be worth it for a decent appointment time. Just going for half each wouldn’t be enough. So what we do is we alternate. So me and my husband go one time and then my ex husband will take [participant’s child’s name] our son the next time. Which actually means that Ive only been to three appointments. But the next appointment is due I think this month if not next month. But we havent had a letter or an appointment date or anything. And there’s no communication in between times or anything. Weve had some summary letters. But [participant’s child’s name]’s, our son’s expressed that he feels like what he says isnt confidential. And it all gets written down and we all find it all out, which obviously is kind of the point. But he needs to feel obviously like he can speak freer. So we agreed to not do the summaries any more so that he could speak without us all finding out exactly what’s been said. But it’s meant that weve got no appointment date sent through, so I need to ring them and try and get through [laughs]. So I feel a little bit like we get left at sea. We had absolutely no leaflets from them for Mermaids or Family Days or anything. And I know they run those. Not that we should get to them, but it’s not the point. It’s if youve got, if we had some sort of support. We have no email addresses for the practitioners. We have no phone numbers other than the main office and you just have to leave a message and hope somebody gets back to you. There’s no way of communicating if you have a question or if something crops up if there’s a big problem. You know, if [participant’s child’s name] suddenly started self harming or something, I would want to be telling them straight away that we need to up the appointments, because obviously he needs to talk more. Do you know what I mean?

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Jan felt the long waiting times were unacceptable and the service needed more funding to meet the growing demand.

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I think it’s absolutely unacceptable, really unacceptable, because a lot of these these kids and young adults and adults that come out theyre, theyre struggling mentally. You know, theyre suffering dysphoria around their body, around their gender. And, you know, if I went to the doctors with a pain in my abdomen and they couldnt work out, you know, they couldnt fix it there and then they would refer me onto a specialist and I would get seen within a reasonable length of time, you know, and, and this is no different. They should be they should be given immediate treatment. And if they cant, at the moment they need to look at the service that’s being provided and the funding that’s been made available to it. And you know, they, they need to provide a service that’s suitable for demand and at the moment it’s not fit for purpose.

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Fears and hopes for future appointments, and views of the service

Some parents we spoke to had children who were on the waiting list to the service, so had not yet experienced going to the GIDS. They shared their hopes and fears about going to see the GIDS. Some spoke about hoping for psychological support, whilst others wanted practical support or a mixture of both.
Oonagh shared that she was hopeful about the possibility of having a good experience with the service but also shared: ‘my worry is that [my daughter] doesnt really display dysphoria. And, that because she doesnt display dysphoria about her body that theyre gonna see that as some sort of indication that shes not trans. To me, Im giving it the benefit of the doubt, everythings pointing to the fact she is trans but she doesnt necessarily have to have dysphoria to be trans. But I worry that the GIDS system seems to think that you have to be really really in, trauma about your body to be trans.’
In our interviews, many people also shared their thoughts on how healthcare and the pathway could be improved for young trans and gender diverse people.
*Gender Identity Development Service, 2020. Support that we offer.

Private healthcare

Adults and children can access NHS specialist gender identity services free of charge. However, the waiting lists at these services may mean a long wait...