A long awaited Dr Levy review of adult gender services has been published today by
NHS England:
The review confirms what so many Our Duty parents already know – the majority of
referrals to gender clinics today are young people in the 18-25 age group, a group that
was identified as high risk in the damning Hilary Cass review of children’s gender
services in 2024. Hilary Cass advised that patients under 25 should not be sent straight
to adult clinics because they are still at a “vulnerable stage in their journey” due to their
psychological, social and physical aspects of adolescent development not complete.
These young people should not be rushed into changing gender, but should receive
“unhurried, holistic, therapeutic support”. Yet hundreds of adolescents per month are
referred to adult gender clinics, according to Dr Levy review.
Speaking about the quality of adult gender services, Dr Levy review states: “The
absence of any patient outcomes data, alongside limited and inconsistent quality data
reporting, and minimal clinical audit makes it impossible to properly understand patient
outcomes and the safety of these services. These gaps place these clinics outside
standard NHS quality assurance expectations.”
Again, this comes as no surprise to Our Duty parents, who raised serious concerns with
adult gender clinics about the referral process, diagnostic assessment and medical
pathway. Parents know that adult gender clinics do not investigate co-occuring
conditions such as autism, ADHD and trauma. In many cases, referrals are based
entirely on young person’s self-reports and are missing important information about
childhood history and existing comorbidities.
“Some GDC clinicians report that 30 to 50% of their patients may present with
additional conditions” according to Dr Levy review. It is scandalous that despite the
obvious complex presentation of so many patients, adult clinics operate under a service
specification where the majority of people are referred for invasive, experimental
medical intervention (cross-sex hormones and surgery) after only two appointments.
These life-altering medical interventions permanently change fertility and sexual
function, vastly increase risks of suicide and cardiovascular disease, and have unknown
long-term outcomes. “The number of patients who express some form of regret,
dissatisfaction or choose to detransition is unknown”, states the review.
Our Duty is also aware that multiple senior doctors at NHS England gender clinics are
affliated with the discredited World Professional Association of Transgender Health
(WPATH). Some clinicians work as paid consultants in companies reliant on the highly
contested premise of ‘gender-affirming care’ and openly resist recent findings in gender
care such as Hilary Cass review. It is disappointing that these circumstances, which
represent significant conflicts of interest and could influence the judgement of these
clinicians when they work for NHS England, were not investigated by Dr Levy.
Whilst Our Duty’s primary concern is health, safety and wellbeing of young people,
there is an additional question at play here, and that’s whether a service falling outside
NHS expectations in terms of quality, should be funded by taxpayers money.
Statement from Our Duty
“The Levy Review confirms that the majority of referrals to the adult gender clinics come from vulnerable young people in the 18-25 age group. These adolescents need therapeutic support. What they are getting instead fails all reasonable quality standards and can only be described as medical malpractice. Adult gender services harm our young people’s chances to grown into healthy, responsible adults and have no place under NHS England.”
Keith Jordan, Our Duty
