Episode 91

91 — Uncovering the GIDS Disaster: Dr. Dave Bell

Published on: 14th October, 2022

Dr. David Bell retired last year from his position as a consultant psychiatrist at the Tavistock and Portman NHS Foundation Trust, where he worked for 25 years. There, he led the Fitzjohns Unit service which provided long-term psychotherapy for those with enduring, severe psychological problems. He is also the former President of the British Psychoanalytic Society.

While he was in the Governor role at the Tavistock and Portman Trust, through a series of events, which we cover today, Dr. Bell discovered that something was going terribly wrong in the Children’s Gender Identity Development Service, or GIDS. Something I didn’t know before speaking to Dave is that the broader Tavistock Service had an established reputation for excellent psychoanalytic treatment models and for providing the highest quality of psychological care. So, clinicians who applied to work there were expecting to join the ranks of the most thoughtful and knowledgeable psychotherapists in the UK. Those young and inexperienced clinicians who were funneled into the GIDS landed in a very different kind of treatment setting. They started raising their complaints and getting nowhere, so they started trickling, one by one, to Dr. Bell with their stories. Not only were they ill-equipped to provide proper, thorough care to kids with incredibly complex stories, but they were also getting a clear message from their direct chain of command: concerns were not going to be properly addressed. In fact, there was a culture of fear about raising these issues and clinicians felt a strong pressure to simply get through their humongous caseloads without rocking the boat.

In 2018, Dr. Bell described all of this in a highly critical report on the GIDS which became part of the chain of events, which included critical involvement from our former guests, Marcus and Sue Evans, which led to the Judicial Review (the Kierra Bell Case), the thorough external Cass Review, and its recent decision to close down the GIDS.


  • Guardian Article about Dave Bell: 



  • Dave’s YouTube talk via Genspect:  



  • Andrew Gilligan at the Times on Marcus Evans’ Resignation: 


Extended Notes

  • Originally, Dave was put off by psychiatry due to the overmedicalization so he involved himself in anti-psychiatry.
  • Dave created a unit for providing psychotherapy for disturbed patients.
  • Dave became a governor at Tavistock.
  • He found little interest at Tavistock in investigating the validity of the GIDS unit.
  • Other doctors at Tavistock had raised their concerns about GIDS, but cautiously.
  • The major complaints at Tavistock were caseloads and unresearched affirmations of children with gender dysphoria.
  • Unexperienced clinicians were often confused about the purpose of the organization.
  • Against a legal recommendation, Dave sent his review of GIDS and the accompanying complaints to the board.
  • There was very little follow-up with adolescent patients so statistics were unavailable.
  • Dave still doesn’t know who leaked his report to the press.
  • Marcus Evans resigned from Tavistock because Dave’s report was being undermined.
  • Eventually, all the child psychotherapists left the organization.
  • The judicial review of the report found that children were not able to consent.
  • Sonya Applebee took action against the trust for the intimidation she experienced after voicing her opinion.
  • The Cass Review confirmed Dave’s belief that no child should be affirmed.
  • At 11 or 12, children are ready for puberty, and puberty blockers should not be used.
  • 98% of children who went on puberty blockers stayed on them.
  • A child has a right to be treated holistically.
  • The process of cutting services year-over-year has left the National Health Service in poor shape.
  • Asking children to consent to something in the future doesn’t make sense.

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About the Podcast

Gender: A Wider Lens Podcast
Two therapists explore the expanding concept of "gender" from a psychological depth perspective.
Gender dysphoria has become a minefield for public discussion, with many afraid to express their views or question the narrative. Our mission is to examine this important and complex topic from a range of perspectives, but always through a psychological lens. By openly considering and examining gender identity, transition, and the transgender umbrella, we hope to give all interested parties permission to engage these fascinating topics with less fear and more honesty. Interviews and discussions will involve clinicians, medical professionals, academics, transgender people, parents, detransitioners and other interesting individuals whose lives have been touched by the concept of gender.

Conversations between two practicing therapists give listeners an opportunity to contemplate gender from a depth perspective not currently taken up in most of today’s accessible debates. As a result of their work with gender dysphoric therapy clients as well as their personal divergent experiences with gender, Stella and Sasha hold a refreshing and informed perspective.

Is gender identity a facilitation of development and expression of creativity, or can it be a defense against painful existential realities of living in a human body? What can we discover about masculinity, femininity, identity, gender performance, and sexuality when we peer beneath the surface and dive into a deeper psychological exploration? What is the relationship between body, mind, identity, culture, and psyche?

This podcast engages listeners in an intimate and fascinating behind-the-scenes inquiry about a topic as taboo as it is salient today.

Thank you to our sponsors:
Genspect - an international organization which offers an alternative to WPATH. Providing a range of education, resources and supports to anyone impacted by gender distress, Genspect unites many different organizations globally, and gives voice to 1,000s of previously untold stories. For more info, visit genspect.org.

GETA - an association of therapists who believe that individuals experiencing gender related concerns ought to be treated using a whole person approach. GETA connects like minded clinicians, provides educational resources and trainings, and helps people with gender dysphoria find support. For more info, visit genderexploratory.com.
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About your hosts

Stella O'Malley

Profile picture for Stella O'Malley
Stella O’Malley is a psychotherapist and author who works in private practice in Ireland. Her work focuses on parenting, family dynamics and working with teenagers.

Much of Stella’s counselling and writing focuses on mental health and the importance of well-being and she is a regular contributor to the media. She is also the resident psychotherapist for the current TV series, Raised by the Village, a family programme that helps troubled teenagers reconnect with themselves and their families.

Stella's first book, Cotton Wool Kids, was released in 2015 while Bully-Proof Kids: Practical tools to help kids grow up confident, resilient and strong was released in 2017. Stella’s latest book Fragile, was released in 2019 and focuses on overcoming anxiety and stress.

Stella was the presenter of the documentary Trans - Kids: It’s Time To Talk broadcast on Channel 4 in November 2018 and she contributed a chapter to the 2019 book, Inventing Transgender Children and Young People.

The Jungian analyst, Lisa Marchiano, and Stella launched Secrets of the Motherworld in September 2019, offering thoughtful exploration of the most intimate aspects of motherhood in a bid to help mothers feel less alone.

Stella is a Clinical Advisor for the Society for Evidence-based Gender Medicine and a founding member of the International Association of Therapists for Desisters and Detransitioners. She is also the lead facilitator for the Gender Dysphoria Support Network.

Stella holds a B.A. in Counselling and Psychotherapy and a M.A. in Cognitive Behavioural Therapy.

Sasha Ayad

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Sasha Ayad is a Licensed Professional Counselor who works in private practice, and has treated adolescents for over 10 years. Her work focuses on teens and young adults struggling with issues of gender dysphoria and gender identity.

She became interested in the sharp rise in teenagers who declare a trans identity for the first time during adolescence. She discovered, through working with hundreds of families, that many teens were developing gender dysphoria only after adopting a transgender identity. She questions the practice of medical transition for children and teenagers, and her clinical work focuses on developmentally appropriate, least-invasive-first talk therapy.

Sasha is also a founding member and Clinical Advisor in the Society for Evidence-based Gender Medicine and a founding member of the International Association of Therapists for Desisters and Detransitioners.

Sasha’s previous work experience includes:
- School counselor for middle and high school students at a charter school for underserved communities

- Behavioral therapy with children on the autism spectrum

- Individual and group counseling for women and children impacted by domestic abuse and sexual violence

- Developed and ran the first counseling program at a large state supported living facility for adults with intellectual disability

Sasha holds a B.S. in Psychology and an M.Ed. in Counseling Psychology.