91 — Uncovering the GIDS Disaster: Dr. Dave Bell
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.
Links:
- Guardian Article about Dave Bell:
- Dave’s YouTube talk via Genspect:
https://www.youtube.com/watch?v=pGJeHcjtI4A
- Andrew Gilligan at the Times on Marcus Evans’ Resignation:
https://www.thetimes.co.uk/article/governor-quits-blinkered-tavistock-clinic-82db7wzq8
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.
