Entry 10 – Post publication reflections

Posted in: Journal

By deceiving one another through false assumptions and misrepresentations there has been, in reality, a great lapse and delay in achieving the real goals.

Dalai Lama

It has been two weeks since the final report and recommendations was published and it’s fair to say it has generated many more newspaper columns, broadcast discussions and social media commentaries than is usual for an NHS service review, not just in England but internationally. But I understand that this is a subject that many different societies are trying to navigate.

I am aware that the release of the report, and the subsequent discourse around it has caused concern and distress among some of the young people and families who are waiting to receive care or may already be receiving care. This has not been helped by some of the assertions being made on social media, and occasionally on mainstream broadcast media, which misrepresent the report and its findings, whether wilfully or otherwise. Whilst some commentators have tried to debunk these misrepresentations, we live in a world where misinformation, when left unchallenged, becomes part of an accepted narrative regardless of its validity.

The Review team has now published a series of FAQs to address some of the questions and inaccuracies that have arisen.

We will also be producing a document for service users which explains the findings of the report in a shorter, more accessible form. This will be published alongside an accessible version of the report in the coming weeks.

On a personal level, I anticipated that my recommendations would generate very mixed responses, and that I could not navigate a way through this complex area that would make everyone happy with the outcome. My only option was to apply exactly the same principles that I would rely on in every other area of paediatric practice; compassionate, evidence-based care focused on the needs of each individual child and young person.

I’m also aware that many young people seeking help with gender related distress have lost trust in NHS services. There is a lot of work to do in building back that trust. My recommendations to the NHS focus on delivering more capacity, a wider range of interventions, upskilling of the broader workforce, and an individualised, personal approach to care.

Having met with the staff in the new regional hubs, as well as in some more local services, I am confident that they will be able to win that trust, although it will take time and mutual respect. However, I very much hope that more open dialogue, shared responsibility for clinical standards, better training, and an embedded clinical improvement and research structure will rapidly attract more people into this area of work.

Having submitted the final report, the Review is now winding down, so this is likely to be my last journal entry. It is over to NHS England and the wider NHS to consider how and whether to implement the recommendations, but I will continue to support NHS England in the new clinical and research programme development. The Review’s website will be archived so the materials will remain accessible.

I wanted to thank everyone who has given their time to share their stories, experiences and thoughts with the Review over the last three and a half years.

 I will sign off by reiterating the first and last paragraphs of the report:

“This Review is not about defining what it means to be trans, nor is it about undermining the validity of trans identities, challenging the right of people to express themselves, or rolling back on people’s rights to healthcare. It is about what the healthcare approach should be, and how best to help the growing number of children and young people who are looking for support from the NHS in relation to their gender identity.

“While open and constructive debate is needed, I would urge everybody to remember the children and young people trying to live their lives and the families/ carers and clinicians doing their best to support them. All should be treated with compassion and respect.”

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