Time To Think: Hannah Barnes. (4)


I am reading this at in chunks so I do the review justice. This one will cover chapters 7 & 8. You can read the rest of the series at the link below. Do buy the book. My review is no substitute and it is an important historical record. Also order it at your Library.

TIME TO THINK: Hannah Barnes

Chapter 7 is aptly titles The Bombshell as there are growing numbers of staff expressing concerns, a huge surge in referrals and staff are failing to meet targets over waiting times.

The decision was taken to invite an external consultant to review G.I.Ds and, for a brief point, it looked as though significant change was on the horizon. For some staff this change couldn’t come soon enough as one commented.

The consultant, Dr Femi Nzegwu, made her recommendations which included reviewing the criteria for referrals, a minimum standard for report writing and even a temporary cessation of the service.

Anna Hutchinson shared her recollections of this time.

According to Hutchinson it was Polly Carmichael who ended the discussion about closure, in her view all it required was “brave leadership”.

There is no evidence that NHS England were ever told of the report, certainly the chief executive of the NHS Trust, where GIDs was based, not: He had to find out from the media.

Meanwhile, in 2016/17, when the report was commissioned, referrals were still increasing and the staff doubles from 40 to 80 and still they could not keep up. The criteria was not tightened up and there were multiple agencies able to refer children.

At around this time the first reported outcomes of the Tavistock experiment with puberty blockers started to emerge. The preliminary findings showed a mismatch between positive reports by the patients which were not borne out by the psychological testing. Amazingly there was no improvement of the Gender Dysphoria or the self-harm. Subjects also had higher degrees of suicide ideation.

Despite this no halt was called to the live experiment which included 162 children by 2016. Carmichael actually argued that this progression rate might mean that some children who would have benefited may have missed out! Though she did conceded it was possible that the puberty blockers influenced the trajectory for these kids. Almost as if going through a natural puberty helped resolve bodily rejection.

There was more. The researchers revealed that near a 100% of the children had progressed to cross-sex hormones. Only one stoped treatment citing issues with bone density development. For some clinicians this was a wake up call.

Hutchinson sounds absolutely horrified by what the clinic was doing to some of the more vulnerable children in our society. A horror I share.

For natal boys there is another consequence. One of the arguments for blocking puberty had been the prevention of the development of secondary sexual characteristics would avoid unnecessary surgery in the future. For males, however, the stunting of their male genitalia actually increased the likelihood they would have to undergo an even riskier type of surgery. The Tavistock staff knew that one of the boys in the Dutch study had died following complications of this type of surgery. We know also, from Marci Bowers, a “trans-identified” man and a surgeon, that these children will likely grow up and be not only sterile but inorgasmic. It shocks me everyday that we are still doing this.

Some of the clinicians describe how there practice changed after this research but the clinic itself issued no directive and did not change practice. One of the clinicians drafted a leaflet, to be shared with patients and their families, warning about the issue with future genital surgery. The leaflet needed approval from Carmichael who did not respond to the requests; a decision described as unethical by one 👇 clinician.

The reluctance to commit this to paper invites speculation as to Carmichael’s motives. This was one suggestion.

Chapter Eight.

This chapter covers the fallout for the staff and how some began to modify their practice in line with the new information. Stress levels were high and staff were offloading to one another but the service itself had not reviewed its treatment protocols. Discussions across GIDs, were they occurred were described as polarising.

This chapter also covers what seems to be the dysfunctional relationship with CAMHS (Childhood and Adolescent Mental Health Services). It appeared that the impact of economic policy “austerity” had placed intolerable pressure on CAMHS who were referring to GIDs partly to relieve pressure on their service. It was not that these children did not express unhappiness with their sexed body they did, but they often had co-morbid mental health issues which were left untreated by a referral to GIDs.

A further difficulty was that it was ideologically driven lobby groups, like Mermaids, who stepped in to provide support to parents and children. Mermaids , as we know, believed in the idea someone could be born in the wrong body and pushed the idea that if you did not medicalise these kids they would commit suicide. There involvement would, inevitably, drive up referrals and make existing referrals anxious for the medical pathway.

Matters were not helped by the number of agencies able to refer children to GIDs.

The feeling I am left with is a service spinning out of control and a leadership team unable to take the hard decisions and, at the heart of this problem, children bing irreversibly damaged.

You can support my work by taking out a paid subscription to my substack or donating below. All donations gratefully received and they do help me cover my costs and also to keep content open for those not able to contribute. (I will add other methods as soon as I have figured it out. 😉)

My Substack

Researching the history and the present of the “transgender” movement and the harm it is wreaking on our society.


Time To Think: Hannah Barnes (3)


This is a ground breaking book even after all the media coverage about the Tavistock.I think I have written about twenty pieces about the U.K’s main Gender Identity Service but I still finding this an absorbing read and learning things I didn’t know. I am writing this series as I make my way through the book.

I will cover chapters five and 6 in this piece. You can catch up with the series here👇:

TIME TO THINK: Hannah Barnes

The clinic had entered a new era now that Dr Polly Carmichael had taken over the helm. Bernadette Wren also joined during this period as did many new staff as the operations of the clinic expanded. The NHS had commissioned G.I.D.s to provide a national service and referrals were increasing at unprecedented rates. It seems the previous head, Domenico Di Ceglie should have heeded the warning which did, in fact, make him laugh. We are not laughing now.

The picture pained by Barnes, based on her interviews with former Tavistock staff, is of exponential growth in referrals, a complete change in the demographic, and a leadership team seemingly unable to manage the risks for this new client group. Therapeutic work was difficult to schedule and some seem to have embraced the “affirmative” model resulting in more than one account of puberty blockers being offered during the first appointment.

Apart from the time constraints the availability of the medical pathway was changing the nature of the relationship between the clinicians and the children referred to the service. One of them describing a “fundamentalist mindset”.

Newer clinicians relies on the more experienced staff to guide them, in the absence of any formal training. This meant they were all being trained in the “affirmative” model as described by Anna Hutchinson.

Many of the clinicians describe the complexity of the cases they were faced with, including one who had three alternative personalities (known as “alters”) two of them with Australian accents even though the patient had never set foot there. Others had competing mental health conditions and suicidal ideation. Yet for all these patients there was just one treatment pathway, medical intervention to block puberty.

More than one interviewee expressed concern about the influence of lobby groups like Mermaids and GIRES. Rather than resisting this pressure Hutchinson felt that the Tavistock were buckling. The impression given is that phone calls and emails from staff at these organisations were often made to Dr Polly Carmichael.

Hutchinson describes how, originally, she was not too concerned about the use of puberty blockers having assumed /been led to believe, there was a strong evidence base behind their usage. In the next chapter this would change.

This chapter ends with another case study of a gay man with extreme Obsessive Compulsive Disorder that practically kept him housebound. He had been subject to homophobic bullying for many years and now began to question his gender identity. His mother describes how a senior clinician, from the Tavistock, travelled to see him at home and how she reacted to the pressure she felt under, going so far as to describe it as “insane”.

Luckily this gay man escaped the clutches of the Born In The Wrong Body brigade.

In chapter six we meet Matt Bristow, a gay man, who considered himself a “trans ally” and was thrilled to join G.I.Ds. Right off the bat he makes an astute ovservation that so many of the referrals are from traumatic background he wondered if they wanted to reinvent themselves via a new gender identity. Bristow also describes the hostility in some of the therapeutic encounters with patients who resented the assessment period prior to receipt of drug treatment. Patients were also predisposed to be dishonest fearful of being deemed ineligible for treatments.

Those of us with children caught up in this know that our kids are being taught a script on line to dish out to gullible, or complicit, clinicians.

By 2014 the Tavistock had determined that they would lower the age for medical intervention to allow prescriptions for those under twelve. Carmichael referred to this as “stage not age” and announced it in the press.

Carmichael is not being quite accurate in this statement. Further interrogation by the Newsnight Team, which included Barnes, forced an admission that no study had been completed and evaluated at the Tavistock, instead they were relying on the Dutch study. The problem with this was that the Dutch had not experimented on those under the age of 12.

The decision was taken by the senior staff and some staff had misgivings as Natasha Prescott recalls.

While Prescott takes a charitable view of the intentions she does question why the therapeutic aim seemed to be to eradicate any stress or discomfort rather than to teach their patients coping strategies. Other staff members too a more cynical view.

The chapter covers both Mermaids pressure for a reduced age for prescriptions and public statements, by Bernadette Wren, on why GIDs were resisting the pressure. In the end Mermaids got their way.

Barnes questions why NHS England agreed this change in the treatment protocol when no formal evaluation has been published on the ongoing study on these over the age of twelve. She also points out that the Dutch study was not an unalloyed success and even resulted in the death of one of the participants. There had also been a loss to follow up of more than 20%.

This chapter gives a good critique of potential flaws in the way participants were evaluated; in particular the way the patient was assessed for satisfaction with their biological sex, at the outset, and, after surgery, asked if they were satisfied with their target sex. Could the positive results be attributed to this methodology?

All this was taking place against a background of increased rates of referrals, inexperienced staff and a complete inversion of the sexes who were present ing at the Tavistock. From a small number of mainly boys with long standing “gender issues” they were now seeing mainly teenage females who had suddenly emerged as “trans”. This is how one clinician described the waiting room👇. This is what social contagion looks like.

Staff were still under the impression that the puberty blockers being administered were fully reversible. This was despite Carmichael making different public pronouncents for different audiences. She can be found describing PBs as a “pause” for childrens BBC but admitting they are not elsewhere.

This is Carmichael to the guardian.

Against this background the Tavistock was still expanding and doubling its contribution to the NHS trust. They were garnering positive press attention and encouraged to expand its staff, reduce assessment periods, and prescribe to everyone more, and ever younger children. We’re they unchallenged because they were a significant source of revenue?

You can support my work by taking out a paid subscription to my substack or donating below. All donations gratefully received and they do help me cover my costs and also to keep content open for those not able to contribute. (I will add other methods as soon as I have figured it out. 😉)

My Substack

Researching the history and the present of the “transgender” movement and the harm it is wreaking on our society.


Time to Think: Hannah Barnes (2)

Part of a series on this excellent book. Waterstones may be hiding it but it’s too big a scandal to cover up and those of you cheering on this harmful ideology are going to pretend you didn’t!

You can find part one here:

Time to Think: Hannah Barnes.

Chapter 3 examines the pressure on G.I.D.s to embrace what has become known as The Dutch Protocol; namely the use of puberty blockers in children presenting with “Gender Dysphoria”. We have seem that there were tensions within the Tavistock as different ideologies were competing for dominance. Crudely, some clinicians were familiar with people presenting with distress, expressed as a bodily rejection, which could manifest as anorexia, self-harm, alcoholism or, in more extreme cases the rejection of a limb. (A condition known as apotemnophilia). The other camp, again crudely, believed in innate gender identity or a “Born In The Wrong Body” narrative. For the latter camp forcing a child to go through the “wrong puberty” was akin to abuse. I have said many times that once you believe in the existence of a “gender identity”, at odds with your biological sex, the next steps seem obvious and, perhaps, inevitable.

Pressure to prescribe came from all quarters, from parents;the kids themselves and lobby groups. The use of threats of suicide often accompanying these demands. Older people with a “trans” identity also seemed to use these kids as a kind of retrospective wish fulfilment. Those of us who cover the topic of autogynephilia see another motive; creating the idea of the “transgender child” to deflect attention away from trans-identified males with a sexual fetish; an accusation that can’t be levelled at a child.

Of course by the time we were in the 2000’s there were plenty of Lobby Groups pushing for earlier, medical intervention. We must not overlook the profit motive; Ferring Pharmaceuticals, the makers of Puberty Blocking drug, Triptolerin, funded the initial research into using Puberty Blockers, at Gender Clinics, and they have also donated £1.4 million to the Liberal Democrats, a U.K political party,

The claims made for the “Dutch Protocol” do not appear to be justified by the paucity of research.

In this chapter we find that clinicians were aware that most of these children, left alone, would reconcile to their sex and turn out to be gay males or Lesbians. Nevertheless despite the risk of “false positives” they would, eventually, capitulate.

In 2005 the association for Paediatric Endocrinology and Diabetes (BPSED) came out against this early intervention.

People were sounding a note of caution but one of the more shocking statements would come from an ex member of G.I.D.s staff about the role the possibility of medical interventions may have played in the strategy of its Director.

Elsewhere Barnes speculated that De Ceglie saw his role as making sure G.I.D.s survived as an organisation and that this may have taken priority over other concerns.

Whether due to the pressure from behind the scenes / public lobbying the outbreak of sanity at BPSED would not last. When the guidelines came up for review in 2008, they changed their stance.

For good or ill the NHS were now sterilising children.

The chapter ends with a reflection from Phoebe, a trans-identified male who had surgery to remove his genitals at age 18. Phoebe’s back story is that of a surviving twin whose sister was lost in uteru. Phoebe was a gender non-conforming male who had extensive homophobic bullying. Clearly he is same sex attracted but, age 28, a man who accepts him as a woman has proved elusive. Despite regretting the loss of a chance at biological children, Phoebe claims to have no regrets about his path but also has not managed to quell all doubts.

I am inclined to agree with Barne’s assessment that Phoebe is quite charming. He is also wary of rushing access to medications and surgeries.I am correctly sexing him here, because it’s important not to yield our language, but I wish him well and hope he never has cause to regret his surgery.

By Chapter 4, De Ceglie has been replaced by Polly Carmichael and G.I.Ds had, after a refusal, obtained ethical approval for a research project to block puberty for some of the children in their care. This chapter is a must read to understand why the staff at G.I.Ds chose not to use a control group so they could compare those given puberty blockers against a cohort who had not received them. It questions the results of the Dutch Protocol and whether the Tavistock were honest about the effect of the puberty blockers. In particular they describe them as granting a “pause” when they knew almost 100% of children progressed to cross sex hormones, as did ALL of the children in the Dutch Protocol. It also questions the impact on boys who would require a riskier surgery, using intestinal tissue, because of a stunted penis. (One patient in the Dutch protocol died from complications of the surgery). Moreover it points out that the fact all of the children who take PBs + Cross Sex Hormones will be sterile and not just have reduced fertility as the subjects were told. This is a must read chapter and while the revelations are explosive it is told in a calm and measured way by Barnes.

Barnes also revisits the first patient that started the push to use puberty blockers, patient B. This does not sound like an unmitigated success. It’s worth a long clip of this section.

Barnes references the excellent work of herself and Deborah Cohen for the Newsnight team and Professor Viper’s response to some of the relegations.


The chapter ends with another case study of a trans-identified female from the foster care system. Jack had a disrupted childhood with a family dealing with alcohol issues. She was a tomboy and attracted to other girls. The foster care broke down when they began to insist Jack ceased hanging out with boys and dressed more “feminine”. Jack had mental health issues and spent two years in a psychiatric facility. She describes a slow and careful assessment at G.IDs which was frustrating at the time. She also did not want to be a Lesbian.

Jack became attracted to the notion she was “trans” after watching the product placement of a trans character on a U.K soap aimed at teens. She also makes a startling observation on a further stint on a psychiatric ward shen she was older.

She also thinks the testosterone may have influenced her sexuality and now identifies as a gay man, attracted to males. In the end Jack took cross sex hormones and had a double mastectomy, neither of which she regrets. She does, however, think safeguarding young people from making a mistake is important.

You can support my work by taking out a paid subscription to my substack or donating below. All donations gratefully received and they do help me cover my costs and also to keep content open for those not able to contribute. (I will add other methods as soon as I have figured it out. 😉)

My Substack

Researching the history and the present of the “transgender” movement and the harm it is wreaking on our society.


Time to Think: Hannah Barnes.


Are we hurting children?

I will probably make slow progress whilst I work my way through this book because it is such a painful read knowing that my own GP referred my son to the Tavistock. I fought a valiant battle to keep my son out of their clutches, because I had done my research. I did actually speak to Hannah but my son was not referred to the children’s unit and, I suspect, she spoke to me more out of compassion than for anything I could add to her research. This series is dedicated to her for doing the work and the Swift Press for publishing. I have purchased the electronic version for review purposes but my birthday gift will be a copy for myself and a copy for me to take to my GP. I will also order a copy for my local library.

This series will probably include more links to my earlier posts as I have covered much of the same territory as this book. It’s is also full of excellent footnotes so I will do detour to follow any of those I had not seen.

The first chapter has a headline grabbing title. I should just say the Hannah avoids sensationalising in all the interviews she has given, which is good to see, we don’t need to over-claim for the harms being done the plain, unvarnished, truth is bad enough.

Concerns were being expressed around the dramatic increase in numbers but also the demographic of referrals. Natal girls had inverted the sex ratios of referrals and bore little resemblance to the previous cohort of, mainly, gender non-conforming boys. Now referrals had an over-representation of natal girls, same sex attracted of both sexes, , autitistic children/teens as well as 25% of referrals of children who had spent time in care. I wrote about the Gender Clinics and looked after children here: 👇. One of the articles is based on the Tavistock’s own data.

Foster kids & Gender Clinics

Concern was often focused on the administration of puberty suppressant drugs to children as young as ten.

These medical interventions were, and still are in some organisations, described as “reversible” and administered to allow a “pause” : Time to think, if you will. However, we knew from the Dutch experience that the vast, vast, majority would progress to cross sex hormones. They will be sterile and it seems they will lose orgasmic potential. Natal boys will have stunted genitalia which will make surgeries more risky, requiring use of the colon to create a facsimile of female genitalia. One boy actually died of necrotising fasciitis following his surgery in the Dutch experiment. More on this below:

Juvenile “transsexuals”: Biggs

While Polly Carmichael, a senior clinician, admitted there was a lack of research into these interventions here’s what we do know: 👇

Here is another senior clinician, Bernadette Wren, with a similar admission.

I have done a series on Bernadette Wren. She famously told the Women’s and Equalities Committee (W.E.S.C.) that she felt at the cutting edge of a social revolution.

Bernadette Wren

Even NICE (National Institute for Health and Care Excellence) concluded that the evidence base was very poor.

Chapter 2 provides the background to the setting up of the service. I covered much of this in my series on the first director, Domenico Di Ceglie.

Domenico Di Ceglie: Tavistock

What was new to me in this chapter was some research donee on the Tavistock cohort. I will have a detour to look at this research before I proceed to chapter three.

Before I leave chapter 2 it’s is worth noting that concerns were being expressed about G.I.D.s as far back as 2005. David Taylor was asked to produce a report which was then hidden for fifteen years! It was only after a protracted battle that the Tavistock were forced to release that report. I covered this below.

Tavistock: Taylor Report

Chapter Two continues by documenting that unease with the service was not long in emerging. Different traditions of approaching physical distress with the body co-existed uneasily. Some clinicians were used to seeing the body used to signal distress. In lay terms they saw this as a problem with the mind, not the body. Medical interventions were regarded as a last resort and, crucially, only with a strong evidence base for the treatment. Therapeutic treatments were prioritised.

This chapter also covers the work of Dr Az Hakeem who ran a group for post -operative patients who were experiencing regret. He decided to combine this group with those who were considering surgery. As a result, Hakeem, advised only 2% of the pre-operative group decided to proceed with surgeries. For Bernadette Wren those working with patients experiencing regret developed a skewed attitude to the work of G.I.Ds.

In 2002 there was an open schism when the European Court issued a ruling that “transsexuals” should be granted full, legal, recognition for the sex they wished to be. Staff at the Portman’s published an open letter opposing this,

Ex staff began to notice the influence of the lobby group Mermaids. Domenico Di Ceglie was even a patron at one point. In the beginning Mermaids recognised that a “transsexual” outcome was unlikely for most of these troubled children but, over time, they became more militant and difficult to work with according to some accounts.

Sue Evans describes how she felt that the cases she was seeing required extensive, exploratory, work but other colleagues were prescribing drugs after a shockingly low number of session. All the recommendations from the Taylor report were ignored. 👇

The chapter ends with the case study of “Ellie” who was a non gender conforming girl who realised she was attracted to girls and found the opportunity to discuss her issues, with Tavistock staff, valuable. She eschewed medical intervention and is now in her forties, bisexual and has been in a same sex relationship for the last decade.

I am already finding this a riveting read. This book has the potential to save more children from being treated as guinea pigs by a health care system that has lost its way. I will be back with the next chapters.

You can support my work by taking out a paid subscription to my substack or donating below. All donations gratefully received and they do help me cover my costs and also to keep content open for those not able to contribute. (I will add other methods as soon as I have figured it out. 😉)

My Substack

Researching the history and the present of the “transgender” movement and the harm it is wreaking on our society.