Gender was often only one of their issues, yet somehow at GIDS, it came to override everything else. These patients were all distressed young people, often with complex problems: autism, eating disorders, self-harm, depression.

One girl asked if when given testosterone she would be able to produce sperm. They feel that the risks of the medical pathway they were put on were never explained to them or that they were too young to understand the full implications. Some of her interviewees are happily transitioned. Barnes is not coming at this from an ideological viewpoint. It is this forensic approach that makes her findings so devastating. She speaks to over 60 clinicians: psychologists, psychotherapists, nurses, social workers. Hannah Barnes’s well-researched book delves into how this situation arose. As shocking as this is, the bigger shock is the number of people who knew about this and did nothing. This NHS service was said to be using “poorly evidenced treatments on some of the most vulnerable people in society”. Yet by July 2022, following Dr Hilary Cass’s report, GIDS was deemed neither a safe nor viable option for young people with gender-related stress and it was closed down. In 1994 GIDS became part of The “Tavi” and by 2009 had a new director, Dr Polly Carmichael. Many of the greats worked there, from Bion to Bowlby to Laing. The “Tavi” was once considered the premier psychodynamic outpatient unit in the country. This was not the case at the Gender Identity Development Service (GIDS) that became part of the prestigious Tavistock clinic. There will always be cutting-edge procedures or drugs but the trialled patients will be consenting adults. Do No Harm is surely the ethical cornerstone for medics. Whenever medical scandals happen, we look back and wonder how well-intentioned people ended up doing bad things.

Hannah barnes time to think