Bell, a distinguished psychiatrist and practising psychoanalyst, is the doctor who in 2018 wrote a controversial report about the activities of the gender identity development service (GIDS), a clinic at the Tavistock and Portman NHS foundation trust in north London, where he worked in adult services from 1995 until his retirement earlier this year.
Writing the report was, he says, a matter of conscience. In 2018, 10 GIDS staff brought their worries to him unsolicited, a figure he estimates to be around a third of those then working there. He had no choice but to act and would do the same again.
Among these concerns were the fact that children attending GIDS often seemed to be rehearsed and sometimes did not share their parents’ sense of urgency; that senior staff spoke of “straightforward cases” in terms of children who were to be put on puberty blockers (no case of gender dysphoria, notes Bell, can be said to be straightforward); that some were recommended for treatment after just two appointments and seen only infrequently thereafter; some felt that GIDS employed too many inexperienced (and inexpensive) psychologists; that clinicians who’d spoken of homophobia in the unit were told they had “personal issues”. One told Bell that a child as young as eight had been referred to an endocrinologist for treatment. “I could not go on like this… I could not live with myself given the poor treatment the children were obtaining,” said another.
In September, Bell sent his report to Jenkins and to Paul Burstow, the chairman of the board. For unspecified legal reasons, he says, they forbade him to send it to the council of governors, which oversees the board. “That was when I got myself a lawyer,” says Bell. His lawyer told him that, on the contrary, a failure to send it out might make him culpable in the event of any future legal case taken against the trust.
Bell wrote to staff at GIDS, reminding them of their right, as NHS workers, to speak confidentially. At this point, he says, the trust “went ballistic… they interfered with my emails so I couldn’t write to them again”. The trust’s review delivered its report in February 2019. Initially, Bell was not allowed to see it. He was then given 30 minutes to read its 70 pages (it was later leaked to him in full). “There was still no data. It mentioned intimidation, but no action was [to be] taken. However, it did acknowledge the inappropriate involvement of trans ideology groups in the work of the service.”
In early 2020, procedures were set up for disciplinary action to be taken against Bell. “All the grounds were in connection with my activities as a whistleblower,” he says.
Last January, he retired as planned, only a month after the Keira Bell judgment. He had long believed a case would be brought against the trust, though he thought the most likely scenario was that a former patient would sue for damages (Keira Bell instigated a judicial review). “It was inevitable,” he says. “I warned the trust of this.” But the Keira Bell judgment has done little to alleviate his concerns. Whatever the outcome of the appeal, he believes more questions must be asked, particularly about the rise in the number of girls presenting at the clinic (three-quarters of patients are now girls; the gender balance used to be closer to 50:50). “We do not know why this is happening.” He worries that too much emphasis is placed on gender and not enough on sexuality – “the children are often gay” – and he continues to be anxious about co-morbidities such as anorexia, autism and history of trauma in its patients. “Some of the children are depressed. It’s said that it’s their gender that is the cause of this, but how do we know? And why don’t we try to treat that first?”
But given his politics – Bell describes himself to me as a “Corbyn-supporting Jew” – he has been most shocked by the reluctance of the left to engage with the issues. “They think this is to do with being liberal, rather than with concerns about the care of children. Mermaids and Stonewall [the charities for trans children and LGBTQ+ rights] have made people afraid even of listening to another view.” It surprises him that the left is unwilling to consider the role played by big pharma.