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An invitation to explore: A brief over


Gender Identity Development Service Jason Maldonado-Page and Sarah Favier


Introduction T e Gender Identity Development


Service (GIDS) was established in 1989 and is located in the Tavistock and Portman NHS Foundation Trust with two offi ces in London and Leeds. It provides a holistic and integrated service alongside the endocrinology departments at the University College London Hospital and Leeds General Infi rmary. It is the UK’s only nationally commissioned highly- specialised NHS service supporting the emotional and physical health needs of gender-diverse children, adolescents, and children of transgender parents. T e service had a 100% increase in referrals between 2015 and 2016. It off ers a multidisciplinary perspective drawing from a clinical team of qualifi ed, experienced and dedicated systemic and family psychotherapists, clinical and counselling psychologists, child and adolescent psychotherapists, clinical social workers, child and adolescent psychiatrists, paediatric endocrinologists and clinical nurse specialists who represent a spectrum of identities. T is article is a brief overview of the service and an introduction to the systemic discipline within the service. It will highlight the assessment and intervention approach, the service’s growing systemic voice and invites you to explore its work with gender-diverse young people and their families.


Assessment and intervention approach


When young people and their families


access the Gender Identity Development Service, clinicians off er a series of appointments to explore a young person’s gender identity in the context of their family, school or college and community. We work within the GIDS NHS service specifi cation and the World Professional Association for Transgender Health international guidance. T e service’s psychosocial assessment off ers gender-diverse children and young


18


Photo: Katy Davies, © Fashion Space Gallery


people, and their families an opportunity to share their stories in a safe and thoughtful environment with at least one, and oſt en two, qualifi ed and experienced clinicians over a period of approximately six months. Around four to six one-hour appointments are off ered, at monthly to six- weekly intervals, although this is fl exible depending on the child’s gender identity development, age, current presentation, additional risks and developmental needs, as well as the complexity of their network and family. T e model of oſt en using two clinicians provides an opportunity for multiple ideas to be generated and for families and young people to have their own concurrent spaces to talk. Our therapeutic assessment aims to explore and understand the young person’s past and current gender identifi cation across space, time and a number of domains such as family, school, social agencies and online social worlds. It allows young people and parents to explore their own gender development, experiences of gender in their family of origin, current family, in wider society, as well as experiences of their body, sexuality and sexual orientation


and puberty. T e clinicians pay close at ention to the various relationships in a young person’s life and every eff ort is made to work closely with those relevant to off ering appropriate support locally such as schools, child and adolescent mental health services, general practitioners as well as voluntary and statutory agencies. Following this assessment, some


young people are referred to paediatric endocrinology teams, in London at University College and in Leeds at the General Infi rmary, to consider the use of a hypothalamic blocker – or puberty blocker, which halts pubertal development but does not alter young people’s bodies. Aſt er the age of 16, some young people who have been on ‘the blocker’ for a minimum of one year are prescribed cross-sex hormones to develop the characteristics of the gender with which they identify. Medical interventions are off ered alongside ongoing appointments and the service can be involved with some young people and families up until the age of 18. T is model of exploration of gender identity development, with elements of therapeutic support and psychoeducation is adopted


Context 155, February 2018


An invitation to explore: A brief overview of the Tavistock and Portman Gender Identity Development Service


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