Over 40 gender identity specialists in the UK have signed an open letter addressed to the Association of Clinical Psychologists UK (ACP-UK) after a position statement was made about the treatment of young gender diverse people. The position statement, released in October, was issued in response to the Cass Review interim findings from February of this year. The Cass Review was led by Dr Hilary Cass, a Consultant Paediatrician and former President of the Royal College of Paediatrics and Child Health.

In August, the NHS in England confirmed that it is to close the Tavistock and Portman Clinic, based on findings from the Cass Review.

Signatories of the open letter describe the statement issued by its own representative body as “misleading,” and that it “contributes to an atmosphere of fear”. The letter refuted the statement’s alleged misinformed ideas about gender identity, particularly regarding language, clinical assessment, psychological and social factors, as well as evidence-based practice. Recommendations have also been made to ACP-UK on how it can improve its own recommendations about the future of gender services.

The open letter writes “We believe that the ACP-UK has failed to adequately seek the views of experts within the field of gender identity and diversity when developing this position statement, including those community members who represent trans and non-binary voices, and that this calls into question the credibility of the statement.”

It continues by alleging that the sentiments held in the statement can perpetuate “damaging discourses” about the work of these services, as well as gender-diverse identities in general. This comes at a time when recruitment and retention are already under strain, and when expansion of services is necessary. According to findings from the Cass Review, referrals to the Tavistock and Portman Clinic had increased from 250 in 2011/2012 to over 5,000 by 2021/2022, before the announcement of its closure.

The open letter states “We believe that how some of the findings of the Cass Review have been summarised and reported at the beginning of the ACP-UK position statement fails to provide critical context.”

One such example of this is the comments made about ‘diagnostic overshadowing’ in terms of mental health, neurodiversity and gender identity. Diagnostic overshadowing describes instances where one’s entire psychological difficulties are overlooked, in favour of focusing on a single issue. Those testifying on the letter ensure they take a holistic approach to treatment, and that this is a misrepresentation of how gender services are run in the UK.

The open letter continues with gender identity specialists refuting statements made about same-sex attraction and gender identity, saying “The statement that ‘we are aware that many young people who experience same-sex attraction will, at some stage, question their gender identity or experience gender dysphoria’ is refuted on the basis of practice-based evidence,

“…this is an amplification of the issue and it is wrong to assume that this is a majority experience for ‘same-sex attracted’ young people.

“Equally, this statement seems to imply that young people might be seeking to transition to resolve negative feelings towards their own (LGB) sexual feelings or to ‘be straight’”

The Chair of the Association of Clinical Psychologists UK responded by saying “ACP-UK included gender specialists as well as specialists in children and young people as well as service users in formulating our response. The reaction and feedback to our statement has been overwhelmingly positive apart from the open letter signatories.”

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