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An independent review has found no evidence of a significant increase in suicide among young patients attending a London gender identity clinic.
Professor Lewis Appleby was asked by Health Secretary Wes Streeting to look into the data after campaigners claimed suicide rates had risen since puberty blockers were restricted at Tavistock and Portman NHS Trust in 2020.
Prof Appleby’s research concluded that “the data does not support the claims”, adding that the way the issue had been discussed on social media was “insensitive, distressing and dangerous”.
Joe Maugham, founder of the Good Law Project, which has been leading the legal action, said the review had been “hugely challenging” and that his analysis included patients on waiting lists.
Unsafe Languages
The Department of Health and Human Services said it was important that public debate on the issue was conducted responsibly.
Prof Appleby, professor of psychiatry at the University of Manchester and a veteran suicide researcher, said online discussion of the issue went against guidelines on safely reporting suicide.
“One risk is that young people and their families will be frightened by the prediction that without puberty suppressants, suicide is inevitable – as some of the reactions on social media suggest,” he said.
There was also a risk that young people would become anxious after hearing the message and imitate the behavior they were warned about.
He also said published claims about an “explosion” in suicides “fail to meet basic standards of statistical evidence.”
The Good Law Project is challenging the former health minister’s decision to stop private clinics from prescribing puberty-blocking drugs to children and young people with gender dysphoria.
This was recommended by the Cass review published in April, which said the evidence for the use of the treatment was “significantly weak”.
In response to their claims, the new Health Secretary launched an independent investigation, led by Professor Appleby, which analysed NHS England data on suicides among patients at the Tavistock Clinic, based on an audit of the Trust.
The study looked at the period from 2018-19 to 2023-24 and found that there were 12 suicides, five of which occurred in the three-year period up to 2020-21 and seven in the three years following.
“This is essentially no difference,” Professor Appleby said in the report, “and given the expected variability in small numbers, it is unlikely to result in a statistically significant difference.”
He added: “Specifically among young people under 18, there have been three suicides prior to the 2020-21 season and three since.”
Prof Appleby noted that the patients who died were at different stages of the care system, including after being discharged from hospital, suggesting there was no consistent link to any one aspect of care.
But he said the trend is likely to increase in the long term as more at-risk youth come forward with gender identity issues.
‘Insufficient evidence’
The Good Law Project based its allegations on information provided by a whistleblower at the now-closed Tavistock Clinic.
This was combined with publicly available evidence – Tavistock’s own minutes – which Maugham, the project’s executive director, said in a lengthy response to the review on X (formerly Twitter).
He said his Freedom of Information request for official statistics had been “refused” and that Tavistock and NHS England declined to comment on his findings.
“We seem to be comparing apples and pears,” Maugham said of X.
“DHSC advisers are talking about a small group of ‘current and former GIDS patients’ but my figures are mainly directed at a larger group of ‘people on the waiting list’.”
A Department of Health and Social Care spokesman said decisions about children’s healthcare must always be guided by evidence.
“Dr Cath’s research found there was insufficient evidence to show puberty suppressants were safe for under-18s, and the NHS has already stopped routinely prescribing them to children with gender dysphoria.”
“We are committed to ensuring that children who are questioning their gender receive the best possible multidisciplinary care, under the clinical guidance of specialists, which is why we are reforming our gender identity service.”
“It is vital that public debate on this issue is handled sensitively and responsibly.”
