I knew Hannah Barnes’ Time to Think was an important book. So many people with good brains and good hearts have been worried about what the current fashion for gender ideology is doing to our kids. Reading reviews and articles about the book, I could see Barnes’ investigation into what happened at the Tavistock was likely to bring us some much-needed explanations, and it does.
Unlike most of the writings on this topic, she takes a professional approach and avoids being virulently pro-this or anti-that. She deals fairly with differences of opinion, seeking and presenting facts amidst the storm of myths and accusations, searching out and analysing human realities.
This week, it was finally my turn to take this much-sought after book out of the library, and I found it does not disappoint. It’s deeply disturbing, but not disappointing. It provides much needed answers to questions on a much wider range of issues than I expected …
How did we get into such a state?
This question applies to the gender ideology situation. How on earth did an evidence-free set of ideas get such a grip on us that friends were falling out over it, jobs and political roles being lost, lives disrupted, hearts broken…?
The question also applies to the excruciating political scene unfolding around us – as the earth heats up, as the vital services we were once so proud of fall apart, as every activist desperately seeks a way of injecting some responsibility into our appalling government…
This is how we got into such a state…
Barnes’ book carefully and sympathetically investigates the decline of a once proud institution at the centre of what is happening to our children, particularly all those girls and young women who are suddenly coming forward in such numbers, fiercely determined to be boys and men. What Barnes demonstrates is that they have been victims of the conflicts that occur when what was a service becomes a business.
The Tavistock and Portman Trust
“The Tavistock and Portman NHS Foundation Trust is a specialist mental health trust with a focus on training and education alongside a full range of mental health services and psychological therapies for children and their families, young people and adults.” Or so says their website – and yes, they do have a proud history – even the staff who recently became horrified whistleblowers say so – so what happened?
GIDS
“The Gender Identity Development Service (GIDS) is for children and young people, and their families, who experience difficulties in the development of their gender identity.” Difficulties. Development. Those are things that need lengthy discussion, careful observation, nurture and analysis – not a fast track into puberty blockers and cross-sex hormones – so what happened?
It’s very complicated. Trusts, services. foundations, charities, commissioning committees, support groups, lobby groups – I’ve already forgotten what is which and what the consequences are, so pardon me while I dive back into the book…
… within the Tavistock and Portman Trust, GIDS gradually mutated from a service that fitted naturally into our NHS to become a money spinner for an organisation that has clients and punters rather than patients and users. Imagine a team built of steely, business-oriented masters and service-minded staff. People who watch the balance sheet and steer the PR, and people who care deeply about those they are responsible for, with middle management in between trying to do both.
I suspect the quote from this book that I’ll remember forever is, “oh, don’t think like that – you’ll go mad.”
How could responsible clinicians be involved in making profit-protecting decisions about young people in distress? Traumatised adolescents want a magical transformation, and they want it now. Profit-oriented businesses need to be seen to hand clients their dreams. But the safeguarding department says… Don’t talk to the safeguarding department!
Barnes describes a discussion in a House of Lords committee room on ‘the ethics of transgender health care’. Laure Thomas, the communications officer of the Tavistock, responded to concerns about a ‘conveyor belt’ process by saying that GIDS is far more cautious with puberty blockers than, for example, the United States.
Elsewhere, a clinician reports being told that “Even if GIDS was struggling, it was doing a better job than others would”. This was presented as a reason not to criticise, not to ask for a pause for thought…
Haven’t we seen that in so many organisations forced onto a bad track when under pressure? “Ah, but we’re not as bad as X. If we stopped, they’d be doing far worse things.”
GIDS could not slow down, and GIDS could not stop, it would not be allowed to stop, because it was becoming an ever-larger proportion of the Tavistock and Portman Trust’s income. Barnes writes about staff handling the GIDS helpline, faced with young people in all kinds of danger and distress, and a directive to try to deal with calls in ten minutes, and to ‘push them back to the referrer if possible’.
The referrer was often the desperately understaffed, under-funded children’s mental health service, CAMHS. Struggling to cope, CAMHS would pass youngsters to GIDS as soon as the word ‘gender’ came up, in an attempt to get their own waiting lists down.
And the quickest, easiest way for GIDS to deal with their waiting lists would be to refer youngsters to hospital for puberty blockers or if old enough, to adult gender services for cross-sex hormones.
So often, desperate measures in one organisation prove to be the result of underfunding or understaffing in others. Barnes carefully and sympathetically covers the struggles of staff members trying to find their way in the resulting turbo-maze. She collates opinions and information from a wide range of professionals about the aims and attitudes of the various organisations involved, about what happened when the Trust started fearing both for its finances and its reputation…
On being progressive
For all its excellent reputation, the Trust has some nightmares in its past – there was a time when it attempted ‘treatments’ for homosexuals. There was that business about babies and Satanists that, after causing vast amounts of work and distress, turned out to be largely mythical.
You need to keep your reputation in order to keep making money so if believing people who say they’re ‘the other sex really’ is the progressive thing to do, you’ll be keen to be at the forefront. If well-funded, high profile lobby groups like Mermaids and Stonewall want you to do more, and do it faster, you don’t want to appear too conservative.
And then when the crisis looms, there are the aggressive media at your door, wanting to feed the monster that is ‘blame culture’, and there are the accountants with this week’s financial headache, and there is your safeguarding lead, wanting to know why clinicians have been instructed not to bring potentially embarrassing problems to her…
And finally, there is the natural human aversion to confrontation. GIDS ran ‘like a family’, a private, tightly knit team battling against a bad world, fending off scrutiny the way a family in fear might fend off a social worker.
Hannah Barnes has put together and explained the human, the political, the financial and the systemic stories that make up the Tavistock situation with remarkable skill. She has carefully laid out everything you need to draw your conclusions and (by the way) presented us with a clear guide as to why profit-based ‘services’ are disastrous for both their staff and their users.
Please read this book
You will gain a mass of ammunition for those debates about why profiteers should not be allowed anywhere near the care of vulnerable young people. You will have good, hard, facts and figures to add to all those campaigns, about why we don’t want essential services run like businesses.
And perhaps most importantly of all, you may well develop a sympathetic, useful understanding of how good people, when under pressure, make such appallingly bad decisions in an organisation that’s presented as a service but subject to PR-men and profiteers.
This book is packed with vital knowledge for anyone hoping to dismantle capitalism.
Go on, read the book – you’ll see what I mean.
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Dear Reader,
Times are hard, and so the articles on this site are freely available but if you are able to support my work by making a donation, I am very grateful.
Cheers,
Kay
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Kay Green 