‘There has been a 3264% rise in referrals to the national gender identity service at the Tavistock and Portman NHS Trust in London over the past 10 years (from 77 in 2009–2010 to 2590 in 2018–2019).^c1 The profile of referrals has also undergone a major transformation: we have seen a reversal of the gender ratio from two-thirds male:female to two-thirds female:male, with a recently described clinical phenomenon of as yet uncertain diagnostic significance making up a substantial proportion. This gender dysphoria of recent onset among adolescents (sometimes termed ‘recent-onset gender dysphoria’ or ROGD, ‘rapid-onset adolescent dysphoria’^{Reference Littmanc2} or ‘adolescent-onset transgender history^{Reference de Vriesc3}) lacks an agreed name or established diagnostic criteria, but its emergence has been documented by a number of gender clinics worldwide.^{Reference Zuckerc4}’

‘Bernadette Wren, the then associate director of the Tavistock and Portman NHS Foundation Trust's Gender Identity Development Service (GIDS), gave evidence to a House of Commons select committee in which she summarised the GIDS intake in the following terms: “many of the young people, and increasing numbers of them, have had a gender-uncontentious childhood, if you like, and it is only when they come into puberty and post-puberty that they begin to question. That now represents a substantial proportion of our group”.^c5’

‘The affirmative approach to gender dysphoria appears to have been adopted by the majority of NHS and privately provided children's services in the UK. Again, Bernadette Wren stated in the House of Commons: “I work in a service where a lot of the young people – and anybody who wants it – have physical intervention. We have no record of turning people down for physical intervention”.^c5’

‘Cantor says “Although almost all clinics and professional associations in the world use what's called the ‘watchful waiting approach’ to helping gender diverse children, the AAP statement instead rejected that consensus, endorsing gender affirmation as the only acceptable approach’.^{Reference Cantorc6} This is despite research findings which strongly suggest that most of these cases would eventually desist if left untreated.^{Reference Ristori and Steensmac7, Reference Steensma, Biemond, de Boer and Cohen-Kettenisc8}’

‘Research Digest, published by the British Psychological Society, reported on an Australian review which concluded that the current medical approach is based on extremely limited evidence.¹⁵’

‘Children are signing up for treatments that permanently modify their bodies, but they may not fully understand the life-long consequences of their decision or acknowledge the potential risks and uncertainties of treatment. Their ability to provide informed consent has been questioned, including by some clinicians working in gender clinics.^{Reference Vrouenraets, Fredriks, Hannema, Cohen-Kettenis and de Vriesc9, Reference Levinec10, Reference Heneghan and Jeffersonc11}’

‘A number of clinicians have called for research into desistance, detransition and regret among gender dysphoric adolescents. The US National Institutes of Health (NIH) Sexual & Gender Minority Research Office (SGMRO) recently named detransition in its report outlining scientific research gap areas in the field of sexual and gender minority health.^c12 The 8th edition of WPATH's Standards of Care will include a section on detransitioning.^{Reference Colemanc13}’

‘M.E. and his wife Sue Evans have provided witness statements for a UK judicial review examining whether minors are able to provide informed consent for gender-affirming treatments. M.E. has previously raised concerns about such treatments with the Board of Governors and the CEO of the Tavistock Trust. Sue Evans administrates the online pages for a crowd justice fund, which will be used to pay the legal fees of the judicial review. Neither M.E. nor Sue Evans has received or will receive any financial reward for participation in the case.’