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Time to Think

The Inside Story of the Collapse of the Tavistock's Gender Service for Children

Hannah Barnes

Time to Think goes behind the headlines to reveal the truth about the NHS’s flagship gender service for children.

The Gender Identity Development Service (GIDS), based at the Tavistock and Portman Trust in North London, was set up initially to provide — for the most part — talking therapies to young people who were questioning their gender identity. But in the last decade GIDS has referred more than a thousand children, some as young as nine years old, for medication to block their puberty. In the same period, the number of young people seeking GIDS's help exploded, increasing twenty-five-fold. The profile of the patients changed too: from largely pre-pubescent boys to mostly adolescent girls, who were often contending with other difficulties.

Why had the patients changed so dramatically? Were all these distressed young people best served by taking puberty blockers and then cross-sex hormones, which cause irreversible changes to the body? While some young people appeared to thrive after taking the blocker, many seemed to become worse. Was there enough clinical evidence to justify such profound medical interventions in the lives of young people who had so much else to contend with?

This urgent, scrupulous and dramatic book explains how, in the words of some former staff, GIDS has been the site of a serious medical scandal, in which ideological concerns took priority over clinical practice. Award-winning journalist Hannah Barnes has had unprecedented access to thousands of pages of documents, including internal emails and unpublished reports, and well over a hundred hours of personal testimony from GIDS clinicians, former service users and senior Tavistock figures. The result is a disturbing and gripping parable for our times.

First published:
March 2023
Published by:
Swift Press
Hardcover 464 pages
What the judges said

"Hannah Barnes steadfastly refuses to enter into the Manichean ideological debates and culture wars around gender identity. Instead she unearths the facts to present an alarming story of medical scandal”

Time to Think book trailer

About the author

Hannah Barnes is an award-winning journalist at the BBC’s flagship current affairs programme Newsnight. She led its coverage of the care available to young people experiencing gender-related distress, which helped precipitate an extensive NHS review and unearthed evidence that was later used in several sets of legal proceedings. Newsnight’s reporting also led directly to an inspection by the healthcare regulator the Care Quality Commission, which branded GIDS, the NHS’s only youth gender clinic in England, ‘Inadequate.’ The work was nominated for an array of awards, including the prestigious RTS Television Journalism Awards.

Over the past decade and a half, Hannah has specialised in investigative and analytical journalism, and has spent many years reporting, editing and producing a variety of the BBC’s most respected long-form programmes and documentaries. She lives in London with her husband and two children.