One of the most prominent former patients of the child gender clinic Gids has told how she wants to see criminal prosecutions as a result of the scandal.
Keira Bell, who was put on puberty blockers aged 16 after attending the Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust, wants “justice” for those treated at the clinic.
She was put on a medical pathway that saw her take testosterone and undergo surgery to remove her breasts, before she later detransitioned back and took the clinic to the High Court.
Bell, now 27, views her treatment as “experimental at best, destructive at worst” and believes professionals ignored her trauma and complex mental health problems.
Reading the Cass review this week, which declared the field of medicine aimed at enabling children to change gender was built on shaky foundations, had been “traumatic” and “sad”, Bell said.
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But she does not feel that the 388-page report should be the end, especially with the emergence of private clinics practising gender medicine. She told The Times: “I think a lot of us are just looking for some actual justice, really.
“A lot of these clinicians have just merged into the private sector now. Or they’re involved in the NHS in some way and just move on. There’s no real talk of justice, from my perspective.”
Asked what justice feels like, Bell added: “To be honest, I feel like prosecution. Because a lot of these clinicians, from what it appears, were very aware of what they were doing. It seems like financial incentive overtook all morality. I’m quite angry about that.”
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Anger was one of the “mixture of emotions” that Bell felt this week. She also described feeling “slightly vindicated” by the review, led by the paediatrician Dr Hilary Cass, which found there was no good evidence to support prescribing hormones to under-18s to pause puberty or transition to the opposite sex.
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This pathway for young people who identify as transgender has become embedded in clinical guidelines around the world over the past two decades, as Bell knows.
She had started to ponder the idea of transitioning at 14. She was “gender nonconforming”, felt awkward around her peers and began experiencing attraction to the same sex.
Bell, who grew up in Letchworth, Hertfordshire, added: “I was really struggling with puberty and how my body was developing.”
After she was referred to the Gids clinic aged 16, in 2013, it addressed her by her chosen male name, Quincy, “straight off the bat”.
She was referred for puberty blockers after her fourth appointment. The appointments were “surface level” and “didn’t go into depth at all”, she said.
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“They said [puberty blockers] would be a pause. So no further developments happen and you can have time to think about whether you’d like to go onto the cross-sex hormones.”
Cass’s review found that there was no evidence that puberty blockers allowed young people “time to think” by delaying the onset of puberty, which had made Bell begin to feel increasingly low.
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She added: “I had extreme depression, massive brain fog. I couldn’t concentrate at sixth form. I had night sweats, no sex drive.” She even began experiencing symptoms of the menopause.
Bell was not sure she “had even heard of puberty blockers” before taking them, but wanted to let the clinicians know that she was serious, so agreed to them. She said she had an “urgency” for change because she “felt like an alien among my peers”.
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After a year, she was prescribed testosterone and had her first injection at her GP’s surgery. The drug lowered her voice and gave her facial hair.
She had endured years of using breast binders, to flatten her bust, so also underwent a double mastectomy on the NHS aged 20.
Bell said: “In hindsight, I was just very numb to the whole thing. I think I actually started to have doubts in the back of my head leading up to the surgery.”
But she had been watching a lot of videos from transitioning trans people beforehand.
She added: “I looked at it as something on my checklist … being ticked off.”
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It was about a year after the surgery that she began to have doubts, which led to her detransitioning. She had begun questioning what actually made her a man.
She said she realised the treatments were “experimental” and had a feeling that she was “being taken advantage of”. Bell also discovered a thread of people experiencing similar feelings on the website Reddit.
She stopped taking the testosterone and her periods returned. She is now adamant that she could not have given informed consent to her treatments. “I just felt very duped. Very angry,” she said.
Bell later helped bring a legal challenge against the Tavistock clinic over whether children under 16 considering gender treatment are mature enough to give informed consent for puberty blockers.
The case was initially won in the High Court before being defeated in the Court of Appeal.
Bell now looks back and believes the clinicians ignored her mental health problems in favour of trying to treat her gender dysphoria. “I was very mentally ill and I had a complex past, dealing with trauma,” she said. “You’re just allowed to go on this crazy, destructive process at a very young age and no one’s really taken responsibility for it.”
Following on from the Cass review, Bell said that medical services “need to completely detach from any sort of political influence”.
As echoed in the review, she wants an evidential look at the drugs given to transgender young people, because they seem to be “experimental at best and destructive at worst”.
Bell is still dealing with mental health problems and is prone to bone dislocations. The Cass review noted concerning links between puberty blockers and the detrimental impact to bone density.
But Bell, who now lives in south London, said she is “learning to be myself again”. She added: “I’m trying to discover who I am as an individual. I feel like I’m on the path to actually deal with my problems now.”
