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There is no evidence of a significant increase in suicides among young patients attending a gender identity clinic in London, an independent study has found.
Professor Louis Appleby has been commissioned by Health Secretary Wes Streeting to review the data following campaigners’ claims that suicide rates have increased since puberty-blocking drugs were restricted at the Tavistock and Portman NHS Trust in 2020.
Professor Appleby’s analysis concludes that “the data do not support this claim.”
He added that the way the subject was addressed on social media was “insensitive, distressing and dangerous”.
The Department of Health and Social Care said it was essential that public debate around the issue was conducted responsibly.
Dangerous language
Professor Appleby, professor of psychiatry and a senior suicide researcher at the University of Manchester, said online discussions about the issue had run counter to guidelines on the safe reporting of suicides.
“One risk is that young people and their families will be terrified by predictions that suicide is inevitable without puberty blockers – some of the reactions on social media show that,” he said.
There was also the risk that distressed adolescents hearing this message would be led to copy the behavior they were being warned against.
He also said that public claims of an “explosion” in suicides “do not meet basic standards of statistical evidence.”
The claims were led by a legal advocacy group, the Good Law Project, on X, formerly known as Twitter.
The group is challenging the former health minister’s decision to end the prescribing of puberty-blocking drugs by private clinics to children and young people with gender dysphoria.
That was recommended by the Cass report, published in April, which found “remarkably weak” evidence on the use of the treatment.
In response to their allegations, the new Health Secretary launched an independent review led by Professor Appleby which analysed NHS England data on patient suicides at the Tavistock clinic, based on an audit of the facility.
Covering the period between 2018-19 and 2023-24, it found there were 12 suicides – five in the three years to 2020-21 and seven in the three years after.
“There is virtually no difference,” Professor Appleby says in his report, “given the expected fluctuations in small numbers, and it would not reach statistical significance.”
He adds: “In the under-18s specifically, there were 3 suicides before and 3 after 2020-21.”
The patients who died were at different stages of the care system, including after discharge, suggesting there was no consistent link to any aspect of care, Professor Appleby noted.
However, he said it was likely there had been an increase over a longer period as more at-risk young people came forward with gender identity issues.
‘Insufficient evidence’
A spokesperson for the Department of Health and Social Care said decisions about children’s healthcare must always be based on evidence.
“Dr Cass’s review found there was insufficient evidence to show puberty blockers were safe for under-18s, which is why 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, led by clinical experts. That is why we are reforming gender identity services.
“It is essential that the public debate around this issue is conducted with sensitivity and responsibility.”
The Good Law Project is said to have based its claims on unpublished figures provided by two staff members at the now-closed Tavistock Clinic.
The project’s executive director, Jo Maugham, said: “I was not contacted before the statement was published and will obviously need time to respond. I am struggling with the figures and analysis and will respond in due course.”
