News broke this afternoon that Charing Cross Gender Identity Clinic is severing its relationship with its current host, West London Mental Health Trust. In a statement the Trust said:
The Board has made a decision that the medium-term strategic focus for the Trust will be to develop mental health services, physical care and integration between the two.
As a result, the Trust has come to the conclusion that patients requiring gender identity services would be better served in the long term by another provider, and has therefore served notice on our contract to NHS England.
Gay Star News, who are not averse to a big of clickbait, followed this up with a report saying that the clinic was about to close, and that this was brought about by a massive increase in demand. Neither of these things appear to be true, at least in the short term. WLMHT makes it clear in their announcement that they intend to continue services until a new host is found for the clinic. While they do mention increased demand in the announcement, they do not blame it for their decision.
Charing Cross has been in the forefront of gender medicine in the UK since at least the 1930s, and for a long time was the only clinic in the country. It is still the only clinic serving the heavily populated South-East of the country, and the whole of Wales because the Welsh government has been shamefully remiss in failing to provide a proper service for trans citizens. Even some of my friends around the Bristol-Bath area attend Charing Cross rather than the more local Exeter clinic. Losing it would be a major blow, but it is by no means clear what will happen.
Dr. Stuart Lorimer, a widely respected gender specialist with a long history at Charing Cross, popped up on Twitter to say that the decision to cut ties with WLMHT had been made by the clinic, not by the Trust.
https://twitter.com/GenderCareDrL/status/768814047420616704
He also noted that the clinic had alternate hosts already in mind.
https://twitter.com/GenderCareDrL/status/768818899525726208
I can certainly see the advantage of trans services not being so clearly associated with a mental health trust. Equally it is true that Charing Cross has been a problem for WLMHT. I doubt that the Trust’s management will have been pleased with this report by the Quality Care Commission. It is difficult to know whose spin to believe here. Possibly there was simply a breakdown of relationships and a need for a new start.
What is clear is that, to coin a well worn political phrase, Something Must Be Done. Because an awful lot of trans people are dependent on Charging Cross and will be very worried about their future right now.
Hopefully this will be an opportunity for Welsh trans activists to pressure their government for a local service. The Assembly has done a lot of talking but very little spending of money. It is time for that to change.
I also know that Caroline Lucas, the MP for Brighton Pavilion, has been pestering NHS England for a GIC in her city to serve its very large trans population. This may help her cause.
Equally hopefully, one of the organizations that Dr. Lorimer has in mind will come through and take on the job of managing the clinic. They might do a better job. Certainly there’s room for improvement. What worries me is what happens if no London-based NHS organization is willing to take up the challenge.
Indeed, it is worrying that an NHS Trust can say publicly that it doesn’t want to provide services to trans people any more and is dumping them, because that’s what the WLMHT press release says. It may not be true, but if it is what is to stop other NHS trusts all over the country from doing the same?
The alternative is that NHS England will give the contract to a private provider. I note that Dr. Lorimer and some colleagues recently set up a private consultancy providing gender services. I have seen some trans people already expressing concern about this. An NHS England contract would presumably stipulate the certain services had to be provided for free, but a private operator would always be looking to squeeze more profit out of the service and would be likely to cut and run if it could not make enough money doing it.
All in all, it is a mess, and a mess that is likely to continue while there is no serious commitment from government to provide health care for trans people. (Or indeed any health care for anyone where some Tory MPs are concerned.)
Update: Dr. James Barrett, the Lead Consultant at Charing Cross GIC has issued a statement. Dr. Lorimer has distributed it via Twitter:
https://twitter.com/GenderCareDrL/status/768884234996023296
That certainly confirms that the clinic feels that the break happened on their initiative. It doesn’t explain why the WLMHT saw fit to claim that the break was their decision. All in all it seems like there is a breakdown of the relationship between the Trust and the GIC, in view of which perhaps a parting of ways is for the best.