Top NHS adviser on trans health failed to cooperate with Cass Review

Dr Derek Glidden of the Nottingham Centre for Transgender Health refused to share patient data

The NHS’s most senior adviser on transgender health refused to share data about his clinic’s patients with the Cass Review.
Dr Hilary Cass said efforts to track the journeys of around 9,000 children who went on to be seen by adult services were “thwarted” by the refusal of clinics to provide evidence.
Researchers were trying to establish the long-term consequences of medical interventions by seeking data from adult clinics, which take patients from the age of 16.
Six of the seven clinics which run adult gender services refused to comply with the request.
They include the Nottingham Centre for Transgender Health, one of the leading centres in the country.
Dr Derek Glidden, its clinical director, refused to comply despite being NHS England’s gender dysphoria national speciality adviser.
He chairs the NHS England Clinical Reference Group on gender dysphoria, while another of its five members, Dr Laura Charlton, the clinical lead at Leeds Gender Identity Clinic, also refused to participate in the research.
The Nottingham clinic has been key to the rollout of a new wave of experimental trans services being set up across the country. It has links to the Indigo Gender Service in Greater Manchester, which describes itself as “trans and non-binary led”, and to the recently launched scheme in Sussex which has put GPs in charge.
Campaigners have raised concerns about the pilot schemes, with one likening them to “the Wild West”, saying responsibility for life-changing decisions was being handed to those with inadequate specialist knowledge.
As chair of the NHS Clinical Reference Group on gender dysphoria, Dr Glidden advises its national programme board, which commissioned the rollout.
Dr Charlton, a clinical psychologist, worked at the controversial and now shut down Tavistock Gender Identity Development Service (GIDS) from 2014 to 2020 and has previously defended the clinic.
In 2022, she was one of the coordinators of a joint letter which took issue with how the GIDS service was being portrayed, saying many staff who left the service did not disagree with its practices.
The clinical leads of the NHS Gender Identity Clinics in Northampton, Newcastle, and Sheffield also refused to cooperate with the Cass Review, as did the now discredited clinic at the Tavistock and Portman NHS Foundation Trust.
Just one of the seven units across the country – the Laurels Gender Identity Clinic in Exeter – agreed to supply any evidence.
On the eve of publication of the Cass Review, NHS England’s national director of specialised commissioning wrote to NHS hospital leaders operating adult clinics, telling them that “mandatory action” would be taken if clinics did not comply.
The letter, seen by The Telegraph, says clinical leads at the clinics failed to co-operate with researchers.
It said: “The study relied upon your organisations fully cooperating with the University of York in support of the research. However despite the best efforts of the research team, the necessary cooperation from the clinical leads within the Gender Dysphoria Clinics was not forthcoming, despite – and contrary to – positive assurances from CMOs [chief medical officers].”
“If left this way, it would represent a missed opportunity for the NHS to lead the way internationally in gathering high quality evidence that can, for the first time, present a better understanding of the longer-term outcomes for individuals who have received clinical or medical intervention for gender dysphoria / gender incongruence in childhood or adolescence.”
On Thursday Victoria Atkins, the Health Secretary, said the failure of the clinics to comply was “disgraceful”.
Writing for The Telegraph after a meeting with Amanda Pritchard, the NHS chief executive, Ms Atkins said “nothing less than full cooperation by those clinics is acceptable”.
The NHS is to review all care at adult clinics, with treatment for any new patients aged 16 and 17 paused, following concern from the Cass Review that life-changing decisions were being made too early.
Helen Joyce, of gender-critical group Sex Matters, said the attempt to block any robust follow-up of gender-distressed children was “inexcusable”.
She said: “The heads, past and present, of these clinics should be held to account for this outrageous failure.”
A spokesman for the Leeds Gender Identity Service said it “fully supports the research into young people’s gender services, and we cooperated as fully as we could with the Cass Review”.
He added that the clinic “is named as a primary data source within the report”.
An NHS spokesperson said: “Ahead of the publication of the Cass Review’s final report, NHS England wrote to all seven providers of adult gender dysphoria clinics setting out our expectation of full participation with the data linkage study, and have now received assurances that the group intend to do so.”
Nottingham Centre for Transgender Health, Dr Glidden and Dr Charlton were approached for comment.