Media & the thousand families myth

The claim

In August 2022, Newsroom published an op-ed “Parents of gender-questioning children in NZ being let down” which was framed by the claim that the now closed Gender Identity Disorder Service (GIDS) in the UK was going face legal action from 1,000 families of patients who’d been referred to endocrinology by the service. 

It was an op-ed about the Interim Cass Report, which was examining the single-service model of gender healthcare the UK provided - and had found that this model led to waiting lists that were neither safe for patients, nor viable as a service. 

But a thousand families? This immediately came unstuck as GIDS highlighted that a total of around 1,000 patients had been referred to endocrinology in the last decade. Surely they couldn’t all be joining a legal action?

This isn’t a thorough examination of the Cass Report itself, but a look at how a claim can be made and repeated so often that it becomes established while remaining unexamined for detail.

The 1,000 families claim came from the law firm Pogust Goodhead, who specialise in these forms of legal actions. Ok, so they’re shopping around for clients. They even set up a website for potential claimees to contact them. They also claimed that the case would be filed “in the next few months”. 

In January 2024, Thomas Goodhead of Pogust Goodhead claimed that while his firm was definitely preparing some serious claims on behalf of a number of victims (no detail, no firm numbers) he has found that there was nowhere near the scale of litigation anticipated stating:

“That could be for a number of reasons,” he added. “It could be that actually, people are satisfied, and they don’t regret the treatments despite all of the evidence that has come out.”

We’ll get back to this claim a little later, but having made a very astute assumption, Mr Goodhead then goes back to what he knows:

“It could also be – and I have suspicions about this – that there is such a fear for people to come forward and admit that they aren’t happy about the treatment they received or that parents are afraid to speak out on behalf of their children.”

This is thousand families revisited. Actually people are too afraid to talk to a legal firm in confidence. It’s because of cancel culture, you see. Those are his suspicions. The same suspicions that led to worldwide news coverage that 1,000 families of patients were going to sue the Tavistock Clinic.

The actual numbers

Let’s just swing by the Cass Report, published this month, with regard to the GIDS clinic. Just to purely focus on the 1,000 families claim using the data gathered regarding the clinic, and then putting it in context.

Between 1 April 2018 and 31 December 2022, over four and a half years, 3,499 patients were seen by the Tavistock GIDS. This audit did not include patients who received fewer than two appointments, so only 3,306 patients were included in the audit (Cass, 13.11, pg 168).

This number is often one used to demonstrate that gender healthcare is an en-masse phenomenon, as is the waiting list of around 5,000 young people. However, being referred to GIDS did not automatically lead them to puberty blockers or other gender affirming care.

Of those 3,306 patients, 892 were referred to endocrinology, or around 27%. 2,414 were not referred to endocrinology for puberty blockers of hormone treatment, around 73% (Ibid).

Those referrals came after an average of 6.7 appointments with GIDS (Ibid). That’s an average, some had fewer and in one example a patient had 44 (Cass, Appendix 8, Page 8). Here’s a graph of all of those appointments.

Of these 892 patients, there is an interesting table about their treatment at the point they aged out of the GIDS service. 74.7%, or 667 patients, received either puberty blockers only or were on puberty blockers or cross-sex hormones.

Another 102, or 11.4% declined treatment. 35, or 11.5% accessed treatment outside the NHS. 29, or 3.3% did not access physical treatment. 18, or 2% had a puberty assessment only. 13, or 1.5% had treatment withdrawn. 

Another 29, or 3.2%, are categorised as Detransitioned/detransitioning, Unknown/unclear, Puberty blockers not started due to Judicial Review, Treatment recommended by supply issues, Treatment withdrawn on professional advice/side effects, Cross-sex hormones only, Puberty blockers and cross sex hormones (privately). The report does note that fewer than 10 patients of those 29 detransitioned (Cass, Appendix 8, Page 13).

Of that 73%, who did not receive puberty blockers from GIDS, 69% were referred to an adult gender dysphoria clinic (Cass, Appendix 8, Page 18). GIDS only covered patients to the age of 18, even though informed medical consent is taken as adult from 16 in common practice.

No, but seriously how many?

So of 3,306 patients referred to GIDS by other clinicians, 27% or 892 of them were referred on to endocrinology. And that referral was not an automatic prescription of puberty blockers and cross-sex hormones, as 25.3% or around 225 were not prescribed puberty blockers and/or cross-sex hormones. This does include the fewer than 10 patients prescribed cross-sex hormones only, and those who sought private prescription.

In total around 667 from 3,306, or 20.1% of referrals to GIDS resulted in endocrinology prescribing puberty blockers and cross-sex hormones. 

GIDS itself said around 1000 patients had been referred to endocrinology in the last decade in August 2022, but that wouldn’t include some of the 892 patients here who were referred after that period - but does cover a period going back to 2012, six years before the audit included in Cass’ report.

The number we have is 667. From 3,306. That does not feel like patients are being rushed into treatment, especially not after the average of 6.7 appointments. Certainly not for those who had many more than that. It’s certainly not 1000.

Selling something

Thomas Goodhead is a good salesman for his law firm. That’s what it means. He managed to get a media release to the receptive press about how up to 1000 families could be taking legal action against the Tavistock Clinic.

This became evidence that something illegal had been occurring at the Tavistock Clinic, in the minds of those who already believed that. It provides an opportunity for an op-ed to appear in Aotearoa, framed by the “concern” that these 1000 families could be taking legal action. 

It didn’t matter that to reach the magic number literally every single patient referred over a decade would have to be unhappy with their treatment and willing to take legal action over it. If that had been the case, there wouldn’t have been a Cass Report - because something would have been obviously and clearly wrong. But it’s not the case, it hasn’t happened like that.

The only legal case brought against Tavistock GIDS was Bell v Tavistock, which sought a judicial review of services. Initially the court found in favour of Bell, that patients at the clinic could not consent under Gillick Competence for endocrinology interventions.

This was later quashed in the High Court court because undermining Gillick Competence, which allows young people under-16 access to medical treatment like contraception and abortion with informed consent, is a very bad thing. It also found that Tavistock’s guidance was lawful. Put bluntly, GIDS didn’t do anything wrong.

That Bell’s lawyer was Paul Conrathe, a noted anti-abortion campaigner, should be noted here. His appeal was denied after the Supreme Court found he could not raise an arguable point of law in the case.

A word for Keira Bell as well. She saw a psychologist as a teenager and was referred to GIDS at 15. She began puberty blockers at 16, the age from which people are entitled to consent to their own treatment. She began cross-sex hormones at 17, and chose to wear a binder. At the age of 20 she had top surgery, or a double mastectomy. She later chose to detransition, but at every step in this process she made decisions about her own treatment - not under Gillick Competence, but with the sufficient judgement and decision capacity that everyone aged 16 years or above is viewed to have in healthcare.

It was very interesting that Bell’s case is often described as her being incapable of making decisions, or being a question of Gillick Competence - when Bell herself did not make any decisions relying on Gillick through her treatment with puberty blockers, hormones or surgery. She made them  consenting as an adult, a long-established precedent for medical treatment.

Tavistock GIDS was found to have acted lawfully by the UK judicial system in the Bell case, and the claim that 1000 families were ready to sue the clinic that was made in August 2022 can be questioned by the recorded numbers of patients who were prescribed puberty blockers or cross-sex hormones following a referral by GIDS. Oh, and it didn’t happen in 2022, 2023 and the last comments made publicly were to the same British newspaper the initial claim was made to, as outlined above.

The Toxic Debate

When the ‘toxic debate’ about trans rights is discussed, it’s not just billionaire authors making extremely unpleasant social media posts or local “researchers” claiming “...I feel the kindest thing I can do is to remain sceptical that transitioning is ever a solution or that anyone is actually transgender” which is a very polite way of saying something extremely unpleasant about trans people.

That a dubious claim made by a lawyer seeking business could be the prompt for round-the-world media coverage is pretty disturbing if considering the media’s ability to critically appraise its sources.

I responded to the Newsroom piece in 2022, and the first draft of this highlighted that the Telegraph had a long history of publishing press-releases on behalf of the anti-trans movement and that British media as a whole is recognised elsewhere as being remarkably anti-trans. I was advised to ease off on this angle and try something a little more focused by the editor of Newsroom, Mark Jennings.

So I did the research, I found the studies, I even answered the questions that had been posed in the original piece about how New Zealand’s gender health care system is set up. I went and found the documents which show how our system works, which are available to the public to view. It ended up being a lot longer than the original op-ed I was responding to, as it had a lot more evidence behind it.

It received a 900+ word complaint which Newsroom sent onto me to respond to. Which I did, exhaustively, including highlighting where the complainant had deliberately edited statements made by AusPATHA to make a false claim, and in one case fabricated a quote entirely and claimed it was from the Interim Cass report. I backed up my opinion with evidence, and it and the complaint are here.

I never heard from Mr Jennings or Newsroom after that, and the complainant did not take the complaint on to the Media Council.

The burden of proof

The big issue here is that the whole sequence of events, especially in the New Zealand media, required those who are broadly supportive of gender healthcare (including more research and provision) to fact-check those who are broadly opposed to it.

The original op-ed in Newsroom asked whether people should be concerned about the 1000 families, whether or not New Zealand’s system was set up like the UK’s and why the media wasn’t covering, in detail, the issues with the UK healthcare system.

Now, GIDS stating there had been 1000 endocrinology referrals in the last decade, was published a week before that op-ed was. The information on what NZ’s gender healthcare system looks like is available on their website, including all the consent forms and information for patients to support making their decisions. So, how did this op-ed with its “concerns” get published, if the concerns could be addressed with a quick web-search?

Then having responded in full to the points raised in that op-ed, the complaint which came in required even more evidence and fact-checking - including pointing out where the complainant had deliberately truncated or fabricated statements to support their anti-trans point of view.

At every point, those who are supportive of the trans community and their rights to healthcare and support, are forced into fact-checking the wild claims of their opponents - be they outright lies, deliberate distortions of facts or the “just asking questions” or “raising concerns” which is always a neat way of spreading a bit of fear about the community, and often have absolutely no basis in fact whatsoever.

Conclusion

I am grateful that the New Zealand media environment is not quite as insanely toxic as the UK. I am very aware that recent coverage of trans healthcare that has centred the experiences of trans people, their families, and practitioners has upset the NZ anti-trans movement considerably. That sort of coverage is proportionally non-existent in the UK when compared to the deluge of articles with the source provenance equal to Mr Thomas Goodhead.

However the UK media was not always as bad as it currently is, and the occasional attempts by the anti-trans movement to espouse the sort of rhetoric which deliberately seeks to delegitimise the trans community and their supporters is something everyone should be aware of and alert to. 

It does feel many media outlets use op-eds as a way to fill space, without having to undertake any rigour in journalistic ethics. The recent Media Council decision around a Stuff columnist’s remarkable erasure of the Israeli occupation of the West Bank was a rare case of the Council going “yes, ok, that’s too far”.

The idea that trans existence can be debated, in the same way that trans people’s rights to accurate documentation was debated, or trans people’s right to play community sport was debated, does not lend itself well to a discussion by opposing op-eds. Especially if one side is held to a higher standard of proof than the other, or one side (hello anti-trans activists) clearly spend more time thinking about trans people than literal trans people do.

If one side is spouting misinformation, distortion and bigotry - and the other has to patiently fact-check the misinformation, present the reality and try and calmly oppose bigotry without being accused of being ‘just as bad’ for getting angry, then the scales are already unbalanced.

In the last few weeks the NZ Herald has republished in full, an anti-LGBTQI screed delivered by Brian Tamaki which hits every single issue the anti-trans and anti-LGBTQI movement holds dear. Once this rhetoric spreads, it can become extremely corrosive and outright dangerous for the community. 

When the Ministry of Health publishes its evidence brief on puberty blockers, and its position statement on their use, in the next weeks or months, voices targeting the trans community will become louder, will appear in the mainstream media, and the same misinformation and fearmongering will be out there.

I advise those who are willing and able to speak publicly to prepare to do so, and for everyone to ensure they take care of themselves during what may prove to be a difficult time.

Postscript: A few of the links above link to places like the UK Free Speech Union, or Yascha Mounk’s horrible blog. I’m aware that these aren’t good places, but they did provide the statements Mr Goodhead made which are behind a paywall and Ms Bell’s own account of her treatment - and I felt they were too valuable not to include here.

You can find the Cass Final Report here, to check my references above: https://cass.independent-review.uk/home/publications/final-report/

John Palethorpe works in communications and media in Te Waipounamu.