International › UK · Last reviewed 2026-05-16

United Kingdom — Tavistock GIDS

Summary

The Tavistock and Portman NHS Foundation Trust ran the Gender Identity Development Service (GIDS), the largest English-language gender clinic, from 1989 until its closure in March 2024 on the recommendation of the Cass Review. Annual referrals rose from 51 in 2009 to over 5,000 in 2021. NHS England in March 2024 restricted routine prescribing of GnRHa, pending further research.

1. History of GIDS

Year	Event
1989	Founding of GIDS, St George's Hospital
1996	Move to Tavistock and Portman NHS Trust
2011	Start of "Early Intervention Study" (GnRHa under 16)
2014	Implementation of GnRHa as routine care
2020	Bell v Tavistock (first ruling)
2022	Cass interim report; announcement of closure
2024	Closure of GIDS; opening of regional hubs

2. Referral figures

Referrals to GIDS rose from 51 in 2009 to about 5,000 per year in 2021–22. Demographic shift: in 2010 MtF referrals were in the majority; from 2014 natal-female referrals became dominant, especially in the 11–16 age group.¹

3. Replication studies of the Dutch Protocol

Tavistock GIDS made two attempts to replicate the Dutch outcomes: Costa et al. (2015, n=201) and Carmichael et al. (2021, n=44, "Early Intervention Study"). Both studies found no significant psychological improvement over psychological support alone. See /studies/replication-attempts/.

4. Cass Review and NHS policy

The Cass Review (2020 interim; 2024 final) concluded that the evidence base was insufficient to support routine GnRHa treatment outside a research setting. NHS England in March 2024 withdrew the standard funding for GnRHa in gender dysphoria.² Hormone treatment with cross-sex hormones for minors remains possible from age 16, within a national protocol.

5. Bell v Tavistock

The case Bell v Tavistock (2020) was the first judicial review of puberty suppression. See /debate/legal-cases/.