BAGIS

Position & Process Statements

BAGIS Statement re: Court of Appeal Ruling 17th September 2021

The BAGIS stands by and welcome the clarity provided by the Court of Appeal’s decision to overturn the High Court judgment that children and young people with gender dysphoria may not be able to consent to puberty blockers. The appeal court judges stressed that it was for the clinicians rather than the courts to decide on the capacity of under 16 year olds to consent to treatment, and that it was ‘inappropriate’ for the High Court to have issued the guidance. The BAGIS holds in the highest regard the competence and expertise of those specialist gender clinicians working with trans youth and their families across the British Isles.

BAGIS Statement re: Judicial Review 1st December 2020

The British Association of Gender Identity Specialists council wishes to express disappointment in the legal judgment which denies the competence and capacity of young transgender people under 18 years of age to consent to hormonal intervention as part of their gender development. It makes a distinction between the self-understanding, bodily autonomy and rights of young trans people and the self-understanding, bodily autonomy and rights of young people who are not transgender. The verdict seems to invalidate the lived experience of trans people and privileges a cisgender outcome over a transgender outcome. The BAGIS is opposed to such discrimination, whenever and wherever it arises. 

The health and wellbeing of trans people is of the highest priority to the BAGIS. We are deeply concerned about the effect the judgement may have on trans people and their lives. The Council has already been made aware of the considerable psychological distress expressed by members of trans youth communities which has arisen as a direct result of the judgement. We implore the government through NHS England and NHS Wales to commit to making support available to children and young people to manage their distress about the outcome of this ruling. 

We await further information regarding appeal of the Judicial Review, and the impact the recent verdict will have on clinical practice and young trans people. In the meantime, the BAGIS council continues to hold clinicians working in the field of trans healthcare across the British Isles in the highest regard and has every confidence in the competence of those specialists working with trans youth. In particular, we wish to express our solidarity and support for those specialists working with trans youth in England and Wales at an extremely challenging time. 

Covid-19: BAGIS position statements

UPDATED RESPONSE – April 2022

The BAGIS continues to support digital, in-person and blended delivery of services across the British Isles, which places safety at the centre. We continue to respond to government policy and health responses to the management of COVID-19 variants, ongoing vaccination and booster programmes.

UPDATED RESPONSE – December 2020 

The BAGIS supports clinical services returning to safe face-to-face interventions in 2021 following roll out of a national vaccination programme for COVID-19. Following data shared by clinical members of the BAGIS representing services across the British Isles at the webinar event 1st October 2020, benefits have been identified to some contexts of remote (digital) consultation. The BAGIS supports developing a blended approach protocol to client interaction commensurate with clinical judgment and evidence based practice.

UPDATED RESPONSE – July 2020

Covid-19 has had a huge impact on the NHS which prioritised its robust response to the pandemic. Some staff were redeployed to assist on the frontline, and it may take some time for clinics to return to their previous capacity. Gender clinicians have provided some remote consultations via digital platforms and telephone to continue to support trans and gender diverse people accessing services.

Whilst lockdown restrictions are easing, risks of rising COVID-19 infection and the possibility of a ‘second spike’ remain. Significant social distancing and risk management are in place within services. Gender clinicians are continuing to offer some remote consultations as well as planning for the resumption of in person consultations.

Fertility services have largely resumed. The following website lists clinics that have received authorisation to resume licensed treatments: https://www.hfea.gov.uk/treatments/covid-19-and-fertility-treatment/coronavirus-covid-19-guidance-for-patients/fertility-clinics-authorised-to-resume-treatment/

The resumption of routine surgery continues to be reviewed. Further information can be found here: https://www.england.nhs.uk/2020/05/nhs-roadmap/

BAGIS members continue to work together to support best practice during the ongoing challenges posed by the pandemic. Our priority remains to provide safe clinical services of the highest quality to trans and gender diverse people.  

INITIAL RESPONSE – April 2020

The Covid-19 pandemic is having a dramatic impact on NHS and independent services across the UK. Routine surgery is not taking place, primary care is under intense pressure, non-urgent bloods are not being taken, and fertility services are unable to offer a full service. BAGIS acknowledges the extraordinary response of NHS services to the crisis, and our members stand in support of frontline health workers and the wider health and social care staff across the UK.​

There is substantial impact upon the NHS and independent trans healthcare pathway. Many staff in NHS gender clinics are being temporarily redeployed into other areas of work to support the Covid-19 crisis strategy.​

BAGIS recognises that trans and gender diverse people receiving treatment need to continue to access support and healthcare advice as necessary. Gender clinicians are committed to providing the best possible support to trans and gender diverse people through this crisis. BAGIS members are currently working together to share practice and develop robust ways to support trans people in this crisis. It is likely, however, that trans people already receiving treatment may experience delays in treatment due to self-isolation or ability to connect with GP and medical services. BAGIS is mindful to avoid placing additional unnecessary strain upon primary and secondary NHS services at this time.

Broad Summary of Services

BAGIS council has been in liaison with adult and young people’s services in the UK at this time. Not all services were available to comment, but below is a broad summary of what is happening during the crisis:​

For the time being face-to-face appointments have been suspended. This is in line with Government advice to restrict travel and enforce social distancing. Gender clinicians are offering support and consultations over the phone and via encrypted video link. Service users will be consented for these ways of consulting. Here is some guidance from the GMC which describes when remote and face-to-face consultations may be preferable: https://www.gmc-uk.org/ethical-guidance/ethical-hub/remote-consultations

Many clinics are not offering new/first appointments until the pandemic eases or resolves.

Trans people receiving treatment may be offered review via telephone and/or encrypted video link, as well as psychological services and voice and communication therapy.

It is not possible to complete gamete storage or obtain routine blood monitoring – therefore initiation or titration of hormones is not possible at this time. Hormone management advice during the COVID-19 crisis (from the London GIC Endocrine Service, Tavistock and Portman NHS Foundation Trust) is available here:  https://gic.nhs.uk/gp-support/issues-around-hormone-therapy-due-to-the-coronavirus-situation/

Referrals for surgery have been paused.

Transfers from young people to adult services will continue where possible as agreed by both services.

BAGIS supports the continuation of as comprehensive support as possible during the pandemic in creative, responsible and safe ways. Members will continue to work together for the benefit of trans healthcare in the UK both now and when this crisis has passed.

Links to specific services websites

Please check with individual clinics and services for specific information. The following gave permission to be published; this is not an exhaustive list.

​Service users in Scotland should refer to their GIC website for information on the services in their local area. Information regarding all Scottish services is provided by the network, NGICNS: https://www.ngicns.scot.nhs.uk

Information regarding services in Ireland can be found at Transgender Equality Network in Ireland (TENI) https://www.teni.ie

For Northern Ireland go to http://www.belfasttrust.hscni.net/GenderIdentity.htm

For services in Wales go to Cardiff Gender Identity Clinic cav.wgs@wales.nhs.uk

The GIDS service continues to offer first appointments and aims to deliver care as usual, albeit remotely. For further information go to https://gids.nhs.uk