Whistleblower who raised fears about the health and safety of patients at NHS Tavistock sues clinic

A whistleblower who raised concerns about the health and safety of patients at the UK’s only gender identity development service is suing them at a tribunal today.

Sonia Appleby is claiming she was ‘subjected to detriments’ by the controversial Tavistock and Portman NHS Trust after she made the warnings.

Her action against the trust – which has been crowdfunded to the tune of some £117,000 online – begins at the Central London Employment Tribunal this morning.

Ms Appleby, who is still the safeguarding lead at the hospital group, alleges that Tavistock misused procedures to ‘besmirch her’ and jeopardize safety.

She is also claiming there was an unwritten directive from management that safeguarding concerns should not be brought to her and clinicians were discouraged from reporting to her.

It comes six months after Kiera Bell, a 23-year-old woman treated there, was victorious in a High Court action against the trust which saw judges rule children under 16 are unlikely to be able to give ‘informed consent’ to take puberty blockers.

MailOnline has contacted Tavistock about Ms Appleby’s claims but has not yet received any response. It is understood they deny her allegations.

The employment tribunal is unusual in that the complainant is still working for the body she is targeting with legal action.

Sonia Appleby is claiming she was 'subjected to detriments' by the controversial NHS trust

Sonia Appleby is claiming she was 'subjected to detriments' by the controversial NHS trust

Sonia Appleby is claiming she was ‘subjected to detriments’ by the controversial NHS trust

The employment tribunal is unusual in that the complainant is still working for the trust

The employment tribunal is unusual in that the complainant is still working for the trust

The employment tribunal is unusual in that the complainant is still working for the trust

While the case officially starts this morning, it is a reading day so evidence will not begin to be heard until tomorrow.

Ms Appleby’s crowdfunding page explains: ‘I am currently the Named Professional for Safeguarding Children and the Safeguarding Children Lead at the Tavistock and Portman NHS Foundation Trust. I am therefore still employed by the Trust against which I am bringing my claim.

‘I lodged a whistle-blowing claim in November 2019 at the Central London Employment Tribunal. Since then I have made two applications to amend my claim as new information came to light.

‘In my claim, I allege that because I made “protected disclosures” to my line manager regarding concerns raised by Gender Identity Development Service staff – that the health or safety of patients was being, had been or was likely to be endangered – I was subjected to detriments.’

She added: ‘I want it known that I have always supported the availability of a gender identity service for children, adolescents, adults and their families, and staff who deliver these services, but like other NHS services, the National Gender Identity Service, in doing its work, needs to be transparent and open to safeguarding commentary regarding the delivery of its services.

Keira Bell, 23, who began taking puberty blockers when she was 16 before 'detransitioning'

Keira Bell, 23, who began taking puberty blockers when she was 16 before 'detransitioning'

Keira Bell, 23, who began taking puberty blockers when she was 16 before ‘detransitioning’

Psychiatric nurse reveals Tavistock referred children for medication in ‘quick’ process

Susan Evans, who was previously employed by the Tavistock as a psychiatric nurse, previously said she hoped for a ‘change their attitude’ at the NHS trust.

She said: ‘It was just to ensure that there was a sort of pause on what’s currently happening with this kind of, at times quick, process towards a medicalised treatment and to allow more time for assessment and psychological treatments for young people.’

She added: ‘I’m hoping now that they will be asked to take serious steps towards addressing their treatment protocols… Certainly what is not going to happen is children won’t go to the Tavistock and after two or three appointments be referred for medication, which is what was happening, despite their denials.’

Asked about whether the ruling would have an impact on transgender adults, Ms Evans said: ‘Generally, this is just my clinical opinion, is that really anyone who considers taking steps to transgender should certainly examine their kind of emotional world, their mental state before progressing to something physical and taking those steps, you shouldn’t do any of that without (a) kind of consideration and investigation.

‘I certainly think that if you’re going to alter your body, and make adjustments to your body, that it’s worth, whether you go on to do it or not, taking steps in that way.’

An NHS spokesperson said: ‘We welcome the clarity which the court’s decision brings. 

‘The Tavistock have immediately suspended new referrals for puberty blockers and cross-sex hormones for the under 16s, which in future will only be permitted where a court specifically authorises it. 

‘Dr Hilary Cass is conducting a wider review on the future of gender identity services.’ 

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‘This is not an “anti-trans” case. I am supportive of the transgender community and their right to seek services that are both supportive and safe.’

In December campaigners celebrated a victory for ‘common sense’ after the High Court ruled children under 16 were unlikely to be able to give ‘informed consent’ to take puberty blockers.

The ruling came after Keira Bell brought legal action against the Tavistock and Portman NHS Trust.

Ms Bell began taking puberty blockers when she was 16, was injected with testosterone at 17 and had a mastectomy aged 20, before ‘detransitioning’. 

She claimed she was treated like a ‘guinea pig’ at the clinic, and said doctors failed to carry out a proper psychiatric assessment and should have challenged her more over her decision to transition to a male as a teenager. 

The judges said in their ruling: ‘It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers.

‘It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blockers.’

Speaking outside the Royal Courts of Justice, Ms Bell said she was ‘delighted’ with the High Court’s ruling.

She said: ‘This judgment is not political, it’s about protecting vulnerable children. I’m delighted to see that common sense has prevailed.’ 

Though she is now in the process of transitioning back to a woman, she faces further legal hurdles because by law she is now a man, and may be infertile.  

Her lawyers had argued that children going through puberty cannot properly consent to taking puberty blockers.

They said there was ‘a very high likelihood’ that children who start taking hormone blockers will later begin taking cross-sex hormones, which they say cause ‘irreversible changes’. 

The Tavistock and Portman NHS Trust had argued that taking puberty blockers and later cross-sex hormones were entirely separate stages of treatment. 

The trust argued that medical specialists in this field should be able to make calls based on their assessments and claimed it was ‘a radical proposal’ to suggest children did not have the capacity to give consent.

But judges ruled that both treatments were, ‘two stages of one clinical pathway and once on that pathway it is extremely rare for a child to get off it’. 

This means doctors may now seek approval or support from the court before prescribing puberty-blocking drugs to children, to try and avoid liability.

Why did the NHS let me change sex? Keira Bell tells her story in the hope that it will ‘serve as a warning to others’

IT engineer Miss Bell is pictured outside the Royal Courts of Justice in London in January

IT engineer Miss Bell is pictured outside the Royal Courts of Justice in London in January

IT engineer Miss Bell is pictured outside the Royal Courts of Justice in London in January

In an interview earlier this year, Keira told the Daily Mail what happened to her, in order to highlight her plight and, she says, serve as a warning to others. 

Keira was brought up in Hertfordshire, with two younger sisters, by her single mother, as her parents had divorced. Her father, who served in the U.S. military in Britain and has since settled here, lived a few miles away.

She was always a tomboy, she said. She did not like wearing skirts, and can still vividly remember two occasions when she was forced by her family to go out in a dress.

She told the Daily Mail: ‘At 14, I was pitched a question by my mother, about me being such a tomboy. She asked me if I was a lesbian, so I said no. She asked me if I wanted to be a boy and I said no, too.’

But the question set Keira thinking that she might be what was then called transsexual, and today is known as transgender.

‘The idea was disgusting to me,’ she tells me. ‘Wanting to change sex was not glorified as it is now. It was still relatively unknown. Yet the idea stuck in my mind and it didn’t go away.’

Keira’s road to the invasive treatment she blames for blighting her life, began after she started to persistently play truant at school. An odd one out, she insisted on wearing trousers — most female pupils there chose skirts — and rarely had friends of either sex.

When she continually refused to turn up at class as a result of bullying, she was referred to a therapist.

She told him of her thoughts that she wanted to be a boy.

Very soon, she was referred to her local doctor who, in turn, sent her to the child and adolescent mental health service (CAMHS) near her home. From there, because of her belief that she was born in the wrong body, she was given treatment at the Tavistock 

Keira had entered puberty and her periods had begun. ‘The Tavistock gave me hormone blockers to stop my female development. It was like turning off a tap,’ she says.

‘I had symptoms similar to the menopause when a woman’s hormones drop. I had hot flushes, I found it difficult to sleep, my sex drive disappeared. I was given calcium tablets because my bones weakened.’

Keira claims she was not warned by the Tavistock therapists of the dreadful symptoms ahead.

Her breasts, which she had been binding with a cloth she bought from a transgender internet site, did not instantly disappear. ‘I was in nowhere land,’ she says.

Yet back she went to the Tavistock, where tests were run to see if she was ready for the next stage of her treatment after nearly a year on blockers. 

A few months later, she noticed the first wispy hairs growing on her chin. At last something was happening. Keira was pleased.

She was referred to the Gender Identity Clinic in West London, which treats adults planning to change sex.

After getting two ‘opinions’ from experts there, she was sent to a hospital in Brighton, East Sussex, for a double mastectomy, aged 20. 

By now, she had a full beard, her sex drive returned, and her voice was deep.

After her breasts were removed, she began to have doubts about becoming a boy.

Despite her doubts, she pressed on. She changed her name and sex on her driving licence and birth certificate, calling herself Quincy (after musician Quincy Jones) as she liked the sound of it. She also altered her name by deed poll, and got a government-authorised Gender Recognition Certificate making her officially male. 

In January last year, soon after her 22nd birthday, she had her final testosterone injection. 

But, after years of having hormones pumped into your body, the clock is not easily turned back. It is true that her periods returned and she slowly began to regain a more feminine figure around her hips. Yet her beard still grows.

‘I don’t know if I will ever really look like a woman again,’ she said. ‘I feel I was a guinea pig at the Tavistock, and I don’t think anyone knows what will happen to my body in the future.’ 

Even the question of whether she will be able to have children is in doubt.

She has started buying women’s clothes and using female toilets again, but says: ‘I worry about it every time in case women think I am a man. I get nervous. I have short hair but I am growing it and, perhaps, that will make a difference.’ 

By law she is male, and she faces the bureaucratic nightmare of changing official paperwork back to say she is female.

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