Name: NHS兒童性別診所。工作人員的擔憂可以追溯到十多年前 - BBC新聞之夜 (NHS child gender clinic: Staff concerns date back more than a decade - BBC Newsnight)
Uploaded: 2020-10-23T20:20:52.000Z
Duration: 9 min 29 s

a gender identity development service at London's Tavistock Comportment Trust, is England's only NHS specialist service for young people questioning their gender identity.

倫敦Tavistock Comportment Trust的性別認同發展服務，是英格蘭唯一的NHS專門為質疑自己性別認同的年輕人提供的服務。

In June, Newsnight revealed that serious safeguarding concerns have been raised by some staff of Jed's during an official review in 2019.

6月，《新聞晚報》透露，在2019年的官方審查中，傑德的部分員工提出了嚴重的保障問題。

We've now learned that some of the worries voice during that review were not new.

我們現在已經瞭解到，在那次審查中，有些擔心的聲音並不新鮮。

There had been another review of the service in 2000 and five by the trust's then medical director, Dr David Taylor.

2000年，該信託基金當時的醫療總監大衛-泰勒博士又對該服務進行了一次審查，並進行了五次審查。

It was triggered by a nurse working at the units to Evans.

這是由一名在組織、部門工作的護士向埃文斯引發的。

She was troubled about what she was seeing.

她為自己所看到的一切感到煩惱。

My experience of working with most of the young people was that once you assess them and found out more about them, they had complex backgrounds.

我與大多數年輕人合作的經驗是，一旦你對他們進行評估，發現他們的背景很複雜。

It wasn't just the gender dysphoria they, some of them had bean sexually abused.

這不僅僅是他們的性別差異，他們中的一些人曾被性虐待。

Some of them had been traumatized in their only life.

他們中的一些人在唯一的生活中受到了創傷。

There were other clinicians who seemed confident that they could see someone for about four to successions and then refer them on for hormone treatments.

還有一些臨床醫生似乎很有信心，他們可以給人看病，大約四到連續，然後轉診他們進行激素治療。

And I just couldn't understand that a satisfactory assessment or any attempt at therapeutic work had been carried out.

我只是不明白，是否已經進行了滿意的評估或任何治療工作的嘗試。

Newsnight has obtained a copy of that 2000 and five review.

新聞晚報》獲得了該2000年和五評的副本。

Taylor stresses that staff were doing all they could to help the patients, who were often very distressed.

泰勒強調，工作人員正在盡其所能幫助病人，他們往往非常痛苦。

But his report went on to detail several areas he believed needed addressing.

但他的報告詳細介紹了他認為需要解決的幾個領域。

He noted that many Children referred to the service had suffered trauma or have mental health problems.

他指出，許多被轉介到該服務機構的兒童都遭受過創傷或有精神健康問題。

Staff face pressure to comply with demands from patients and their parents to be referred for puberty blocking medication.

工作人員面臨著壓力，要滿足患者及其家長的要求，轉診服用青春期阻斷藥物。

There wasn't a robust evidence base underpinning this treatment on staff disagreed about the best way to treat these young people.

工作人員對對待這些年輕人的最佳方式意見不一，沒有一個強有力的證據基礎來支持這種治療。

The implications for this other young people might not have had other issues addressed before making a potentially life changing decision to go into puberty blocking drugs.

這對其他年輕人的影響可能沒有解決其他問題，然後再做出可能改變生活的決定，進入青春期阻斷藥物。

Thes concerns are strikingly similar to those raised by staff in recent years.

這些問題與工作人員近年來提出的問題驚人地相似。

The service was much smaller in 2000 and five, receiving tens of referrals rather than thousands, and did not contribute significantly to the Tavistock trusts finances.

該服務在2000年和5年的規模要小得多，接受的轉診人數只有幾十人，而不是幾千人，而且對塔維斯托克信託基金的財政貢獻不大。

Young people had to be 16 before referral for puberty blockers.

年輕人必須在16歲時才可轉診服用青春期阻斷劑。

Now they could be as young as nine, and yet there are still questions about the evidence base.

現在他們可能只有九歲，然而證據基礎還是有問題。

The findings of the 2000 and five review have never been made public, and getting sight of them hasn't been easy.

2000年和五次審查的結果一直沒有公開，要看到這些結果並不容易。

In May 2019 Newsnight requested a copy of Dr Taylor's review using the Freedom of Information Act.

2019年5月，《新聞之夜》利用《資訊自由法》要求獲得泰勒博士的審查報告副本。

The Tavis stock declined, arguing its disclosure could adversely impact on the trust's ability to provide effective and safe services to its patients.

泰維斯股票下跌，認為其披露的資訊可能會對信託公司向患者提供有效和安全服務的能力產生不利影響。

We appealed in July 2019 and, when refused again, went to the information commissioner's office in October.

我們在2019年7月提出上訴，再次被拒絕時，10月到資訊專員辦公室。

In August 2020 the CEO ruled that it was in the public interest to disclose the document, saying patients, prospective patients and their families should be able to see this information.

2020年8月，首席執行官裁定披露該文件符合公眾利益，稱患者、潛在患者及其家屬應該能夠看到這些資訊。

We received the report a few weeks later.

The recommendations made by Dr Taylor were, in his words, not rocket science, he says.

他說，泰勒博士提出的建議，用他的話說，不是火箭科學。

They reflect core principles of clinical practice on could be applied toe any part of medicine.

它們反映了臨床實踐的核心原則，可以應用到醫學的任何部分。

You call for the service to follow up all its patients for more research in this area of health care and for staff to be supported if they came under pressure to refer for a treatment they thought was inappropriate.

你呼籲服務部門對所有病人進行跟蹤，以便在這一保健領域進行更多的研究，如果工作人員受到壓力而轉診他們認為不合適的治療，他們應該得到支持。

Dr Taylor said that puberty blockers might be an appropriate course of action for some, But all young people needed exploratory therapy first looking at the report today that was written 15 years ago in those years, the missed opportunity for me is that Dr Taylor recommended there should be clinical audit, better understanding developed of gender dysphoria in young people.

泰勒博士說，青春期阻斷劑對一些人來說可能是一個合適的行動方案，但所有的年輕人都需要探索性治療首先看今天的報告，那幾年寫的是15年前的報告，對我來說，錯失的機會是泰勒博士建議應該進行臨床審計，更好地瞭解年輕人的性別不同步。

Research should be woven into the work of the clinic, and I really don't think listening to the more recent reports about the cleaning I I really can't here that that has gone on sufficiently.

研究應該交織在診所的工作中，我真的不認為聽了最近關於清潔的報道，我我真的不能在這裡，已經充分地去。

Last year, Evans initiated Judicial Review proceedings against kids arguing under Eighteens cannot give informed consent to puberty blockers, where not enough is known about what they do.

去年，埃文斯對孩子們發起了司法審查程序，認為八歲以下的孩子不能對青春期阻斷劑給予知情同意，在那裡對他們的作用還不夠了解。

The perception that Jude's could have done things differently has angered some staff.

認為裘德氏可以採取不同的做法，這激怒了一些員工。

Kirsty Entwistle, left Kids leads in 2018.

Kirsty Entwistle，2018年左孩子們領先。

She's not spoken publicly before but is a witness against the service in the upcoming judicial review.

她以前沒有公開發言，但在即將到來的司法審查中，她是反對服務的證人。

I left the service kind of wondering why me like, why did I have, like, such a strong reaction and then and then you know, it takes away this time, and I find out that there's a these clinicians in London who had the same concerns as me, and and then you find out what actually, you know, people have been having these concerns about the service for years.

我離開了服務那種想知道為什麼我喜歡，為什麼我有一樣，這樣一個強烈的反應，然後，然後你知道，它需要離開這個時候，我發現，有一個這些臨床醫生在倫敦誰有同樣的關注，我，然後你發現其實，你知道，人們一直有這些關注服務多年。

You know, just seems like it's more convenient just to plow on, because I think the concerns that people are raising, you know, require a fundamental reorganization or a fundamental rethink off what's going on here.

你知道，只是似乎它更方便 只是犁上， 因為我認為人們的關注 提出，你知道，需要一個基本的重組 或基本的反思 關閉什麼是怎麼回事。

Taylor, a psychiatrist who worked at the tavern Stock for 30 years, wrote in his review that some of what he'd suggested would likely be resisted by some patients and patient organizations.

泰勒是一位在酒館股票工作了30年的精神病學家，他在評論中寫道，他所建議的一些內容很可能會受到一些患者和患者組織的抵制。

He recognized that this could lead to a fall in referrals.

他認識到，這可能導致轉診率下降。

If you try to set out to please or comply with someone, whether your apparent or a clinician, then you won't be helping.

如果你試圖著手討好或順從某人，不管是你的表象還是臨床醫生，那麼你不會有任何幫助。

It's very important that you keep an independent perspective, but I do think that maybe the service, as it developed to some extent, lost its compass in those respects, so I would.

你保持一個獨立的視角是非常重要的，但我確實認為，也許服務，因為它發展到一定程度，在這些方面失去了它的指南針，所以我會。

The demand for these services was greater than the capacity off the unit to cope to cope by maintaining its standards off thoughtful mental health care, which considers all the factors biological on social.

對這些服務的需求大於該組織、部門的應對能力，以維持其周到的精神保健標準，考慮到所有生物和社會因素。

Andi, he say's the setting in which the service was working society.

安迪，他說的是服務工作社會的環境。

Shifting attitudes towards gender identity on the lack of alternative provisions are also important.

對缺乏替代性規定的性別認同的態度轉變也很重要。

Many patients would have been better served, referred to other services.

許多病人本來可以得到更好的服務，轉到其他服務機構。

But underfunding of child and adolescent mental health services made that impossible.

但是，由於兒童和青少年心理健康服務資金不足，使得這一點無法實現。

Over the last 14 months, Newsnight has looked at the uncertainties about treatments given to young people questioning their gender identity.

在過去的14個月裡，"新聞之夜 "關注了對質疑其性別認同的年輕人進行治療的不確定性。

We've also revealed allegations that safety concerns weren't taken seriously enough.

我們還透露了有關安全問題沒有得到足夠重視的指控。

Last week, the NHS announced an independent review into gender identity services for young people.

上週，NHS宣佈對年輕人的性別認同服務進行獨立審查。

I think that's Ah, a very, very good development and entirely the right way forward Andi, because those those reviews are arenas that are more public, in which the kind off discussions and debate that we're talking about can go on.

我認為這是啊，一個非常，非常好的發展和完全正確的方式前進安迪，因為這些這些審查是舞臺，更公開，在其中的那種關閉討論和辯論，我們正在談論可以去。

15 years after Dr Taylor's report, key issues at the heart of service provision for young people questioning their gender identity are still being debated.

泰勒博士的報告發表15年後，為質疑自己性別身份的年輕人提供服務的核心關鍵問題仍在爭論之中。

The question now is, will this review bring some resolution zone?

現在的問題是，這次審查會不會帶來一些決議區？

Newsnight put the issues raised in their report to the Taba stock, who responded by saying, This report from 2000 and six is not relevant to the circumstances and issues faced by Jin's.

新聞晚報》將報道中提出的問題向塔巴股份提出，塔巴股份迴應稱，2000年和6年的這份報道與金氏面臨的情況和問題無關。

That's the Gender Identity Development Service today, they continued.

這就是今天的性別認同發展處，他們繼續說道。

While the demand for the aged service has increased markedly since 2000 and six, each young person does receive ah, highly personalized service from Jim's Clinicians that we're sorry that this is now delivered after a longer wait than we'd like.

雖然自2000年和6年以來，老年服務的需求明顯增加，但每個年輕人都會得到啊，高度個性化的服務，從吉姆的臨床醫生，我們很抱歉，這是現在交付後，比我們希望更長的等待。

It has recently been announced that Dr CASS will lead a wider review of the care provided to gender questioning young people.

最近宣佈，CASS博士將上司對向有性別問題的年輕人提供的照顧進行更廣泛的審查。

We welcome this and hope this will lead to better and quicker access to support for these young people.

我們對此表示歡迎，並希望這將使這些年輕人更好、更快地獲得支持。

Some of the young people we see in the service experience difficulties which may or may not be related to gender dysphoria.

我們在服務中看到的一些年輕人遇到的困難可能與性別不平等有關，也可能無關。

 Kids is a specialist service and relies on integrated care model, in which it works closely with local cams to support ongoing difficulties. 

孩子們是一項專業服務，依靠綜合護理模式，與當地的凸輪緊密合作，支持持續的困難。