Getting referred to the Gender Identity Development Service (GIDS)

To be seen by a gender specialist within the NHS, a young person needs to be referred to the Gender Identity Development Service (GIDS). The GIDS accepts referrals from Child and Adolescent Mental Health Service (CAMHS) as well as other health, social care, and education professionals, including directly from GPs. GIDS national contract covers referrals from England, Scotland and Northern Ireland. For referrals from Wales or from any other country or territory, funding confirmation is required (GIDS, 2020).

Parents and carers we spoke to had a range of experiences of the referral process. Whilst for some getting their young person referred was easy and quick, others encountered difficulties and unhelpful or uninformed health care professionals. Parents also spoke about the different ways a young person can be referred.

Getting referred by CAMHS

Kate talks about her son’s referral to the Gender Identity Development Service (GIDS) via Child and Adolescent Mental Health Service (CAMHS).

Getting referred by the local Child and Adolescent Mental Health Service (CAMHS) is one way that a young person can access specialist services that are delivered by the Gender Identity Development Service (GIDS). The GIDS lists a referral from CAMHS as their preferred route, because a holistic assessment of the young person is undertaken by CAMHS. However, this isn’t always understood by CAMHS and some families struggle to get referrals through CAMHS.

Most children whose parents we spoke to, who were referred to the GIDS by their local CAMHS, were already receiving support from CAMHS. Ross talked about himself and his child’s mother attending CAMHS with their child separately on different occasions before being referred on to GIDS.

The young person can be referred to CAMHS for issues that are not immediately related to their gender identity and they might also not readily disclose that gender identity as something that needs addressing. Lesley’s son was struggling with self-harm and suicidal ideation. However, because Lesley felt that gender identity was a central issue for her son and she was very concerned about her son’s mental health, she ‘specifically asked CAMHS to refer’ him to the GIDS. Another parent shared that a psychiatrist her son was seeing highlighted gender identity as key to the young person’s mental health. They emphasised: ‘this psychiatrist, thought the gender stuff was a big issue, He said, I think he’s on the right medication for the anxiety and the depression, but he said, ‘I think the gender stuff is, is a big issue,’.

CAMHS could be a step in the referral process to GIDS. Andrew’s daughter was referred to CAMHS specifically to get a referral to the gender identity services ‘GP had to refer [my daughter] to CAMHS. And then CAMHS refer to [GIDS]’ This meant that there were additional waiting times.

Andrew felt his daughter’s referral via Child and Adolescent Mental Health Service (CAMHS) was straightforward.

In a few cases, getting a referral by CAMHS was complicated by what parents saw as an unhelpful response from the service. Ali said she had tried to get her daughter referred through her local CAMHS, who were already supporting her daughter, but was told ‘that they didnt handle things like that.’ Whilst her daughter was eventually referred by her GP, this increased the overall waiting time before she could see a gender specialist. Ali also felt disappointed with the lack of support from CAMHS whilst her daughter was on the waiting list to the GIDS, but she put that down to CAMHS shortage of funds.

Ali talked about her experiences of her daughter’s referral to the Gender Identity Development Service and how she felt her daughter was cut loose and left to float’ by the Child and Adolescent Mental Health Service.

One parent experienced difficulties when a referral went to both CAMHS and the GIDS at the same time. Adele, whose son was not in the care of CAMHS at the time of referral, spoke about her experience of unsuccessfully trying to access support from CAMHS. She shared that ‘the GP wrote the referral to both the [Gender Identity Development Service] and to CAMHS. And CAMHS came back and said, ‘No, we are not gonna accept him, because actually he needs to be at the [Gender Identity Development Service].’ And, we were like, ‘Okay. Are you sure?’ So we actually went and asked again and said, ‘Can he come and see you? I think maybe that would be a useful thing.’ And then, they came wrote back again, ‘No, no, absolutely no, we are not gonna see him.’ And he can be at the [Gender Identity Development Service].’

Read more about people’s experiences of CAMHS.

Getting referred by a GP

Many young people, whose parents we spoke to were referred to the specialist gender identity services by their GP. Their parents and carers shared both positive and negative experiences of this process with us.

For some, like Leigh, a GP’s previous experience working with trans patients meant that they were familiar with the referral process. Leigh observed that her foster son’s GP had been ‘super helpful’ and ‘knew to refer straight to the [Gender Identity Development Service].’ Similarly, Mel said about her stepdaughter’s referral that ‘the GP was pretty good’ and shared: ‘I think what had happened is that someone else either in the area that they lived, had just gone through it who was quite a prominent, whether it was a teacher or it was another doctor. Their child was going through it. So, they [the GP] were fairly clued up, I think, if I remember this rightly and put the referral in.’

Other parents spoke about the GP being inexperienced, but nonetheless willing to help and educate themselves to support the referral process. Both Josie and Georgina appreciated the proactive attitude of their GPs in finding out how to put in the referral for their children.

Georgina said the GP was helpful and proactive in getting the referral done, despite not having prior experience and needing to do some research.

Josie appreciated the honesty of her GP and his willingness to find out about the referral process.

Not everyone had a positive experience of the referral process with their GP. One parent said her and her partner were met with disbelief from their GP who didn’t think a young child could have significant gender issues. She also felt the GP was dismissive and ‘not keen at all to do a referral’ for their daughter.

Lisa felt her GP ‘was obviously unsupportive of our difficulties’. Lisa wanted a referral directly to GIDS but instead her GP insisted referring via CAMHS as they believed this was the best protocol to follow. She felt that her GP didn’t really understand their situation or listen to her.

Lack of familiarity with the existing referral process was also something that Oonagh emphasised when she shared that the GP ‘was going to take [the referral] to a panel to decide whether that was gonna be the case.’ She emphasised that ‘our experience is that you needed to do your own research to prove to the GP, what they needed to do. Felt like you had to make a case for referral.’ This can be a barrier for people seeking a referral as not everyone is equipped with the knowledge around referrals to be able to guide their GP.

Interview 1 felt her GP was uneducated and dismissive and reluctant to refer her young daughter to the Gender Identity Development Service.

The GP’s lack of familiarity with the referral process was a concern for Oonagh.

Parents of young adults were understandably less involved in the referral process than parents of children who were under the age of 16. However, E spoke about supporting her son by paying to see a gender specialist privately. Her son was referred through his university GP to Gender Identity Services. But the waiting list was about four years and she felt this was unacceptable and worried about her son’s mental health.

Find out more about parents and carers experiences with the GP.

Getting referred through another route

Whilst the majority of young people whose parents and carers we spoke to were referred via CAMHS or the GP, some were referred via a different route. Lisa, whose GP refused to refer her son, said she contacted the charity Mermaids and the charity offered to refer him.

Read more about Mermaids and other sources of support for parents.

Find out what the people we spoke to had to say about their experiences of seeing GIDS.

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