There are knowns, as the saying goes, and there are known unknowns. But most difficult of all, perhaps, are the things we can’t know for sure, but must still make definitive judgments about. The latter form the heart of the BBC journalist Hannah Barnes’s densely reported account of events inside the Tavistock Centre’s Gender Identity Development Service (Gids) in London, the country’s only specialist clinic for transgender children, where, as one clinician tells her, it was “impossible to be sure” of getting decisions 100% right, but mistakes had frightening consequences.
The book traces Gids’s evolution from its foundation in 1989 – offering a non-judgmental therapeutic approach to exploring gender identity, and serving a handful of mainly natal boys – to a modern service swamped by demand, much of it from natal girls, providing a gateway for the prescription of puberty-blocking drugs.
