Dr James Palmer

Medical Director for Specialised Services

NHS England

PO Box 16738


B97 9PT


Dear Dr Palmer,

On December 22nd, 2020, we wrote to you in your capacity as Medical Director for NHS Specialised Services regarding the panic and distress being caused by the determination against The Tavistock and Portman NHS Trust.

We highlighted the fact that the lack of clarity provided to trans youth and their families, on whether or not they will be able to access care moving forward, was causing extreme distress. We also appealed to you to take steps to provide clarity to alleviate this distress.

We never received a response.

As the appeal draws nearer, families live in hope that the ruling will be overturned, that the needs of their loved ones will be taken into account and that their voices will be heard.

It is a national scandal that trans youth are being left out on a limb. Proven treatments are being discounted, medical professionals do not know what to do for the best – help and risk the associated backlash or ignore the problem and hopefully it will go away.

It will not go away.

We urgently request that you provide some clarity and guidance so that young people and their families can access the care they need to live a normal life – which I am sure you will agree is their basic human right.

We request:

  1. A statement from you on the current status of service provision to trans youth.
  2. Clear expectations of specialists who are commissioned to provide this care.
  3. Clear guidance to General Practitioners and other healthcare professionals who are currently supporting the psychological and medical care of transgender children and adolescents.
  4. An investigation into why the clinical protocols and evidence of qualitative care were not able to reassure the court that patients could safely consent to a treatment that is standard practice in centres for the care of trans youth across the world.
  5. Interim solutions to prevent harm.


Yours sincerely

Katie Tiplady-Startin

Chief Operating Officer