Dozens of under-5s have been referred to the controversial NHS transgender service as officials consider introducing a minimum age for referrals

• Over 70 children have been sent to the Gender Identity Development Service 

More than 70 children aged three and four have been sent to the controversial NHS transgender clinic, it can be revealed.

The pre-schoolers were among 382 youngsters aged six and under referred to the Gender Identity Development Service (GIDS) over the past decade, official figures show.

Campaigners say they never should have been put forward by doctors or parents for psychological assessment at such a young age.

Health Service bosses are now considering introducing a minimum age of seven for future patients on the grounds that younger children are unable to communicate meaningfully with medics about wanting to identify as the opposite sex.

A new consultation by NHS England also acknowledges that little boys showing an interest in girls’ clothes or toys, or vice versa, is ‘reasonably common’ and ‘usually not indicative of gender incongruence’.

It comes ahead of a long-awaited final report by consultant paediatrician Dr Hilary Cass, which is expected to make further far-reaching recommendations about transgender services for young people after her interim study led to GIDS being ordered to shut down. 

The Government is also trying to stop the spread of contentious gender identity ideology in schools, with equalities minister Kemi Badenoch declaring that teaching children they can be born in the wrong body is harmful.

The GIDS clinic, run by the Tavistock and Portman NHS Foundation Trust in north London since 1989, had no lower age limit on referrals – but not all were accepted or led to treatment being provided.

Statistics produced by the trust show the astonishing growth in numbers of young people seen there over the past decade, from 136 in 2010-11 to 3,585 in 2021-22.

Further details show that 12 three-year-olds were referred to the clinic over that period, along with 61 four-year-olds, 140 five-year-olds and 169 six-year-olds.

The NHS trust that runs GIDS stressed no three-year-olds would have received ‘treatment’, with staff normally holding a ‘one-off discussion’ with parents or carers to provide support and advice.

But former health minister Jackie Doyle-Price hit out at the clinic last night, saying: ‘They should never have been seeing three-year-olds.

‘There needs to be a clear message that goes out to let kids be kids. Let them play and use their imaginations. We shouldn’t be medicalising something which is just growing up.’

She said part of the problem with GIDS was that activist groups were referring children, rather than only doctors.

‘There should only be a medical pathway for referrals in future,’ she said.

Stephanie Davies-Arai of campaign group Transgender Trend said: ‘Children really don’t need gender clinics. Unfortunately, some parents are now worried that their gender non-conforming child may have been ‘born in the wrong body’ and need professional help. This has been pushed by transgender activists who have no understanding of perfectly normal childhood developmental stages.’

She said the new minimum age of seven may seem like an improvement but warned: ‘The problem is that by that age, the parent may have ‘socially transitioned’ their child for years so the child arrives at the clinic fully convinced they are really the opposite sex.

‘What’s really needed is sensible training for all NHS health professionals who can advise parents on ways to support their child to be happy as they are, without the need for future hormones or surgery.’

Conservative MP Nick Fletcher, a leading campaigner against pupils being allowed to change their names, pronouns and uniforms in the classroom, said: ‘It is tragic that their parents would not have known that the clinic was using treatment approaches biased towards affirmation and unsupported by rigorous evidence.

‘We have not even begun to understand how gender ideology managed to get such a strong grip on the NHS – including the Adult Gender Clinics which are seeing vulnerable teens and young adults and which have, to date, escaped the close scrutiny of, for example, the Cass Review. We need to turn a spotlight on this in the New Year. Our NHS must be driven by science and evidence – not ideology.’

A spokesman for the Tavistock said: ‘The GIDS pathway provides psychological assessment, treatment and support for families, so we are unable to provide figures on those who have undergone physical interventions.

‘The outcome of gender identity development in younger pre-pubertal young people is uncertain and so ‘treatment’ is not provided.

‘Most often there would be a one-off discussion with the parents/carers to provide support and advice.’

All of the under-sevens referred to GIDS could be deemed ineligible under its replacement, two regional hubs which are due to open their doors from April.

From now on, only NHS general paediatric services or young people’s mental health services will be able to make referrals to the national waiting list after a backlog of 8,000 built up under GIDS.

A consultation on the new service, published by NHS England earlier this month, stated that some people think the current lack of minimum age results in ‘unnecessary and inappropriate referrals being made’.

It said: ‘For example, we know that showing an interest in clothes or toys of the opposite sex – or displaying behaviours more commonly associated with the opposite sex – is reasonably common behaviour in childhood and is usually not indicative of gender incongruence.’

It proposed a ‘minimum age threshold of seven years for referral into the service’ as ‘by this time children may have more developed their cognitive, comprehension and communication skills to an extent that they will be able to engage with health professionals in the process of a holistic clinical assessment and formulation’.

But NHS England add that it ‘welcomes views on this proposal including the evidence that may support an alternative lower or higher minimum age threshold’.