A pilot project to provide gender services in Sussex, rather than having people travel to London, is now halfway through its three-year programme.
Brighton and Hove City Council’s Health Overview and Scrutiny Committee quizzed representatives of Sussex Gender Services about the project at Hove Town Hall on Wednesday (29 January).
The pilot, run by Sussex Partnerships NHS Foundation Trust, has been running for just over a year. It was initially meant to be a two-year pilot but has been given approval to run for a third year and should include an independent evaluation.
So far, more than 300 people have been seen. Consultant clinical psychologist Kat Allen said: “We’re expecting to see around 1,300 service users within the course of the pilot (or) around 40 first assessments a month.”
Dr Allen said that one person had waited seven years to reach the gender services specialist although the aim is a maximum wait of three years.
Councillors were told that once patients were seen by the Sussex Gender Service, they could expect to have two assessments within the service before moving forward with hormone treatment.
Labour councillor Jackie O’Quinn asked about young people and a trend for more teenage girls to seek to transition and the age at which they received care and support.
Dr Allen said that the service specification was for 17-plus but the reality of waiting lists meant that the youngest clients were 19 or 20.
The Sussex Gender Services update came days after councillors approved the fifth version of the Trans Inclusion Schools Toolkit.
Campaign group PSHE Brighton has criticised the report as not compliant with the Cass Report which “distinguishes between social transition” where individuals change their name and pronouns, both before and after adolescence.
Councillors were told that PSHE Brighton was supporting a family taking legal action against a doctors’ surgery, the WellBN Clinic.
The campaign group believes that the surgery acted unlawfully by prescribing cross-sex drugs to a 13-year-old and the NHS Sussex Integrated Care Board did so too by funding the treatment.
At the cabinet meeting, PSHE member Adrian Hart raised the case when asking about the new toolkit.
Mr Hart said: “How will the Toolkit V5 prevent the ‘classroom to clinic pipeline’ that has developed across the city, something highlighted in the recent High Court case launched by a Brighton parent against the NHS and which began with a child being socially transitioned in a local secondary school?
“I’m sure cabinet will want to reassure parents that the activist organisation Allsorts Youth Project will cease its activities inside schools in facilitating this pipeline.”
Labour councillor Emma Daniel said that the toolkit said that schools should not make decisions about medical treatment and she declined to comment on an active court case.
PSHE Brighton sent a formal response which was noted by Labour council leader Bella Sankey.
The response said: “Edition 5 of the toolkit attempts to circumvent both Cass and the Monaghan advice by referencing both of these, finding forms of words that acknowledge the need to have regard to all protected characteristics under the Equality Act 2010 and the Cass review, but then proceeding to keep nearly all elements that contravene equality and human rights legislation that do not comply with Cass or address safeguarding concerns.
“(And) by passing off responsibility to schools by saying it is up to them to ensure compliance with evidence, policy and law and saying that the council’s toolkit is non-prescriptive schools and other educational settings are exposed to potential litigation, while enabling the council to protect itself from challenge.”
Green councillor Kerry Pickett backed the toolkit and said that local children were lucky to live in a place where their wellbeing took precedence.
Councillor Pickett said: “Shockingly, Brighton and Hove is now the only council brave enough to revise its trans toolkit and maintain its use.
“All other councils have withdrawn their toolkits, not because they don’t believe in them or think they provide good guidance, but because they have been bullied by fear that they may be sued, something few councils can ill afford.
“I salute the bravery of this council to not only refuse to bow to the bully tactics of such groups but also to put the lives of these children and the staff that teach them at the forefront of policy.”
Fellow Green councillor Raphael Hill said that fears about transgender people being part of an ideology were similar to those surrounding gay people back in the 1980s.
Councillor Hill said: “I claim I exist and I am a woman who is transgender. I was a child and I was transgender when I was a child although I did not have the words that could describe my experience at that time.
“People like me exist in every country in the world, even in the most repressive regimes on this planet. Treating our existence as an ideology and as a disease won’t make us disappear.”
For the over-18s, fine. They have protected characteristics in law, and a right to do what they want with their own bodies.
The under-18s are legislated by Safeguarding and Age of Consent for a reason. If these are eroded in any way, children are also open to legalised sexual and other abuses.
Safeguarding, medical ethics, and standards of care apply at all ages, including over 18. We do not simply provide any medical intervention a person requests; decisions must be evidence-based and in their best long-term interests.
For example, there is a well-documented condition called Body Integrity Dysphoria, where individuals experience intense distress over the presence of a healthy limb and may strongly desire amputation. However, medical professionals do not amputate these limbs because the underlying issue is psychological, and the appropriate response is mental health support, not surgery.
The principle of ‘first, do no harm’ applies across all medical decisions, regardless of age.
The same applies to Transgender healthcare.
Good points. Well put. I agree. There are also so many screwed up easily influenced youngsters around these days who don’t know what they want, except to feel special in some way. Will this facility have the morality to say ‘Actually I think you might have a different issue here and might need to get help from X, Y or Z instead’
Green councillor Kerry Pickett asks us to follow science and evidence when it comes to climate change (rightly) but not science and evidence when it comes to transgender healthcare.
Why is that?
Transgender people of any age need and deserve high quality, evidence based care and overwhelmingly, across the world, it is being proven, by high quality evidence and research that these individuals need holistic, therapy and mental health support – they never need hormones, surgery or drugs. The outcomes for individuals who do have those steps are never good.
Why is Brighton council the last holdout to maintain the use of the outdated, illegal and prejudiced Trans Inclusion Toolkit? Why is the council so unable to change its mind in the face of new high quality evidence?
Do we want councillors who are unwilling to follow the science? To update their views in light of new evidence?
Transgender people deserve better and the council is letting them down badly
I have been seen by the Sussex Gender Service after waiting nearly 5 years for a first appointment with a London gender clinic – which never happened. I was treated well and professionally and I finally received the care I had been waiting for and I believe that this service will save lives.
I’d like to thank the staff at B&HN for finally featuring an article on trans issues which includes a trans voice.
Lived experience is valuable in many discussions, but when it comes to medical treatment and safeguarding children, expert voices must take precedence. Medicine is based on evidence, not personal anecdotes.
We don’t design treatments for conditions like anorexia, schizophrenia, or Body Integrity Dysphoria based solely on the feelings of those experiencing them—we rely on rigorous research, clinical expertise, and long-term outcome data. Gender incongruence should be no different.
The Cass Review and other systematic reviews have highlighted the lack of robust evidence supporting medical transition in children and the risks of an overly affirmative approach. Yet, some insist that personal testimonies outweigh medical scrutiny. Responsible healthcare policy must be led by data, ethics, and safeguarding, not just the voices of those who feel a certain way at a given moment in time.
Brighton and Hove City Council is the last council captured by, and promoting an ideology, and promotion of harmful practices that damage children and young people. Councillors continue to defend their position using excuses that have been widely challenged or disproven. Rather than putting our young people’s health and wellbeing at risk in the name of an unproven ideology, and putting the city at risk of being sued at cost to all tax payers they should now be personally held to account for the harm they continue to promote in positions of authority.
I agree with you – Brighton and Hove City Council has a responsibility to safeguard children, yet it appears to have prioritised ideological commitments over evidence-based care. Safeguarding is not optional—it exists to protect vulnerable young people from harm, including harm caused by medical interventions that lack long-term safety data.
There is growing concern that the council has ignored key principles of child protection by endorsing social and medical transition pathways without proper scrutiny. The Cass Review, for example, has highlighted the lack of robust evidence for affirmative medical interventions in children, yet local policies continue to promote an approach that fails to meet the highest safeguarding standards.
When public bodies push contested practices that may lead to irreversible harm, they not only risk the wellbeing of young people but also expose taxpayers to legal liability. Those in positions of authority must be held accountable for ensuring that children receive the highest standard of care—based on evidence, not ideology.