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The Gender Identity Development Service (GIDS) , based at the Tavistock and Portman Trust in North London, was set up initially to provide - for the most part - talking therapies to young people who were questioning their gender identity. But in the last decade GIDS has referred more than a thousand children, some as young as nine years old, for medication to block their puberty. In the same period, the number of referrals has exploded, increasing thirty-fold, while the profile of the patients has changed, from largely pre-pubescent boys to mostly adolescent girls, who are often contending with other difficulties.Why had the patients changed so dramatically? Were all these distressed young people actually best served by taking puberty blockers and cross-sex hormones?While some young people appeared to thrive after taking the blocker, many seemed to become worse.