Who Trolled Amber? - The Tavistock - Episode 2: The broom cupboard

Episode Date: September 18, 2023

Polly Carmichael became the director of the Gender Identity Development Service at the Tavistock in 2009. “I remember our office was literally a room that had probably been a broom cupboard at one stage”, she recalls. But the decision in 2011 to start offering puberty blockers to under-16s, and in 2016 to widen the professionals who could refer a child to GIDS had a major impact. The numbers of people on the waiting list ticked inexorably up, until the clinic felt it could barely cope. Listen to the full series today. For the premium Tortoise listening experience, curated by our journalists, download the free Tortoise audio app. For early and ad-free access to all our investigative series and daily and weekly shows, subscribe to Tortoise+ on Apple Podcasts.If you’d like to further support slow journalism and help us build a different kind of newsroom, do consider donating to Tortoise at tortoisemedia.com/support-us. Your contributions allow us to investigate, campaign and explore, and to build a newsroom that is responsible and sustainable. Hosted on Acast. See acast.com/privacy for more information.

ACAST powers the world's best podcasts. Here's a show of glamour and scandal and political intrigue and a battle for the soul of a nation. Hollywood Exiles, from CBC Podcasts and the BBC World Service. Find it wherever you get your podcasts. ACAST helps creators launch, grow, and monetize their podcasts everywhere. Acast.com Hi, Colleen.

Hiya. Hello. Just to say me and Katie are outside. Oh, okay, sure, I'll come and grab you. All right, thanks, mate. See you in a couple of seconds, mate. I'm in North London about to meet Polly Carmichael inside the Tavistock Centre, and I've been told to call in advance because we're arriving with our recording kit.

They're wary of journalists here. The centre is in a purpose-built 1960s concrete building. It has that multi-storey car park sort of vibe and it looks a little bit out of place here. This is Belsize Park and it's definitely what you'd call a desirable area. Leafy, quiet and full of grand white stucco houses and nice little cafes. In some ways it's the home of psychotherapy in the UK. Sigmund Freud, the father of psychoanalysis, lived just around the corner. His house is now a museum

and he's immortalised in a large bronze statue just to the left of the Tavi's entrance. Nice to see you. How's it all going? Good. Polly is friendly and welcoming and her breezy manner implies she's at ease. But she's also wary. Of course I'm aware that anything I say will probably be used against me by someone.

And she's right to be concerned. Her clinic is at the centre of a storm, and as clinical director, Polly's got used to taking flak from all sides. In the week we meet at the Tavistock one newspaper headline labels it a transing factory. It's frustrating to sort of feel under attack but you know genuinely I think you know that there is a huge debate to be had. And I suppose at this stage, I'm still interested in trying to move that debate into a more constructive space. Holly Carmichael has run the clinic at the Tavi for 13 years. In that time, it's grown from being a tiny set up treating just a handful of children. We had our office was literally sort of a room that

had probably been a broom cupboard at one stage. It was absolutely tiny. The clinicians would sort of come in and sit on children's chairs, you know, around the edges of this room. To a fully fledged NHS service with over 2,000 referrals a year. One of my NHS sources described Tavistock to me as a cottage industry that turned into a start-up. But I like to think of those early, pre-Gold Rush years as the broom cupboard years. Back in 2009, when Poly first started there, no-one really cared what they did,

and, crucially, it wasn't particularly controversial because they weren't offering a route to puberty blockers for children and adolescents. It was mostly talking therapy. In 2011, that all changed. The TAVI started to refer children under 16 for puberty blockers. It's a treatment which is licensed in the UK but only for children who have very early onset puberty. The idea is to pause puberty for those children, just give them a little bit more childhood. So extending that to teenagers didn't seem that outlandish. It was thought to be a temporary and reversible pause on puberty to give children more time to think and better understand their gender. There was very little actual evidence to go on,

but clinics abroad were starting down this path and the results seemed to be hinting that this novel new way of helping young people with gender dysphoria might ease their distress. Incidentally, the TAVI doesn't actually prescribe the puberty blockers. That has to be done by an endocrinologist. But you can't get them on the NHS without the TAVI say so. They have to decide whether a teenager who is identifying as trans now will always identify that way. That's not easy. Having worked in this field for so many years, I couldn't predict with, you know, 100% accuracy at all what an individual's outcome is going to be.

I find that uncertainty unnerving. I can't imagine prescribing hormonal treatment for teenagers without feeling some degree of certainty. But Polly Carmichael says she thrives in this environment. I think I'm someone who doesn't have to have certainty, actually. I think I work very well with uncertainty. But it turns out the world does not. So is it right to medicalise trans kids? We need to go back to the beginning when the decision was first made to begin hormonal treatments for under-16s. I'm Polly Curtis. From Tortoise, this is The Tavistock. Episode 2,

The Brim Cupboard. The Gender Identity Development Service at the Tavi has been around since 1989. Polly arrives on the scene about a decade later, long before the rows and the politics. It was quietly just doing its thing. For those in the know it was a fascinating new area. Well I guess I came to this area of work completely by accident not by design. Polly trained as a clinical psychologist and specialised in working with children with differences in sex development also known as intersex conditions. These are children with ambiguous sex characteristics because of chromosomal abnormalities. So they might have an enlarged clitoris or no vaginal opening or a very small penis. About 150 children are

born in the UK every year with some form of intersex condition. People just didn't know how to talk about it, how to share with a young person their medical history and perhaps uncertainty around their sex at birth. And I think there were also great fears that in doing that you may in some way disturb a young person's sense of themselves. She tells me about David Reimer, a Canadian boy born in 1965, whose story became known as the John Joan case. There were twins and they were both boys. And one of them had a circumcision that went wrong and ended up with no penis. And the family were obviously devastated.

And the family saw this psychologist on TV. When they met, Dr Munny suggested that the Reimers could turn their baby son into a baby girl. Who was talking about how gender is developed through nurture, that it's not nature and that it's about socialisation and how you bring someone up. And I thought, here's our answer, here's our salvation, here's our hope. The psychologist they saw on TV was called John Money. And on his advice, the boy's parents changed David's name to Brenda and brought him up as a girl. The young person was then assigned a female gender,

I guess with perhaps anachronistic ideas that, you know, you can't be male without a penis. And one of the things about that was that that gender needed to be adhered to, and the young person needed to be treated as that gender in order for them to develop that gender and identify as female in later life. John Money claimed that gender identity was all about nurture, and that because Brenda was treated as a girl, she lived successfully as a girl. The case of John Joan became widely quoted. Except it wasn't true.

It's a very contentious story now because ultimately, as an adult, the individual did not identify as female. I was told I was a girl. I didn't like dressing like a girl. I didn't like dressing like a girl. I didn't like behaving like a girl. I didn't like acting like a girl. I'm not a professor or anything, but you don't wake up one morning deciding that you're a boy or a girl. You just know.

By 15, David Reimer was living as a boy, matching his birth sex. He died by suicide in 2004 at the age of 38. His story has been used by both sides of the nature-nurture debate when it comes to gender identity. First, to prove that it's all about nurture. Then, when he resumed life as a boy, to do the opposite. But I guess that contributed to ideas and worries that if you gave a young person their history, then you may in some way disturb their development

and disturb that identity as female in this case. And I think, in a sense, that then got translated into secrecy. Polly heard about JIDS and asked to visit to learn more about gender dysphoria. I remember going along and I took a Barbie doll just as a sort of thank you for them to put in their toy box for the work with young children. And it happened to be a Barbie doll that was a mermaid. Now, mermaids are a thing in this story.

For some trans people, they're a symbol of physical transition. Remember the little mermaid wanting to be part of another world? But when Polly turned up with a mermaid Barbie, it wasn't a deliberate symbolism, it was an innocent coincidence. And I had absolutely no idea at that moment that mermaids were a sort of feature, if you like, for many young people who identify as a gender other than the one they were assigned at birth. Her visit became a secondment to learn more about gender dysphoria. Then that sort of extended over the years. So for

many years, I mean, the service was really tiny at that stage. Tell me about that first meeting you went to. Do you recall kind of what you saw in that meeting? Well, I guess it was in the Tavistock and it must have been 99 something like 98 99 I think and it was very different from a paediatric setting because it was all a psychotherapist and psychologist and Domenico who's a psychiatrist talking about young people and how to support young people who were attending the service. I guess there was discussions around families and their difficulty, I think, really, in understanding or supporting a young person who was strongly expressing that they were a girl when, you know, perhaps they'd been assigned male at birth. It was a completely different world, really, but fascinating. At this stage, the service is still tiny.

Fewer than 100 kids a year are being sent there. These are the broom cupboard years. For the young people who came and for their parents, it was often the first time they could talk openly about what was happening. Few would have started to publicly identify as a different gender, what's now known as socially transitioning. You know, they would be going to school in their birth assigned gender and, you know, perhaps only at home being able to express how they felt inside.

So that was very different. In the broom cupboard years, there was little public debate or even interest. When I hear various members of the team describe those early days, it's with a sense of nostalgia for a more innocent era, just a small number of clinicians working with a tiny number of patients, with time and space to explore what would be best for each child. There was also little risk involved. They saw patients quickly within a couple of weeks and there were no difficult decisions to be made about puberty blockers for under 16s.

Polly and the team are curious about this world and there are so few experts in the field that they begin to make links with gender clinics elsewhere. They notice the Dutch and their work with puberty blockers for under-16s, how they're using them to pause puberty, to give young people more time to think. Stopping the development of secondary sex characteristics such that if the feelings in the young person continued into later adolescence, they would pass better in the gender that they identified with.

Halting the development of breasts or an Adam's apple so that it might be easier for the teenager to transition later. It became known as the Dutch Protocol. Bernadette Wren remembers the pressure to adopt it at the TAVI. There was a very persuasive case made in the name of sort of justice to children that, you know, families were making the quite persuasive case, well, it's really not doing anything because most people are going to puberty. I mean, the age of puberty is coming down. In 2011, the Tavistock was granted the ethical approval it needed to adopt a version of the Dutch protocol and offer puberty blockers to under-16s. This is the first major turning point before the numbers of referrals had really started to increase and before the

media zoned in. That's probably the point at which once that was more known we lost more public support and yet it had its own logic. You've got this extraordinarily tiny niche group of young people who might or might not be helped by this. And it was absolutely done in the spirit that it was reversible in some absolutely fundamental sense. And that it really would buy some time. I mean, there was real sign up to that idea. That was the rationale. And now people are saying, well, that can't ever have been really it was absolutely the rationale that this would pause the changes in the body and the rationale made sense imagine you're a young trans person struggling with the effects

of puberty taking your body further down what you feel is the wrong path for you there are drugs that could stop it but you're not allowed them until you're 16, just when it's too late. At the time, they were seen as a temporary pause on puberty, time to think. In 2011, the year that decision was made, there were 127 referrals to JIDS. It was the first year that the referrals crept into triple digits.

The only real criticisms at that time came from trans activist groups that accused the TAVI of being too cautious about the number of people they put on puberty blockers. But there were other changes coming that no one at the TAVI could yet see that would knock them off course in an entirely different way. Because every year thereafter, right up to the pandemic, there was an increase in referrals of between 50 and 100%. Whether or not that was unbeknownst to us, if you like, a really radical step to have taken.

And that if we had anticipated the number of people who would take it up and the kind of demand and the kind of forceful demand and the fact that a private provider would step in and do it and all that kind of thing, it's easier now to look back and think, you know, was that the wise thing to do? That decision to trial the puberty blockers changed everything. They were so controversial, they came to dominate the whole conversation about what was happening at the TAVI.

Every year the scrutiny increased. The accusation was that they were rushing children into transitioning. An impression was growing that the clinic was handing out puberty blockers on demand. Was that really what was happening inside the Tavistock? I want to understand what happens in those therapy rooms

between a therapist and a patient. Yeah, so I'm James Barclay and I'm a family therapist and I work with the Leeds Kids team and I've been working here for just over seven years. So, yeah, that's who I am. The TAFI has a branch in Leeds where James works. It looks very different from the London Centre. It's in a Victorian square in a double-fronted four-storey house.

So, yeah, they would meet the receptions downstairs and then they would wait. And I think usually we're pretty good at getting that down there to meet them on time. In the Leeds office, they call themselves GIDS. In London, it's generally JIDS. There's a blue plaque by the door. Dr Edith Petchy, Yorkshire's first female doctor, had her consulting rooms here. I've been meeting with a family this morning who travelled on the way down from the north-east to see me.

So we're going to be in the room that I met with them. It's a huge consulting room. It would probably have been the drawing room in the old townhouse looking out over the square. There are comfy chairs and a box of toys for the kids to play with. There has been so much said about what happens at the clinic. And what we want to do is understand what really happens, you know, what happens in that conversation between you, a young person and the family. They first attended here probably when they were about eight or nine years old. He tells me about a family who came to see him a few years ago. They were born male or signed male at birth, but they've been identifying as a girl for several years. And they attended with their parents, their mother and father,

which is very much how we would work. What sort of struck me about the family was, you know, that the child's identification as female was completely out of the blue for the parents. It's not something they had previously ever encountered or aware of. So for the parents, this was like, where has this come from? Is there something we've done? So often you do get that with parents where they think, oh God, is there something I've done wrong here? Or am I responsible for this in some way or to

blame? Can you remember what that child said about their identity? How did they kind of verbalise it? They said very clearly, they sort of said, I am a girl and said, I don't want to grow up to look like daddy. And in that first meeting with the family, what are you trying to understand? Well, I'm trying to, first of all, engage them. I often quite regularly say to families, my goal for this meeting is that you want to come back and talk to me again. Often it's broadening out from the gender identity, it's just getting to know them. It's asking some very basic questions around school, friendships, interests. And gradually, as the child and the parents talk about that,

you start to get little inroads into their lives. Over the course of a number of sessions, he builds up a picture of the child's life. Just where all of the parents often sort of say, well, we thought it was just a phase, because actually little children often do experiment with dressing up or different role plays and things like that.

We thought it was just a phase. We thought it was just a phase, or they were gay and it would kind of just sort of fizzle out or whatever. James mentions the parents a lot, their fears and worries. For him it's about treating the whole family. So one of the things that struck me in that first meeting

was he was a tough man, the dad, and he did a tough job. I think he worked in building trade or mining anyway, sort of a real hands-on job. And he wept in the first meeting because it completely sort of just blown his mind really it was just completely beyond anything he'd ever known he's come from a very very traditional working class sort of background and that's a lot from parents where they really want to be proud and support their child um and to feel good you and for the child to feel good about themselves.

But privately, they think, this is a hard life. This is a really tough journey. And the world out there is not kind to people who are different. I'm struck by something James says next about keeping all the options open. So one of the things I think we have to work with here and we work with on a regular basis is about both understanding but also trying to support parents to manage anxiety around pubertal change and what we have to do I think is work very hard to to kind of keep the options open to continue to explore gender identity not to go down the particular say for example medical route

prematurely even when young people often turn up eager to access the drugs and quickly quite a lot of them will come with that initial i want want blockers, I want testosterone or estrogen. Actually, through the discussions and through the work we do, they might take a different route. I suppose research has told us that things can change with the onset of puberty, that sometimes young people do resume their assigned gender at birth, a birth gender,

or it starts to sort of be more of an issue around sexual identity. So we're kind of keen to try and keep the options open. And what about the child that James was seeing? One of the things that really scared the parents was that the child had, you know, we hear this quite a lot, had talked about wanting to cut their penis off. So we do hear this quite a lot, had talked about wanting to cut their penis off. So we do hear that quite a lot. And obviously, you know, that is extremely worrying, I think, for parents to hear that and quite shocking, I think.

So the parents in this case made the decision to allow their child to go to school dressed as a girl and to identify as a girl. And they could just see the weight of anxiety and anger lifted off the shoulders of that child. But puberty brought more distress. The clinic didn't judge puberty blockers to be the right route at that point. In the end, the family decided to seek treatment privately. So that's the clinician's view of how it works. For Sandra, the mother who opposes her child's transition, the experience of those first meetings at the TAFI with her child was different.

She felt there wasn't enough questioning. So their starting point is the child is trans. How is the child coping with life? You know, as a girl, how are you coping with breasts, with puberty, blah, blah, blah. You know, what toilets to use at school and all the rest of it, all this stuff. It's not, why do you think you are trans? Why do you want to present as a boy when you're actually a girl? Which is what I naively thought would be the starting point.

But it wasn't. The starting point is that the child is trans. How's the child managing to navigate life as a trans child? That's not what Sandra wanted from the clinic. She'd heard some name of a puberty blocker or something from a YouTuber. And she sat down. And virtually the first thing she said was, can I have whatever it was,

this long, long name of this drug? The first thing they said was, no, we don't prescribe drugs here. So that was a bit of a wake up call for her. Nonetheless, Sandra felt the clinicians were too quick to affirm her child's new gender. I hoped and sort of naively assumed that there would be therapy and they would try and unpick why she wanted, why these kids were wanting to change sex. And I thought that they would spend time, you know, going into that, giving a therapy to try and unpick all of this. But they didn't. Just think about those two meetings. James's tactic is to build trust with the young person and their family. Sandra felt the clinician at her child's appointment was way too affirming and didn't question why her child might want

to change their gender. We met Steph in episode one, they're 20, non-binary and attended the TAVI. In episode one, they're 20, non-binary, and attended the TAVI. It started off with, oh, how was the journey? Did you get in fine? Did you find us? Whereabouts in the country were you coming from? And then it was very much setting expectations, kind of saying, this is what we do here, this is how we work. You'll have four to six initial appointments. Steph just wanted the blockers not the small talk. So yeah I remember just wanting everything to happen because as a

kid I mean you want things and you want them now and so when I got to when I when I found out that that wasn't the case and that it would take various sessions, it was like, OK, well, let's get these sessions booked in and let's get that assessment done, shall we? Three different reactions to the same service. Think about it. They could have been one and the same meeting, but they all went in with different hopes and dreams.

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Find it wherever you get your podcasts. ACAST helps creators launch, grow, and monetize their podcasts everywhere. Acast.com So how on earth do the clinicians get from that first consultation to a decision on whether a teenager is ready for medical intervention? I suppose from the young people, do they have a consistent understanding across time about the implications of the treatment? I asked Polly Carmichael the same question.

How do we know? I guess it's, you know, a multiple range of factors. So it's thinking about, I mean, it's really difficult to put this into words and simplify this really because it you know it's a complex process so obviously central to that is the young person's sense of themselves their sense of their gender so we're looking for whether, I suppose, words that get used very regularly are consistency and persistency. So I guess if something has remained consistent and persistent over a long period of time, then that would be part of an assessment in terms of predicting that that was going to continue to be the case. Consistent and persistent. The job these clinicians have is to assess the future. They are trying to predict. So ultimately, in that prediction,

in that prediction how certain do you feel you need to be in order to refer them for puberty blockers so i i need to be as certain as i can be uh in order to do that i certainly wouldn't be putting forward anyone where I felt an element of doubt or that there was more work required to really feel confident that this was the right pathway for an individual young person. However, paradoxically, at the same time, I always hold uncertainty in my mind. It's not massively reassuring, is it? But to be fair, these are decisions that clinicians face in many different contexts every day. Uncertainty is inherent. Let's consider the outcomes. Does this treatment work for children and young people?

Do the right people get it and not regret it? Well the thing is, for the most part, we just don't know. One of the problems with this story is that there hasn't been enough evidence collected along the way. The Dutch protocol that ran for three years until 2014, under which the Tavistock first prescribed puberty blockers to under-16s, followed 44 children who went through the service all the way to the endocrine clinic. 43 of them went on cross-sex hormones, and only one stopped in favour of living in their birth-assigned gender. It told us one really important thing. The idea that puberty blockers were simply a pause on puberty wasn't true. In almost every case, they led directly to further hormonal treatment transition.

Cross-sex hormones are the next step to medically transitioning. They have irreversible effects. Cross-sex hormones are the next step to medically transitioning. They have irreversible effects. So decisions made to take puberty blockers were more profound than was originally thought. The Dutch study showed that most patients had a positive experience. Any negative experiences related to the everyday side effects of the drugs, the headaches, flushes, fatigue. But there is some developing science relating to puberty blockers.

We know there is an effect on young people's bone density. Puberty blockers arrest bone development, which in older age is likely to mean people are more susceptible to fractures. In isolation you wouldn't want those side effects but if you're a person suffering from gender dysphoria you might think the trade-off is worth it. Most medications have a trade-off. What's extraordinary is that apart from that emerging evidence about side effects, is we don't know any more now than we did then. Only 44 children have ever been followed over any length of time. The TAVI says they weren't funded to do the research. But why was no one following the hundreds of children who came through the service?

Just to check that the treatment was right for them. Just to build confidence that it would be right for those who came next. We do have some numbers though. According to a study led by University College London, 1,151 JIDS patients have been referred to the endocrine clinic for puberty blockers between 2008 and 2021. 236 of them were under 16. That's out of around 20,000 people who were referred to the Tavistock over that period.

I think about James's description of what happens in his clinic. We're kind of keen to try and keep the options open. Are kids being fast-tracked to puberty blockers? Is it a transing factory? I'm not so sure. Understanding these things about puberty blockers starts to change my thinking. And I think my central question is changing.

I started out asking whether it's right to medicalise trans kids. But now, in the absence of really convincing science, I want to know whether we've done the right thing by them at all. Just because your service is growing you don't feel immediately worried that the world's gone mad you think, okay, there are those kids out there, but there are vanishingly small numbers still when you look at the population. We're back in 2014, and for Bernadette, the rising numbers of patients feels positive. It felt encouraging the more people knew JIDS existed and they could ask for help.

Hi, I'm Leo, and I want to do this documentary to show that my life isn't that different to yours. That same year, I Am Leo airs on the BBC. It's broadcast on the children's channel CBBC and describes the life of a young trans boy. It shows him attending the Tavistock as he transitions and it has a huge impact. In most ways, I'm like an average 13-year-old boy, apart from I was born in a girl's body. Suddenly, the idea of a transitioning child is not so unusual. And the numbers of referrals to JIDS keeps ticking up,

more than doubling every year. By 2015, it's nearly 1,400. For those working in the service, it's starting to feel much less manageable. NHS England is pouring cash into the TAVI to scale the operation, but they can't spend it fast enough. The Tavistock's board papers actually show an underspend, even as the waiting lists are growing. It's taking too long to recruit and train people.

Staff have to increase their caseloads, and the waiting list keeps on growing. It's taking too long to recruit and train people. Staff have to increase their caseloads and the waiting list keeps on growing. Things are now starting to get more worrying. So at that point you have the dual pressure of, you know, have smaller caseloads and pay more attention to them and see them more often versus clear the waiting list. And then the problem comes in who is responsible for the fact that people on waiting lists might do risky things what what kind of risky things Oh harm themselves in some way so it wouldn't be surprising if you would have a phone call from a parent of somebody on the

waiting list saying I'm really worried about them they're you know if they don't get seen soon they will kill themselves and some did exactly and so there had to be a way of diverting people to another service and when that happened when when those young people did take their own lives on the waiting list or after treatment, I've only seen the details in the board papers, really. How did that affect the team? What do I think? Yeah, I mean, that's... You don't want to talk about it? Well, I don't know what you could possibly expect me to say.

Whether people were deeply, deeply distressed doesn't begin to describe it. In a situation for which we were powerless. powerless. So the key decision to introduce the blockers was in 2011. But in 2014 there's another critical decision. As the three year trial ends, Polly makes the decision for the blockers to become standard practice. But you continued offering the puberty blockers without the protocol. It was a sort of intervention that was well tried and tested in Holland, was being used internationally.

There were young people going abroad to get that treatment and the UK were quite an outlier in terms of not offering it. So in 2014, puberty blockers moved from a trial to a small but increasingly important part of the JIDS mainstream practice. And by now, the broom cupboard years are well and truly over. The clinic is expanding, but not fast enough. In 2015, JIDS breaches its waiting list target of 18 weeks for the first time. And the pressure on the service is about to get much, much worse. In 2016, something seemingly mundane happens. The way in which people are referred to JIDS changes.

It's no longer just a doctor or mental health professional who can refer. Now you can be sent by your school, your social worker, or even just a support group. Understanding this seems critical to me in understanding what went wrong at the Tavistock. JIDS is one of the NHS's most specialised services. Yet now, almost anyone can refer to it. The floodgates open. How much kind of day-to-day was that waiting list kind of playing on your mind? Every day. What was that waiting list kind of playing on your mind every day what was your fear fear the fear was that whatever we tried we had no adequate response to it it was beyond our

abilities our abilities. Next time in episode three, I can feel your anger. Yeah, it's something that makes me pretty angry. They know what people think about autistic people and you don't really need to spell it out a lot of the time.

Teenagers pick things up from each other, you know, whether it's being a fan of Harry Styles or a new, you know, way to wear your hair or the new length of your skirt. Why would they not pick this up? Why would this be the one thing immune to social contagion? That doesn't make any sense. So when you were 16, you actually, were you asking for a referral to JIDS and they offered you testosterone? Well, I got the referral as well.

And then, yeah, I just walked in and was like, can I have some testosterone? This series is written and reported by me, Olly Curtis. The producer is Katie Gunning. Additional production by Phil Sansom. The executive producer is Jasper Corbett. The Tavistock is a Tortoise production. Thank you.