As the increase in referrals to the Gender Identity Development Service increases, the profile of the young people seeking treatment changes too. There are now two natal girls for every natal boy, a complete reversal of what it had been a decade before. Polly Curtis tries to make sense of this change and goes to Blackpool which has the highest referral rate of anywhere in England.

The internal divisions at GIDS and the wider Tavistock centre spill out into the open. Whistleblowers are publicly critical of GIDS. One accuses the service of fast tracking young people onto puberty blockers after just one meeting with clinicians. The senior leadership team at GIDS desperately tries to hold the team together. Meanwhile the numbers on the waiting list tick up and up.

The public debate around the work of the Tavistock is getting louder. Kiera Bell wins a landmark ruling at the High Court which halts all new referrals for puberty blockers for under 18s on the NHS in England and Wales. She was prescribed puberty blockers at 16 but later decided she wants to detransition. The Tavistock appeals and the ruling is overturned. But for many people the narrative of the Gender Identity Development Service is now set in stone.