A charity supporting gender-questioning young people has been told to rewrite its guidance about the risks of puberty blockers, after a two-year Charity Commission investigation, which also concluded that there had been mismanagement within the organisation.
However, the investigation found that the charity, Mermaids, had appropriate safeguarding policies in place and there was no evidence that it provided medical advice to children, which would have been outside its remit.
It also ruled that the charity did not have inappropriate ties to private medical gender clinics, or to the now-closed gender service at the Tavistock, in north London.
Mermaids has been told by the Charity Commission that it must not resume a service providing chest binders to teenagers with gender dysphoria, without parental involvement. The charity paused this service in 2022, after reports that the organisation was supplying binders to young people aged between 13 and 19 without parents’ knowledge.
The chair of the charity watchdog said there were wider lessons for Mermaids and other charities offering services to children affected by gender identity issues, noting that they must “have regard to the findings, conclusions and recommendations of the Cass review” – the review of NHS services provided to children and young people questioning their gender published earlier this year.
The watchdog asked Mermaids to review its position on puberty blockers, particularly a section on its website stating that the effects of the treatment were reversible. The Cass review found that the evidence base on puberty blockers was “weak”; puberty blockers will now only be prescribed as part of a NHS clinical trial. Mermaids has removed text stating that puberty blockers are an “internationally recognised safe, reversible healthcare option”.
The report revealed that the charity’s former chief executive Susie Green was dismissed in November 2022 after a “loss of confidence by the trustees” in her capacity to lead the organisation. At the time the charity simply said that she had left after six years in charge. The charity saw a high turnover of senior leadership and trustees, and its infrastructure failed to “keep pace with its speed of growth and increasing public profile”, the report noted.
The watchdog also found that the charity had failed to carry out sufficient due diligence checks when recruiting trustees, which resulted in the recruitment of someone the charity said should “never have been appointed” – a reference to a former trustee who had previously spoken at a conference organised by a paedophile support group.
Mermaids, established in 1995, describes itself as a charity providing support to trans, non-binary and gender-diverse children, young people and their families.
Its chair of trustees, Kathryn Downs, said: “We are relieved that the Charity Commission inquiry which began nearly two years ago is finally over. The report states, as we anticipated, that there is no finding of misconduct at Mermaids.
“The commission has also confirmed, as we have repeatedly asserted, that we have not provided medical advice or acted improperly in our work with children, young people and their families.” Downs said the two-year investigation had been “frustrating” and had significantly affected Mermaids’ fundraising.
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Orlando Fraser, chair of the Charity Commission, said: “We have carefully scrutinised Mermaids’ activities through a statutory inquiry and have found mismanagement in a number of areas. Mermaids cooperated with our investigation and has been actively addressing the various concerns raised.
“Additionally, following the Cass review, we have required Mermaids to present a more accurate picture on its website as to the risks involved in the use of puberty blockers, and to follow Cass review findings on the involvement of parents in social transitioning as regards any future provision of chest binders to children.”
The watchdog’s report said that the charity had distributed 125 binders, commonly used to flatten an individual’s breasts with constrictive materials to make them more male-presenting, between January 2021 and September 2022; 24 of these were issued without parental consent.
The inquiry found that the charity had a detailed policy relating to its chest binder service and demonstrated compliance with this policy, providing guidance prior to issuing binders as to potential health implications, including back or chest pain, postural issues and rib damage.