Introduction: Children, young people, and families are increasingly seeking clinical support regarding their gender identity, though the landscape of this support in England is changing. An independent review recently raised several concerns regarding the processes and quality of clinical care, including that the assessment procedures were inconsistent and varied between clinicians.
Aim: This study aimed to establish consensus amongst an expert group regarding the core components and processes of a developmental psychosocial gender identity assessment with a gender diverse young person and their family. It aimed to produce a detailed description of the assessment procedure that would be clinically useful for staff working in new gender services.
Method: Clinicians with recent experience in conducting the assessments were recruited to an expert panel. The Delphi technique was followed. Experts completed three rounds of iterative questionnaires that explored various aspects of a developmental gender assessment, including their purpose, processes, domains, components, and the clinical stance. Expert responses were evaluated against a consensus threshold that included quantitative and qualitative criteria.
Results: Statistical agreement was high throughout the study, though 491 comments were provided that discussed the items and their implications. There were frequent concerns regarding how the statements could be interpreted and subsequently how the information that was gathered may be used. Fifty-six items met the final consensus threshold.
Discussion: A new holistic assessment framework is being implemented within NHS services for gender diverse children and young people. Many findings from this study align with this framework. Additionally, this study has provided a more detailed description of the assessment procedure. It is, therefore, hoped that this study’s findings can be used to support the ongoing implementation of a new service model in the NHS by supporting clinicians to deliver more consistent gender identity assessments with children, young people, and families.
