Solving gender identity issues in children is complicated, and is not always going to be the answer to everything, says NHS England’s gender identity development service.

They need help “from all sides”, say experts from the London clinic, because many of the under-18s are also dealing with mental health problems.

Referrals to the service have more than tripled since 2014-15 – to 2,590.

Fewer than half decided to have any physical treatments.

The Tavistock and Portman NHS clinic, which was the first gender identity clinic to be set up in the UK, has now been joined by two others in Leeds and Bristol.

Another clinic in Birmingham is also planned.

The clinics all see children and young people experiencing distress over their gender identity, also known as gender dysphoria.

Most are aged

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