Great Ormond Street Hospital is not meeting care standards for intersex children, a BBC investigation says.
It found that some patients who had been born with sexual development disorders, and their families, had no access to psychological care.
And not all cases were properly discussed before the patient had life changing, irreversible surgery.
Health regulator CQC is investigating. The hospital said it was committed to working with seriously ill children.
Intersex, also known as disorders of sexual development (DSD), is when sex characteristics - including genitals, reproductive organs and chromosome patterns - do not fit into the typical notions of female or male bodies.
The BBC has learned that at Great Ormond Street Hospital (GOSH):
- There is currently no face-to-face psychological support for children and their families who have been referred in the last six months despite surgery continuing. The BBC understands tens of families are waiting for therapy. For several years not all children and their families have had access to face-to-face support, before having surgery
- Not all cases were discussed at full the multidisciplinary team meetings at GOSH
- Information about this surgery is complex but information given to parents is not in a written form that they can take away, to ensure proper comprehension prior to giving informed consent for surgery. The BBC has been told that this raises doubts as to whether parents have given truly informed consent on behalf of their child before irreversible surgery.
Over the last decade, standards and guidelines say DSD cases should be discussed by specialist teams of experts, to ensure the best possible outcome. They also say that it is crucial that families and children should be seen by a psychologist.