A charity supporting gender-questioning young people should ensure parents are informed if it provides chest binders to children in future, a watchdog said after ordering it to be clearer about puberty blocker risks.

A two-year investigation into Mermaids by the Charity Commission concluded there had been mismanagement at the organisation, which had failed to adapt as it grew “considerably in a short period of time”.

But the charity was cleared of misconduct, with the chairwoman of the organisation’s trustees saying they are “relieved” the investigation is “finally over”.

Mermaids, established in 1995, describes itself as a charity providing supporting to trans, non-binary and gender-diverse children, young people and their families.

It has an income of almost £2.3 million and said it currently supports more than 10,000 people every year.

An inquiry was opened into the charity in 2022 after what the commission described as “critical media articles” and complaints from the public raising concerns around chest-binding services and the online support Mermaids was offering to young people.

The Telegraph newspaper had reported the charity had been offering binders to children as young as 13 despite their parents saying they opposed the practice, and concerns were raised in Parliament, with then-Conservative MP Miriam Cates alleging “serious safeguarding failures” and then-prime minister Liz Truss saying the allegations “should be properly looked at”.

The watchdog’s report, published on Thursday, said the charity had issued 125 binders – used to flatten breasts with constrictive materials to make the person more male-presenting – between January 2021 and September 2022.

A total of 24 of those were provided to what the charity termed “unsupported young persons”, meaning those under the age of 19 whose parents or carers were not supportive of the young person’s gender identity or expression.

Fifteen of those went to children aged between 13 and 16.

While the commission noted that supplying a binder to a young person is not a criminal offence, it found a “lack of transparency” on at least two occasions, where the charity told someone inquiring about a binder that they did not have the right size in stock, rather than informing them they had failed the organisation’s checks.

While the charity argued this was done in an attempt to reduce harm to the young person, the commission said such a lack of transparency “can be problematic and could potentially undermine the credibility of the charity”.

It said the media attention following this had “significantly damaged the charity’s reputation and could have been avoided”.

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

The charity suspended the service in September 2022 “following adverse publicity regarding the service and to protect its staff who had been subject to threatening calls, emails and web chat contacts as a result of the adverse publicity”, and formally ended it in October the following year.

The watchdog said if the charity does ever resume its supply of binders to young people in future, its policy should reflect the findings of the Cass Review, which recommended that parents should be actively involved in such decisions around social transitioning unless there are strong grounds to believe that this could put the young person at risk.

Elsewhere in its 22-page report, the commission said it had ordered Mermaids to review statements on its website about puberty blockers being “an internationally recognised safe, reversible healthcare option”.

The watchdog said the charity had been “unclear” about whether the information it was providing was a statement of fact or Mermaids’ own opinion, and said that by law charities are required to ensure information provided on an educational basis is accurate, evidence-based and balanced.

The charity “should have mechanisms in place to keep their position under review as this is clearly an area of medicine where there is ongoing development and change”, the watchdog added.

References to puberty blockers and reversibility have been removed from the charity’s website.

The commission said its findings of mismanagement related to trustee failures to address internal issues around culture and inclusivity at the charity.

It also said there had been a failure to carry out sufficient due diligence checks when recruiting trustees, referring to an incident where an ex-trustee of the charity, known as Dr Breslow, had spoken at a conference organised by a paedophile support group before being appointed.

The charity, which said it only became aware of his attendance at that event when a news story was published, released a statement at the time, in 2022, saying he “should never have been appointed to the board”.

The trustees accepted that governance did not keep pace with the charity’s rapid growth linked to rising support needs from trans young people and their families

The commission also found mismanagement because trustees had failed to “properly adhere to their own internal HR policies” regarding the dismissal of its chief executive, Susie Green, in late 2022 after six years at the helm, with the announcement at the time having been reported as a resignation.

Addressing concerns around alleged ties between Ms Green and the Tavistock and Portman NHS Foundation Trust – which ran the now-closed Gender Identity Development Service (Gids) for children – the watchdog said it saw “no evidence” to suggest that she or the charity had “inappropriate influence or ties to Gids or that referrals were made without the support and knowledge of a parent or carer”.

Commission chairman Orlando Fraser said providing services to children affected by gender identity issues is “a highly challenging area that requires great care and sensitivity”.

He added: “This is especially so for charities, given the authority that registered status will likely carry with children and their families.

“We have carefully scrutinised Mermaids’ activities through a statutory inquiry and have found mismanagement in a number of areas. Mermaids co-operated 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.”

Mermaids’ chairwoman of trustees, Kathryn Downs, said the commission had “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”.

On the mismanagement findings, she said: “The trustees accepted that governance did not keep pace with the charity’s rapid growth linked to rising support needs from trans young people and their families.”

She said the issues she described as “historic” have been addressed by the charity through two independent reviews and that the board has “strengthened due diligence processes for trustee recruitment”.

Ms Downs described the length of time the inquiry took as “frustrating, significantly affecting Mermaids’ fundraising and ability to deliver on our charitable objectives”, and urged the commission to “ensure that organisations serving groups facing rising hostility are supported and protected, whilst being held to account where this is necessary”.