Noah McCrory
London — The only gender identity clinic in Scotland has stopped prescribing puberty blockers to new patients under the age of 18, reflecting action taken by health authorities in England after a milestone review found that young people were let down by “remarkably weak” evidence supporting medical interventions in gender care.
The report, commissioned by Britain’s National Health Service, also concluded that the “toxicity” of the debate around gender identity meant doctors were acting in fear.
Dr. Hillary Cass, who led the review that produced the 388-page report published earlier this month, said “we don’t have good evidence” that puberty blockers are safe to use to prevent changes that occur during puberty.
“It’s unusual for us to give a potentially transformative treatment to young people and not know what happens to them in adulthood, and that’s been a particular problem, not having had follow-up into adulthood to know what the results of that are,” he said. Cass to BBC News, a partner of CBS News.
Puberty blockers suppress the release of hormones that cause puberty. They may be prescribed for children who question their gender in order to prevent physical changes such as facial hair or breast growth.
“The next step from here is to work with the Scottish government and academic partners to generate evidence that allows us to provide safe care for our patients,” said Emilia Crighton, director of the Glasgow region public health service, in a statement. . “We echo Dr Hilary Cass’s view that the toxicity surrounding the public debate is impacting the lives of young people seeking care from our service and is not serving the teams who work hard to care and support them. We understand the distress that gender incongruence can cause and although all referrals to endocrinology are on hold, we will continue to give anyone referred to the youth gender service the psychological support they need whilst we review pathways in line with the findings. “
Scottish Trans, an advocacy group, said it disagreed with the decision to suspend puberty blocker prescriptions for minors, which it said “was taken within the context where the reality of trans people’s experiences and lives are questioned almost daily in some media”. and some political circles.”
“It concerns us that the decision was influenced by this context, rather than just consideration of the best interests of trans children and young people,” said Scottish Trans. said in a statementadding that between 2011 and 2023, just 87 young Scots were prescribed puberty blockers.
“The exceptionally rare and cautious choice to prescribe puberty blockers, made to a small number after enormous waits, is being wrongly portrayed by some as common and rushed. Nothing could be further from the truth. We are saddened that this change will result in some young people not being able to access the care they need or having to wait even longer for it,” said Scottish Trans.
Before Cass’s review was published, the NHS said in March that it would stop prescribing puberty blockers to under-18s in gender identity clinics in England. New young patients in the UK can still be prescribed hormone blockers, but only as part of a clinical trial.
Cass’s review called for better research into the medications and their long-term effects, as well as the characteristics of children seeking treatment.
“The reality is that we do not have good evidence about the long-term outcomes of interventions to manage gender-related distress,” she wrote in the review.
She encouraged a holistic assessment of patients, taking into consideration issues that may not be related to their gender identity, including screening for conditions such as autism to address the “diagnosis overshadowing” that can occur when gender issues are raised.
“What unfortunately happened to these young people is that, because of the toxicity of the debate, they were often ignored by local services who were very nervous about seeing them,” Cass told the BBC. “So instead of doing the things they would do for other young people with depression or anxiety, or perhaps undiagnosed autism spectrum disorder, they tend to refer them directly to the GID (Gender Identity Disorder) service.
The Cass review was commissioned following a sharp rise in referrals to gender identity services in the UK, from around 250 per year to more than 5,000 in 2022.
