Children given NHS transgender treatment have been set on a path of irreversible change despite scant medical data, and based on “remarkably weak evidence” according to a damning independent report led by a leading British paediatrician.
The landmark study by Dr Hilary Cass was commissioned nearly four years ago, and makes 32 recommendations to overhaul NHS trans services to improve the care that children receive.
Her findings include that there was a “lack of high-quality research” on the effects of giving children puberty blockers and hormones, and recommended that NHS England establish its own research programme.
She said teens had suffered irreversible changes based on the unproven treatments and the “toxicity” of the trans debate, reports The Guardian.
Health harm
The UK’s only NHS gender identity development service used puberty blockers and cross-sex hormones, which masculinise or feminise people’s appearances, despite “remarkably weak evidence” that they improve the well-being of young people and concern they may harm health, Cass said.
She said her findings were not intended to undermine the validity of trans identities or challenge people’s right to transition, but rather to improve the care of the fast-growing number of children and young people with gender-related distress.
But she said this care was made even more difficult to provide because of the polarised public debate, and how opposing sides had “pointed to research to justify a position, regardless of the quality of the studies”.
NHS England commissioned her inquiry in 2020 amid rising concern over the care provided by the Tavistock and Portman NHS mental health trust’s gender identity development services (Gids). It treated about 9 000 children and young people, with an average age at referral of 14, during 2009-2020.
Her inquiry has already led to NHS England closing Gids, banning puberty blockers and switching to a new “holistic” model of care in which under-18s experiencing confusion about their gender identity will routinely receive psychological support rather than medical intervention.
“For most young people, a medical pathway will not be the best way to manage their gender-related distress. For those young people for whom a medical pathway is clinically indicated, it is not enough to provide this without also addressing wider mental health and/or psychosocially challenging problems,” said Cass, an ex-president of the Royal College of Paediatrics and Child Health.
The report recommends that all such young people should be screened to detect neuro-developmental conditions, like autism spectrum disorder, and there should be an assessment of their mental health, because many who seek help with their gender identity also have ADHD, anxiety or depression, for example.
Cass told The Guardian that gender-questioning children have been “let down” by the NHS, health professionals and a “woeful” lack of evidence about what treatment works.
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