Children should stop being given puberty blockers at gender identity clinics, says NHS England
Children will no longer be prescribed puberty blockers in gender identity clinics, NHS England has confirmed.
The government said it welcomed the “landmark decision”, adding it would ensure care is based on evidence and in the “best interests of the child”.
Puberty blockers, which interrupt the physical changes of puberty such as breast development or facial hair, will now only be available to children as part of clinical research trials.
It follows a public consultation on the issue and an interim policy, and comes after NHS England commissioned an independent review of gender identity services for children under 18 in 2020.
That review, led by Dr Hilary Cass, followed a sharp increase in referrals to the Tavistock and Portman NHS Foundation Trust’s Gender Identity Development Service (Guide), which is closing at the end of March.
In 2021/2022 there were more than 5,000 referrals to Guide, compared to just under 250 ten years earlier.
In February 2022, Cass published an interim report stating the need to move away from one unit and recommending the creation of regional services to better support young people.
She pointed to a lack of long-term evidence and data collection about what happens to children and young people who are prescribed medicines.
She added that Gids had not collected routine and consistent data “which means it is not possible to accurately track the outcomes and pathways that children and young people take through the service”.
Following the closure of Tavistock, two new NHS services will open in early April, located at London’s Great Ormond Street Hospital and Liverpool’s Alder Hey Children’s Hospital.
The NHS has said that children attending these clinics will be supported by clinical experts in neurodiversity, paediatrics and mental health, “resulting in a holistic approach to care”.
Health Minister Maria Caulfield said: “We have always been clear that the safety and wellbeing of children comes first, so we welcome this groundbreaking decision from the NHS.
“Ending the routine prescribing of puberty blockers will ensure that care is based on evidence and expert clinical advice and is in the best interests of the child.”
The consultation on the future of services received more than 4,000 responses, including around a quarter from members of the public, 22% from patients, 21% from parents, 10% from trans adults and 5% from doctors.
John Stewart, national director of specialist commissioning at NHS England, told the PA news agency: “Given that the debate is often very polarised, so were the responses to the consultation.
“Many people said the policy did not go far enough in still allowing potential access (to puberty blockers) through research, and others clearly said they fundamentally disagreed and that these should be routinely available are for anyone who thinks they need them.”
It is expected that approximately 250 patients will be transferred to the new Gids clinics when they open. Currently, around 5,000 children and young people are still on the waiting list for referral to the new clinics.
Stewart said he hoped other regional centers could be up and running quickly “and once we get to that point we should see significant movement in that waiting list and a reduction in numbers”.
Fewer than 100 young people currently use puberty blockers. They will be able to continue their treatment and be seen by specialist endocrine services at Leeds Hospital and University College London.
It is understood that NHS England hopes to have conducted a study into the use of puberty blockers by December 2024, with eligibility criteria yet to be determined.