Getty ImagesBy Josh Parry, LGBT & identity producer, and Hugh Pym, health editorBBC NewsChildren have been let down by a lack of research and “remarkably weak” evidence on medical interventions in gender care, a landmark review says.The Cass Review, published on Wednesday by paediatrician Dr Hilary Cass, calls for gender services for young people to match the standards of other NHS care.She says the “toxicity” of the debate around gender meant professionals were “afraid” to openly discuss their views.NHS England says it has already made significant progress in making changes.Leaked emails reveal child gender service concernsTrans treatment waiting list a ‘death sentence’NHS England to stop prescribing puberty blockersThe Cass Review, which looked at gender identity services for under-18s, was commissioned by NHS England in 2020 after a sharp rise in the number of patients referred to the NHS who were questioning their gender.It was announced after whistleblowers raised concerns about care at the Gender Identity and Development Service (Gids) – which was the only specialist gender clinic for children and young people in England and Wales.Gids closed last week, four years after it was rated as “inadequate” by inspectors.Regional hubs have now opened in London and Liverpool in an effort to move away from a single-service model and to tackle long waiting lists, which are currently around four years long.The Cass Review’s conclusions are documented in a 388-page report, which makes 32 recommendations on how gender services for children and young people should operate. They include considerations around medical interventions, further research, and safeguarding measures.Dr Cass calls for better research into the characteristics of children seeking treatment and to look at outcomes for every young person.In essence, she says children have been let down by a failure to base gender care on evidence-based research.She is clear that children and young adults using the services deserve the highest standards of care and research, which are expected elsewhere in the NHS. Addressing children and young people in the foreword to her report, she wrote: “I have been disappointed by the lack of evidence on the long-term impact of taking hormones from an early age; research has let us all down, most importantly you.””The reality is we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.”James Anderson/BBC NewsDr Cass also raised concerns about what she called “diagnostic overshadowing” – when patients’ other healthcare issues were overlooked in cases of patients questioning their gender.The report recommends that young people referred to the new clinics should have a “holistic assessment”, which Dr Cass says should include screening for neurodevelopment conditions such as autism, and a mental health assessment.It also says representatives from the regional centres should form a national group to oversee ethics, training and to ensure everyone receives “the same high standards of evidence-based care”.The report warns the “toxicity of the debate” around gender has been “exceptional” and has had a negative impact on the quality and availability of evidence.Young people have been “caught in the middle of a stormy social discourse”, Dr Cass says.”There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour.”In the weeks leading up to the review’s publication, NHS England announced new policies around the use of puberty blockers and cross-sex hormones.It said puberty blockers – which Dr Cass defines as hormones that “stop the progress of puberty” – would no longer be routinely prescribed, and that they should only be given to gender-distressed children as part of clinical trials.Details of those trials are yet to be announced.What does trans mean and what does the law say?Involve parents on pupils’ gender identity – guidanceLife on transgender waiting listUnder NHS England’s latest policy on cross-sex hormones, 16-year-olds can be prescribed feminising or masculinising hormones in the form of testosterone or oestrogen.Dr Cass’ report warns that this should only be done with “extreme caution” and there should be a “clear clinic …
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[mwai_chat context=”Let’s have a discussion about this article:nnGetty ImagesBy Josh Parry, LGBT & identity producer, and Hugh Pym, health editorBBC NewsChildren have been let down by a lack of research and “remarkably weak” evidence on medical interventions in gender care, a landmark review says.The Cass Review, published on Wednesday by paediatrician Dr Hilary Cass, calls for gender services for young people to match the standards of other NHS care.She says the “toxicity” of the debate around gender meant professionals were “afraid” to openly discuss their views.NHS England says it has already made significant progress in making changes.Leaked emails reveal child gender service concernsTrans treatment waiting list a ‘death sentence’NHS England to stop prescribing puberty blockersThe Cass Review, which looked at gender identity services for under-18s, was commissioned by NHS England in 2020 after a sharp rise in the number of patients referred to the NHS who were questioning their gender.It was announced after whistleblowers raised concerns about care at the Gender Identity and Development Service (Gids) – which was the only specialist gender clinic for children and young people in England and Wales.Gids closed last week, four years after it was rated as “inadequate” by inspectors.Regional hubs have now opened in London and Liverpool in an effort to move away from a single-service model and to tackle long waiting lists, which are currently around four years long.The Cass Review’s conclusions are documented in a 388-page report, which makes 32 recommendations on how gender services for children and young people should operate. They include considerations around medical interventions, further research, and safeguarding measures.Dr Cass calls for better research into the characteristics of children seeking treatment and to look at outcomes for every young person.In essence, she says children have been let down by a failure to base gender care on evidence-based research.She is clear that children and young adults using the services deserve the highest standards of care and research, which are expected elsewhere in the NHS. Addressing children and young people in the foreword to her report, she wrote: “I have been disappointed by the lack of evidence on the long-term impact of taking hormones from an early age; research has let us all down, most importantly you.””The reality is we have no good evidence on the long-term outcomes of interventions to manage gender-related distress.”James Anderson/BBC NewsDr Cass also raised concerns about what she called “diagnostic overshadowing” – when patients’ other healthcare issues were overlooked in cases of patients questioning their gender.The report recommends that young people referred to the new clinics should have a “holistic assessment”, which Dr Cass says should include screening for neurodevelopment conditions such as autism, and a mental health assessment.It also says representatives from the regional centres should form a national group to oversee ethics, training and to ensure everyone receives “the same high standards of evidence-based care”.The report warns the “toxicity of the debate” around gender has been “exceptional” and has had a negative impact on the quality and availability of evidence.Young people have been “caught in the middle of a stormy social discourse”, Dr Cass says.”There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour.”In the weeks leading up to the review’s publication, NHS England announced new policies around the use of puberty blockers and cross-sex hormones.It said puberty blockers – which Dr Cass defines as hormones that “stop the progress of puberty” – would no longer be routinely prescribed, and that they should only be given to gender-distressed children as part of clinical trials.Details of those trials are yet to be announced.What does trans mean and what does the law say?Involve parents on pupils’ gender identity – guidanceLife on transgender waiting listUnder NHS England’s latest policy on cross-sex hormones, 16-year-olds can be prescribed feminising or masculinising hormones in the form of testosterone or oestrogen.Dr Cass’ report warns that this should only be done with “extreme caution” and there should be a “clear clinic …nnDiscussion:nn” ai_name=”RocketNews AI: ” start_sentence=”Can I tell you more about this article?” text_input_placeholder=”Type ‘Yes'”]
