In a significant policy change, the National Health Service (NHS) in England has confirmed that children will no longer receive routine prescriptions for puberty blockers at gender identity clinics. Puberty blockers, medications that temporarily pause the physical changes of puberty, will now only be accessible to minors as part of clinical research trials. This decision, hailed as a milestone by the government, aims to ensure that medical care is grounded in evidence and serves the best interests of the child.
The decision follows a thorough public consultation and an interim policy, stemming from a 2020 review of gender identity services for under-18s conducted by NHS England. A review led by Dr. Hilary Cass, prompted by a surge in referrals to the Gender Identity Development Service (Gids) operated by the Tavistock and Portman NHS Foundation Trust. Notably, the clinic, slated for closure at the end of March, witnessed a remarkable increase in referrals over the past decade, with over 5,000 in the year 2021/22 compared to just under 250 ten years earlier.
Dr. Cass’s report highlighted critical deficiencies in data collection and long-term evidence regarding the outcomes of children and young people receiving medication at Gids. The report stressed the necessity to shift from a centralised unit to regional services for enhanced support.
With the impending closure of Tavistock and Portman, NHS England is set to open two new services in April: one at London’s Great Ormond Street Hospital and another at Alder Hey Children’s Hospital in Liverpool. These clinics will offer comprehensive care, with support from clinical experts in neurodiversity, paediatrics, and mental health.
The NHS welcomed the decision, prioritising the safety and well-being of children. The move aligns with evidence-based care and expert clinical opinion.
The consultation on the future of gender identity services received over 4,000 responses from various stakeholders, reflecting a diverse range of perspectives. NHS England’s national director of specialised commissioning, noted the polarised nature of the debate, with some advocating for broader access to puberty blockers and others fundamentally disagreeing with their routine prescription.
Approximately 250 patients are anticipated to transition to the new clinics from Gids, while over 5,000 more children and young people remain on the waiting list. Presently, fewer than 100 individuals are receiving puberty blockers.
A former Prime Minister welcomed the NHS decision and urged the government to support a bill aimed at reinforcing this decision in law and preventing the private supply of these drugs.
In summary, the NHS decision marks a significant departure in the treatment of gender dysphoria in children, prioritising evidence-based care and the best interests of young patients. The transition to regional services signals a commitment to providing holistic support for children and young people navigating gender identity issues. As the landscape of gender identity services evolves, continued scrutiny and collaboration among stakeholders will be vital to ensure the well-being of children remains at the forefront of healthcare decisions.
