Scotland’s only gender identity clinic for under 18s has “paused” prescribing puberty blockers to children following a landmark review in England and Wales.
NHS Greater Glasgow and Clyde (NHSGGC) said new patients aged 16 or 17 would no longer receive gender-affirming hormone treatment at its Sandyford clinic in Glasgow until they are 18.
In a statement, the board said the decision came with the support of Scotland’s chief medical officer, Professor Sir Gregor Smith, following a review by Dr Hilary Cass in England, which prompted the health service in England and Wales to take the same action.
The Glasgow clinic posted on its website: “Young person’s gender service referrals from the Sandyford sexual health services to paediatric endocrinology for the prescription of puberty suppressing hormones have been paused for any new patients assessed by our young person’s gender service.
“Patients aged 16 to 17 years old, who have not been treated by paediatric endocrinology, but who are still seeking treatment for their gender incongruence, will no longer be prescribed gender-affirming hormone treatment until they are 18 years old.
“If you are already being treated by paediatric endocrinology and being prescribed either of these medications, you will have been contacted and advised that there will be no change to your course of treatment. You will also have been informed that you can contact your clinician if you have any concerns.”
The clinic said the update follows the Cass Review and added: “While this pause is in place, we will continue to give anyone who is referred into the young people gender service the psychological support that they require while we review the pathways in line with the findings. A number of support networks are also available via mental health support (sandyford.scot).
“If you’re waiting for an appointment with our service, please be assured that this service update won’t impact your position on the list.”
Dr Cass said children had been let down by a lack of research and that there was “remarkably weak” evidence on medical interventions. NHS England confirmed it would stop prescribing puberty blockers in March. NHSGCC said it would work with officials on research into the treatments.
Dr Emilia Crighton, director of public health at NHSGGC, said: “The findings informing the Cass Review are important and we have reviewed the impact on our clinical pathways.
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“The next step from here is to work with the Scottish Government and academic partners to generate evidence that enables us to deliver safe care for our patients. We echo the views of Dr Hilary Cass that toxicity around public debate is impacting the lives of young people seeking the care of our service and does not serve the teams working hard to care and support them.
“We understand the distress that gender incongruence can cause and, while all referrals to endocrinology are paused, we will continue to give anyone who is referred into the young people gender service the psychological support that they require while we review the pathways in line with the findings.”
Scotland’s Health Secretary, Neil Gray, welcomed the move, saying the final decision was one that should be made by clinicians rather than Government.
Scottish Tory deputy leader, Meghan Gallacher, has said the decision should have been taken “weeks ago”.
Ms Gallacher had repeatedly pushed for a statement to be made in Holyrood on the Cass Review, which ministers rejected.
“This long overdue decision should have been taken weeks ago when NHS England put a pause on the prescribing of puberty blockers,” she said after the decision was announced.
“The SNP government have been dragged kicking and screaming towards taking the necessary action to safeguard vulnerable youngsters after days of shameful silence and dithering in response to the Cass Review – presumably to placate the gender zealots in the Scottish Greens.
“[First Minister] Humza Yousaf repeatedly passed the buck – insisting it was up to clinicians to decide on the efficacy of puberty blockers and saying he wouldn’t be rushed into responding to Cass – when it was clear decisive action was required.”
NHS Lothian has also formally paused the prescription of puberty blockers and gender-affirming hormones for new young patients in Scotland seeking gender-affirming care.
Tracey Gillies, the health board’s executive medical director, said: “The Cass Review is a significant piece of work into how the NHS can better support children and young people who present with gender dysphoria. Patient safety must always be our priority and it is right that we pause this treatment to allow more research to be carried out.”
The Cass Review criticised the lack of evidence around the use of puberty blockers and other medical interventions, saying the entire area of gender care had been built on “shaky foundations”.
Puberty blockers work by suppressing the release of hormones that cause puberty and are often prescribed to children questioning their gender as a way of stopping physical changes such as breast development or facial hair.
Two charities have said a decision to pause the prescription of puberty blockers and gender-affirming hormones for new young patients was the wrong one. The Equality Network and Scottish Trans said in a joint statement the decision could harm transgender young people who are already rarely prescribed the drugs.
“We’re saddened that this change will result in some young people being unable to access the care they need at all, or having to wait even longer for it,” said Vic Valentine, manager of Scottish Trans.
