NHS England has announced a significant shift in its approach to caring for children with gender dysphoria, stating that puberty blockers will no longer be prescribed due to insufficient evidence regarding their safety and clinical effectiveness. The decision, applauded by the government as a “landmark,” follows a public consultation and evidence review by the National Institute for Health and Care Excellence (Nice).
NHS England
The NHS decision means that upcoming regional services for under-18s with gender dysphoria, set to open next month, will not include puberty blockers in their treatment protocols. Going forward, these medications will only be accessible through participation in clinical trials, with at least one trial scheduled to commence later this year, though specific details remain undisclosed.
This move reiterates NHS England’s stance from the previous year, when Dr. Hilary Cass, leading an independent review into gender identity services for under-18s, cautioned against routine prescription of puberty blockers. Dr. Cass was appointed by NHS England in late 2020 to examine gender identity services previously provided exclusively by the NHS’s Tavistock and Portman mental health trust in London. The trust’s gender identity development service, including the use of puberty blockers, had faced criticism.
The closure of the trust’s service at the end of the month marks a shift to new centers opening in April at specialized children’s hospitals like Great Ormond Street in London and Alder Hey children’s hospital in Liverpool. NHS England aims to establish seven or eight such centers in total, delivering services fundamentally different from the current model following the Cass recommendations.
Health Minister Maria Caulfield welcomed the decision, emphasizing the importance of evidence-based care in the best interests of the child. However, LGBTQ+ rights charity Stonewall expressed concerns about the policy change, emphasizing the importance of timely access to healthcare for trans young people, while Sex Matters praised NHS England’s return to evidence-based policymaking in the realm of childhood gender distress treatment.
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