Children in England will no longer be prescribed puberty blockers at National Health Service gender identity clinics. This is good news: it was never appropriate to halt the normal physical development of young people struggling with the concept of growing up into the men and women that nature intended.
Puberty blockers, followed by cross-sex hormones, were a so-called solution that, in my view as a transgender adult, created a very serious problem. A cohort of young people identified as transgender, non-binary or maybe something yet more mysterious. They demanded powerful and life-altering drugs to ward off what they — or their parents — feared might be a mental health catastrophe. All too readily, those demands were met.
Now, Hilary Cass — the pediatrician who is conducting an independent review of gender identity services for children and young people — has helped put the brakes on this madness. She said, in a 2022 review, that there is a lack of clarity over whether the drugs simply “pause” puberty or if they act as “an initial part of a transition pathway” with most patients becoming “locked in” to changing their gender. The landmark guidelines issued yesterday back Cass up: these said that there is not enough evidence that the drugs are safe and from now on they should only be given as part of clinical trials. This is long overdue.
Hundreds of under-sixteens have been prescribed puberty blockers on the NHS since 2011, having been referred to the gender identity clinic run by the Tavistock and Portman NHS Foundation Trust in north London. In recent years, demand for treatment has overwhelmed the limited provision and waiting lists for children — as well as adults — have mushroomed. According to reports, fewer than 100 children are now currently on puberty blockers through the NHS Gender Identity Development Service, though how many more have their lives on hold is unknown. Waiting forlornly for a call from a distant clinic is no way to live.
The fact that the treatment may ultimately be worse than the wait is hardly comforting to children who have been led to believe that it would solve their problems. It won’t — and that is a particular tragedy for children who would otherwise benefit from timely community mental health support. If the promises made by gender clinics cannot be delivered, then it is better not to make them at all. As such, yesterday’s news is welcome all round.
Unfortunately, that is not the full story. The interim policy on which NHS England consulted last year suggested that, “access to puberty suppressing hormones for children and young people with gender incongruence/dysphoria should only be available as part of research.” One would hope that further research involving clinical trials would now be struck down as unethical, but a loophole is left open for further meddling with children’s development.
Then there is the rest of the United Kingdom to worry about. NHS England’s remit is for England. Scotland, whose government seems desperate to be ever more wokier-than-thou, has a separate NHS. While increasing caution has been applied south of the border, Healthcare Improvement Scotland (HIS), part of NHS Scotland, outlined the need for prescribing to continue outside research because of rising numbers of adults and children seeking help.
Finally, there are private providers ready to sell into a market that will pay. Last year, GenderGP asserted that NHS England Specialist Services does not govern what GPs and hospital consultants do in their own services, and has “no impact on private doctors and what they decide is the right care for their patients.” GenderGP says it will “continue to provide puberty blockers and gender-affirming hormones to patients who need them.”
So, while yesterday’s announcement is a step in the right direction, more is needed to protect children. Liz Truss’s private members’ bill to Amend the Health and Equality Acts is due to be debated on Friday. This bill would make it an offense to prescribe, administer or supply medicinal products to a child as part of a course of treatment for gender dysphoria for the purposes of stopping or delaying the normal onset of puberty, or affirming the child’s perception of their sex where that perception is inconsistent with the child’s sex.
It’s a worthy and valuable aim, but one that is unlikely to be delivered without the active support of the government. To make progress, this bill needs time and expertise to ensure that the drafting is watertight. The Tories look doomed whatever Rishi Sunak does between now and the election. But what better legacy to leave than the protection of children? If Sunak means business, this is an opportunity to make a lasting difference.
This article was originally published on The Spectator’s UK website.
