A long awaited report on NHS gender identity services has found that children and young people have been provided with unproven treatments, while the ‘toxicity’ of the debate has left health care professionals afraid to discus their views. The report from Dr Hilary Cass, found out that doctors prescribed puberty blockers and cross sex hormones on the basis of ‘no good evidence on the long-term outcomes of interventions’.
A former president of the Royal College of Paediatrics and Child Health, Dr Cass was commissioned by NHS England after a sharp rise in the number of young people referred to the NHS for gender issues, and whistleblowers started to rise concerns about the Gender Identity and Development Service, run at the Tavistock Clinic The clinic recently closed after being rated as inadequate by inspectors.
Dr Cass raised concerns about ‘diagnostic overshadowing’, where gender issues were prioritised above investigating any mental health concerns, or neurodevelopmental conditions. As a result of her findings, the NHS has effectively sopped prescribing puberty blockers and has moved to a model of care which stresses psychological support over medical interventions.
'For most young people, a medical pathway will not be the best way to manage their gender-related distress,’ she said. ‘For those young people for whom a medical pathway is clinically indicated, it is not enough to provide this without also addressing wider mental health and/or psychosocially challenging problems.’
Dr Cass also called for a more respectful, evidence-based debate around the issue, warning that some professionals had become afraid to work in the field. ‘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. This must stop,’ she said.