NHS to Introduce Comprehensive Autism Assessments for Children Identifying as Transgender
In a move to provide more holistic care for children who identify as transgender, the NHS is set to introduce new guidance that will see all children referred to its gender identity clinics assessed for autism. The new guidance, which is due to be published for public consultation, is part of a broader effort to revamp the way the NHS provides care for children struggling with their gender identity.
According to The Times, the new network of gender clinics for under-18s will provide comprehensive care for children who identify as transgender, replacing the Tavistock gender identity clinic, which was found to have rushed children onto a medical pathway of puberty blockers without fully assessing their mental health. The new clinics will examine children to see whether they have other conditions, including ADHD, autism, learning disabilities, or mental health problems, which may be considered to be the underlying cause of their distress.
The specification for the new services, seen by The Times, states that “given the high prevalence of neurodiversity identified within this population, all those attending the NHS Children and Young People’s Gender Service should receive screening for neurodevelopmental conditions.” This includes screening for autism spectrum disorder (ASD), and if screening identifies the presence of neurodevelopmental conditions, a referral should be considered to the Paediatric Neurodevelopmental Service or Paediatric ASD service.
As The Times reports, a multidisciplinary team involving doctors and psychologists will assess eight key areas of a child’s life, including whether they are attracted to members of the same sex, their family relationships, and a full medical history. This new approach is in line with the recommendations made by Dr Hilary Cass, a retired consultant paediatrician and former president of the Royal College of Paediatrics and Child Health, who led the Cass Review into gender services.
Dr Cass emphasised the importance of treating children who identify as transgender as “whole persons and not just through the lens of their gender identity.” She also highlighted the link between the rise in teenage girls struggling with gender identity and cases of “undiagnosed autism, which is often missed in adolescent girls.” According to Dr Cass, it is vital that children who identify as transgender receive treatment for “ordinary” problems such as depression or autism.
The NHS has already opened two new gender clinics at Great Ormond Street in London and Alder Hey in Liverpool, with up to six more set to open in the next two years. The health service has also announced plans to offer some children puberty blockers as part of a planned £10.7 million clinical trial. However, this move has been met with controversy, as puberty blockers were “indefinitely” banned across the UK last year for children identifying as transgender, due to fears they are unsafe and harm bone and brain development.
As the NHS prepares to go to full public consultation on this draft specification, it has confirmed that it will be changing the referral pathway for children accessing gender services. From now on, child patients will only be able to access commissioned gender services if they are referred by a paediatrician or a child and adolescent mental health worker. As The Times notes, this move is part of a broader effort to ensure that children receive comprehensive and holistic care for their complex needs.
The introduction of comprehensive autism assessments for children identifying as transgender is a significant development in the provision of care for this population. As reported by The Times, this new approach reflects a growing understanding of the complex needs of children who identify as transgender and the need for a more nuanced approach to their care. With the publication of this new guidance, the NHS is taking a significant step towards providing more comprehensive and effective care for children struggling with their gender identity.
The guidance will ensure that children are treated as “whole persons” – according to The Times, this reflects in a move away from the approach of the Tavistock clinic which was criticised for over-reliance on medical interventions such as puberty blockers.
The plan of the new service according to The Times has been developed based on The Times review carried out by Dr. Hilary Cass which noted a lot of children had undiagnosed Autism – indicating, a holistic approach to assessment would provide robust support.
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