New Guidance on Transgender Children and Gender Dysphoria
New guidance is set to be issued in England, which calls for transgender children to be screened for neurodevelopmental conditions, including autism and ADHD. This move comes in the wake of the Cass Review into gender identity services in the NHS, which was published in April 2024. The review led to the banning of puberty blockers as a treatment for under-18s in December of the same year.
The guidance, which is reportedly to be published imminently, is expected to see the health service in England move away from a "medical model" in favour of a "holistic" approach to care. Medics will examine various aspects of children’s lives when they are referred to services, including mental health assessments, family relationships, sexual development, and the presence of learning disabilities or neurodevelopmental conditions.
According to a report in The National, the leaked document states: "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." If screening identifies the presence of neurodevelopmental conditions, including autism spectrum disorder (ASD), a referral should be considered to the paediatric neurodevelopmental service or paediatric ASD service.
An NHS England spokesperson said: "As part of NHS England’s commitment to implement advice from the Cass Review, we have recently gone out to stakeholder testing on a proposed revised specification planned to replace the interim service specification for the children and young people’s gender service." The spokesperson added that NHS England has recently changed the referral pathway so child patients can only access gender services that are commissioned if they’re referred by a paediatrician or a child and adolescent mental health worker.
The Scottish Greens have described the intervention as "inappropriate", adding that it would make waiting lists for both trans healthcare and autism assessments longer. Scottish Greens MSP Gillian Mackay said: "This assertion is totally inappropriate and is part of an attempt to further stigmatise and delegitimise trans people and their identities and shows a lack of understanding about people with autism." Mackay added that it would only extend the waiting times that are already far too long, both for trans healthcare and for autism assessments.
UK health minister Stephen Kinnock said he was "not familiar" with the reported plans, but told BBC Radio 4’s Today Programme: "I think the Cass review set out very clearly that change is required, that some mistakes have been made and we need to rectify those." Kinnock added that the best way to do that now is to really look at how to get gender services working for young people in a way that reflects the complexity of each individual.
The Scottish Government has stated that it remains committed to working with NHS Scotland partners to improve access to, and delivery of, NHS gender identity healthcare for children and young people. A spokesperson said: "Following publication of a Chief Medical Officer’s report on the implications of the Cass Review for NHS Scotland in July 2024, a Task and Finish Group of NHS planners and clinicians is currently in the process of designing a new, more sustainable model for young people’s gender identity healthcare services which will be based in a paediatric clinical setting." The process will include consideration of available evidence and best practice in this clinical field.
As reported by The National, the UK’s Equality and Human Rights Commission (EHRC) has released guidance on single-sex spaces following the Supreme Court’s gender ruling. The guidance states that it is "compulsory" for workplaces to provide single-sex toilets and changing facilities. The EHRC’s interim guidance also states that transwomen cannot use female toilets, while transmen cannot use male toilets as they would "no longer" be single-sex facilities.
The new guidance on transgender children and gender dysphoria is set to have significant implications for the way that the NHS approaches care for young people with gender dysphoria. As The National reports, the guidance is expected to be published imminently, and will see the health service in England move away from a "medical model" in favour of a "holistic" approach to care.
This move has been reported by The National and further information can be found on their website.
