NHS England recently declared that puberty blockers for adolescents with gender dysphoria will only be administered within the context of clinical research, as part of their newly launched gender incongruence service for minors.
This guidance comes as the controversial Tavistock and Portman NHS foundation trust, England and Wales’ sole NHS gender identity service for youth, is set to shut down in May 2024 after being labeled ‘unsustainable’ in an interim review by Dr. Hilary Cass in July last year. The service will be replaced by two regional hubs located in the northern and southern parts of the country.
NHS England’s announcement echoes Dr. Cass’ independent review, which highlighted considerable uncertainties concerning hormone treatments. The strategy entails replacing the Gender Identity Development Service at the Tavistock with a model that includes medical doctors overseeing physical treatments rather than therapists or psychologists.
The guidance also specifies that data and subsequent treatment follow-ups will be part of an ongoing process under an NHS research program. Furthermore, the NHS advocates that social transitioning should be led by the individual and their family, assisted by clinical input.
The NHS recognizes the complexities and varying outcomes associated with early social transition and argues that more information regarding long-term effects is crucial for making informed decisions. They point out that gender incongruence in prepubescent children can be unpredictable and may change over time.
Over the last decade, referrals to the Tavistock service have increased from nearly 250 in 2011/12 to over 5,000 in 2021/22. The patient demographic has also shifted significantly from primarily birth-registered males to mainly females, many of whom have additional neurodiverse and mental health needs and engage in risky behaviors. This change comes amid whistleblower allegations of inconsistent practices at the Tavistock clinic regarding the prescription of puberty blockers, given the lack of understanding about their long-term effects.
