Scotland’s Health Secretary has welcomed the decision of two health boards – one of which covers the only gender clinic in the country for young people – to pause the prescription of puberty blockers to new patients.
NHS Greater Glasgow and Clyde (NHSGGC) and NHS Lothian said the decision came with the support of Scotland’s chief medical officer, Professor Sir Gregor Smith, following a review by Dr Hilary Cass in England and the same decision being taken south of the border.
NHSGGC covers Scotland’s only gender clinic for under-18s while NHS Lothian provides care to those aged 17 and over at its Chalmers gender identity clinic.
Scottish Health Secretary Neil Gray said it was right for the decision to be made by clinicians rather than politicians, adding the Government and boards are considering the recommendations of the Cass Review.
“We have been clear it is for clinicians and health boards to make decisions about clinical pathways, and that these decisions should be made carefully and based on the best evidence available.
“This is what both health boards have done and their position is supported by the chief medical officer.
“More broadly, the Cass Review’s final report and findings are being closely considered by both the Scottish Government and health boards, in the context of how such healthcare can be best delivered in Scotland.”
He went on to lament the “toxic” debate around gender issues – mentioned by Dr Cass in her review – saying those in receipt of care should be “at the centre of our thoughts when we discuss this issue”.
“The next step from here is to work with the Scottish Government and academic partners to generate evidence that enables us to deliver safe care for our patients.
“We echo the views of Dr Hilary Cass that toxicity around public debate is impacting the lives of young people seeking the care of our service and does not serve the teams working hard to care and support them.
“We understand the distress that gender incongruence can cause and while all referrals to endocrinology are paused, we will continue to give anyone who is referred into the young people gender service the psychological support that they require while we review the pathways in line with the findings.”
The Cass Review criticised the lack of evidence around the use of puberty blockers and other medical intervention, with the health boards saying they will work with Government on research into the treatments.
Under the changes, those who have already been prescribed the drugs will continue to receive them, but new patients will not.
Today the Sandyford Young People’s Gender Service has announced that they will no longer be referring under 18s for endocrine treatments.
Read our full response: https://t.co/pqP2aqPAi9 pic.twitter.com/uMt1kXe1s4
— Scottish Trans (@ScottishTrans) April 18, 2024
The boards said they had made the decision to “defer” putting new patients on hormone suppressants in mid-March following the same decision by NHS England.
Tracey Gillies, executive medical director at NHS Lothian, said: “The Cass Review is a significant piece of work into how the NHS can better support children and young people who present with gender dysphoria.
“Patient safety must always be our priority and it is right that we pause this treatment to allow more research to be carried out.”
But two Scottish charities have said the decision is wrong.
The Equality Network and Scottish Trans said they are concerned about the impact the decision could have on transgender young people, who they said were rarely prescribed the drugs.
“We’re saddened that this change will result in some young people being unable to access the care they need at all, or having to wait even longer for it,” Scottish Trans manager Vic Valentine said.
“We want every child or young person to get the individualised care that’s right for them at the time that’s right for them. We don’t think this decision will make that possible.”
The charities called on health boards and the Scottish Government to “urgently prioritise” research required to “make sure that no child or young person is denied the care they need”.
Since the publication of the Cass Review, the Scottish Government has faced pressure to respond to its findings, with high-profile politicians including SNP MP Joanna Cherry calling for the use of puberty blockers to be halted.
She said: “The SNP Government have been dragged kicking and screaming towards taking the necessary action to safeguard vulnerable youngsters after days of shameful silence and dithering in response to the Cass Review – presumably to placate the gender zealots in the Scottish Greens.
“Humza Yousaf repeatedly passed the buck, insisting it was up to clinicians to decide on the efficacy of puberty blockers and saying he wouldn’t be rushed into responding to Cass – when it was clear decisive action was required.”
Scottish Labour deputy leader Dame Jackie Baillie said she was “pleased” at the decision and urged the Government to lay out what changes will be made to treatment in the wake of the Cass Review.
“The guiding principle for all actions must be to ensure that young people with gender dysphoria get safe treatment,” she added.
“The messaging from the Scottish Government on the Cass report has been all over the place, leaving the public without clarity on this vital issue.”
Alba Holyrood leader Ash Regan – who resigned from the Scottish Government over her gender-critical views and later defected from the SNP – welcomed the announcement and called for a timetable to be set out for a “full response” to the Cass Review’s recommendations.
