UK’s only children’s gender clinic ordered to close — Analysis

NHS England took the decision after concerns about the use puberty-blockers and other controversial methods.

The only children’s gender identity clinic in the UK has been ordered to close after an independent review accused it of “Rushing” kids into the use of hormonal therapy and neglecting other medical needs.

According to a statement from National Health Service (NHS) England published by British media on Thursday, the Tavistock & Portman NHS Foundation Trust’s clinic must close by next spring. It will be replaced by two ‘early adopter services’ centers, in London and in the North West, which will be run by prominent children’s hospitals – Great Ormond Street, Evelina, Alder Hey, and the Royal Manchester.

“The establishment of the Early Adopter services will happen as quickly as possible but, crucially, at a pace that appreciates the complexity of the change, while minimising disruption and any additional anxiety for patients,”NHS England.

Pediatrician Dr. Hilary Cass, who began the review into the Tavistock Gender Identity Development Service clinic’s work in 2020, expressed concern earlier over its rushed use of ‘puberty blockers’. These prescription drugs, which suppress the body’s release of hormones, have been issued to children experiencing gender dysphoria. The use of puberty blockers by the Tavistock’s clinic was previously the subject of litigation. The Court of Appeal upheld a ruling from a divisional court in 2020 that stated that children under 16 years old cannot consent to such treatment. 

Appeals court overturns controversial ruling on child gender treatment in UK; doctors CAN prescribe puberty blockers to under-16s

In a letter to the NHS, Cass said the controversial treatment’s role in the development of sexuality and gender identity for people in their teens has not been studied well enough yet. The therapy is not effective, she said. “may trigger the opening of a critical period for experience-dependent rewiring of neural circuits underlying executive function (i.e. maturation of the part of the brain concerned with planning, decision making and judgement).”She concluded that a cautious approach to prescribing these medications is necessary. “understanding both the risks and benefits of having treatment and not having treatment.”

Another reason for concern for Cass is that once children and young people were identified as having gender-related distress, “Sometimes, important issues in healthcare that should be handled by local services are overlooked.” by the clinic. 

More broadly, the entire model for providing care for children with gender identity issues needs to be changed in a way to make it safer for children and to involve more research into these practices, the review’s author noted. Cass suggested that regional centers be established. “by experienced providers of tertiary paediatric care to ensure a focus on child health and development, with strong links to mental health services.”

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