The United Kingdom's National Health Service is advising health professionals to take a more watchful approach to gender dysphoria cases among minors, saying that children proclaiming to be trans-identified may be going through a "phase" and shouldn't be encouraged to socially transition so quickly.
The NHS proposed new guidelines Thursday, warning that doctors shouldn't so easily encourage minors to socially transition by changing their names or pronouns during what may be a "transient phase." The proposed guidelines would regulate an interim service to help young people with gender dysphoria following the announced closing of the country's largest gender clinic.
The document comes as an independent review led by Dr. Hillary Cass, the former president of the Royal College of Paediatrics and Child Health, was released this year, finding that "social transitioning" is not a "neutral act" and could have "significant effects" in terms of "psychological functioning."
"The clinical management approach should be open to exploring all developmentally
appropriate options for children and young people who are experiencing gender
incongruence, being mindful that this may be a transient phase, particularly for prepubertal children, and that there will be a range of pathways to support these children and young people and a range of outcomes," the proposed guidelines state.
The document advises that the "clinical approach in regard to pre-pubertal children will reflect evidence that suggests that, while young people who are gender querying or who express gender incongruence may have started their journey as younger children, in most prepubertal children, gender incongruence does not persist into adolescence."
The document adds that doctors should consider whether autism or other mental health conditions are relevant to a child's desire to transition.
A 2018 study conducted by the American Academy of Pediatrics and a 2016 study published in the Journal of Clinical Child & Adolescent Psychology suggest that large percentages of children with a history of gender dysphoria have a mental health or neurodevelopmental condition.
The NHS's proposed guidelines intend to replace protocols at the now-shuttered gender identity clinic at the Tavistock and Portman Trust in London, which pursued "gender-affirming" intervention for trans-identified minors.
The government launched the independent review following an exponential rise in children referred to the Tavistock gender clinic. The Cass review found that "potentially irreversible treatments" were "given to children and young people, when the evidence base underlying the treatments is inconclusive, and when there is uncertainty about whether, for any particular child or young person, medical intervention is the best way of resolving
Cass criticized the clinic's use of experimental puberty-blocking drugs to treat gender dysphoria in a July 19 report. She also recommended moving away from the sole provider care model and urged the development of regional services to meet the needs of patients.
"The rationale for use of puberty blockers at Tanner Stage 2 of development was based on data that demonstrated that children, particularly birth-registered boys who had early gender incongruence, were unlikely to desist once they reached early puberty; this rationale does not necessarily apply to later-presenting young people, including the predominant referral group of birth-registered girls," Cass wrote.
"We do not fully understand the role of adolescent sex hormones in driving the development of both sexuality and gender identity through the early teen years, so by extension we cannot be sure about the impact of stopping these hormone surges on psychosexual and gender maturation. We therefore have no way of knowing whether, rather than buying time to make a decision, puberty blockers may disrupt that decision-making process."
NHS reports there were over 5,000 referrals for gender identity services between 2021 and 2022, compared to just 250 referrals from 2011 to 2012.
"Staff [at regional centers] should maintain a broad clinical perspective in order to embed the care of children and young people with gender uncertainty within a broader child and adolescent health context," Cass wrote.
Worldwide detransitioners — individuals who once trans-identified and now regret their decisions — have spoken out about being too young to be given the ability to make body-altering decisions.
One of the most prominent cases in the U.K. is that of Keira Bell, a young woman who underwent a cosmetic double mastectomy and took opposite-sex hormones as a teenager but later regretted the decision.
Bell alleged in a judicial review that she was incapable of understanding the risks associated with taking puberty blockers when she was treated at the Tavistock clinic as a teenager. The U.K. High Court of Justice initially ruled in Bell's favor before reversing the decision a few months later.
As NHS reported in May 2020, "[l]ittle is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria."
"Long-term cross-sex hormone treatment may cause temporary or even permanent infertility," the NHS website states. "There is some uncertainty about the risks of long-term cross-sex hormone treatment."
Samantha Kamman is a reporter for The Christian Post. She can be reached at: firstname.lastname@example.org.