New review launched into NHS gender identity services, puberty blockers, hormones

By Brandon Showalter, Opinion writer and social commentator Thursday, September 24, 2020

A new independent review has been launched into Britain's National Health Service regarding gender identity services for young people and children.

The NHS said Tuesday that Dr. Hilary Cass OBE, who is the former president of the Royal College of Paediatrics and Child Health, will lead a wide-ranging review examining several dimensions of such services, including how and when referrals are made to specialists and how clinical decisions are made pertaining to treatment of gender dysphoric patients.

The review will additionally establish "workforce recommendations for specialist healthcare professionals and examine the recent rise in the number of children seeking treatment."

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The Gender Identity Development Service for Children and Adolescents is managed by the Tavistock and Portman NHS Foundation Trust. The London-based Tavistock clinic has come under considerable scrutiny this year amid allegations that minors were being rushed into medicalized gender transition and that the physical and psychological risks were not explained.

Keira Bell, a detransitioner in her 20s who underwent hormonal transition as a teenager and then went on to have her breasts amputated, joined a lawsuit against the clinic early this year, saying she was harmed.

"The news of this review has come as a surprise as it was unexpected and it covers the same issues my proposed court case was going to raise," Bell said in a Tuesday update on her crowdfunding page.

"This type of case is front-loaded and my legal team had worked hard to prepare evidence that raised concerns about the [memorandum of understanding], the default approach of positive affirmation [of trans identity] that it created and the dangers associated with the lack of therapeutic work to address the reasons why a young person has gender dysphoria."

She added: "In the light of the decision of the NHS to conduct a thorough review of practice at GIDS my lawyers have advised me that my case would be unsuccessful. Judicial Review is a legal remedy of last resort and there is an alternative remedy that it going to explore my concerns – namely the NHS review of GIDS."

The case against the Tavistock clinic that pertains to informed consent and was brought by whistleblower psychologist Sue Evans is reportedly still going forward and will occur on Oct. 7 and 8.

The independent review includes an examination of the issues surrounding children and young people who are given puberty blockers and cross-sex hormones.

Earlier this year, the NHS quietly removed language from the transgender guidance section of its website claiming that drugs used to arrest the pubertal processes in trans-identifying youth were "fully reversible."

The updated guidelines noted that little is known about the long-term side effects of hormone or puberty blockers in children suffering from gender dysphoria.

"Although the Gender Identity Development Service (GIDS) advises this is a physically reversible treatment if stopped, it is not known what the psychological effects may be," the new guidelines read.

"It's also not known whether hormone blockers affect the development of the teenage brain or children's bones. Side effects may also include hot flushes, fatigue and mood alterations."

The doctor leading the review welcomed the process.

"It is absolutely right that children and young people, who may be dealing with a complexity of issues around their gender identity, get the best possible support and expertise throughout their care,” Cass said in a statement.

“This will be an inclusive process in which everyone will have the opportunity to make their views known. In particular I am looking forward to hearing from young people and their families to understand their experiences."

Dr. Michael Brady, the National Adviser for LGBT Health stated: “Every child matters and children and young people who are exploring their gender or experiencing gender dysphoria, including those who are trans or non-binary, deserve the very best from the NHS."