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

NHS England made the decision following concerns over the use of puberty blockers and other controversial practices

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 said.

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. Last year, the Court of Appeal overturned a 2020 ruling by a divisional court which stated that under-16s lack the capacity to give informed consent to this treatment. 

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. She noted that the therapy “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).” For these reasons, she concluded, a more cautious approach is required when it comes to prescribing these drugs, which should also include “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, “other important healthcare issues that would normally be managed by local services can sometimes be 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 said the new regional centers should be run “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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