Private clinics may face ban on giving out puberty blockers
PRIVATE clinics could be banned from prescribing puberty blockers to trans children after they were strongly criticised in a landmark medical review.
Ministers have pledged to ‘look carefully’ at proscribing private clinics after an independent report by expert paediatrician Dr Hilary Cass expressed concern over their behaviour.
Dr Cass’s review found GPs were ‘pressurised to prescribe hormones’ by patients who had seen a private clinician, outside of the NHS’ remit.
The report, which ran to nearly 400 pages, issued a stern warning over ‘the use of unregulated medications and of providers that are not regulated within the UK’.
Last month, the NHS said children would no longer be prescribed such blockers at gender identity clinics.
And Dr Cass said GPs should resist attempts by private providers to prescribe puberty blockers or hormones, ‘particularly if that private provider is acting outside NHS guidance’. There was no good evidence to support the use of puberty blockers, with gender medicine ‘built on shaky foundations’, the review said.
Home Office minister Laura Farris said the Government was ‘ looking carefully’ at the Cass review when asked whether it would legislate to ban access to prescriptions for gender-blocking drugs from private clinics and online.
She told Times Radio: ‘ We are absolutely clear that there should not be obtaining of any drugs that haven’t been prescribed and [Dr Cass has] given very strong conclusions on puberty blockers, so we will be looking carefully at what she said and act accordingly.’
Campaigners said the ‘ cowboy clinics’ must be closed and called on the Government to legislate against them.
Fiona McAnena of charity Sex Matters said: ‘It’s scandalous that rogue private “gender” clinics in the UK and abroad are still free to supply British children with off-label puberty blockers.
‘Worried parents have been misled by false claims about child suicide, so they think they have no choice but to allow their children to use these powerful drugs, for which there’s zero evidence of benefit.
‘Dr Hilary Cass has done everything she can to close this dangerous loophole, including by warning GPs not to get involved in shared care with private providers.
‘She also reminded pharmacists of their responsibility for the safety of patients and that they could be criminally liable if they fall short of professional standards.
‘Dr Cass has done her best, but shutting down cowboy clinics is beyond the scope of her review.
‘Ministers must now act urgently, and prevent overseas and private clinics from prescribing these dangerous drugs to gender-distressed children.’
Dr Cass’s comments have been seen as a warning shot to GenderGP, a private clinic which operates in the UK, but is based in Singapore.
Run by Dr Helen Webberley, the clinic has taken a defiant stance against NHS guidance and only days ago issued a statement denouncing the NHS’s ban on puberty blockers
It read: ‘The decision by NHS England to ban puberty blockers for trans adolescents is empirically unjustified, ethically unacceptable, and is based on assumptions that are inaccurate and unsupported.
‘The systematic reviews by NICE [The National Institute for Health and Care Excellence], which informed NHS England’s decision, not only fail to acknowledge several relevant studies, but also use an inappropriate evaluative framework that unduly minimises several important sources of evidence.’
Last month NHS England announced it was banning the routine prescription of puberty blockers to children, following the recommendations made in Dr Cass’s interim review.
In the days following the announcement, Dr Webberley said: ‘GenderGP will not be following the NHS guidance, it will be following international guidelines and best practice.’
She cited guidelines from the World Professional Association for Transgender Health, which were discredited in Dr Cass’s review having created ‘an apparent consensus on key areas of practice despite the evidence being poor’. The Mail has attempted to contact Dr Webberley for comment since the publication of the Cass review.
Dr Cass said in her review: ‘ GPs have expressed concern about being pressurised to prescribe hormones after these have been initiated by private providers and that there is a lack of clarity around their responsibilities in relation to monitoring.
‘ The review understands and shares the concerns about the use of unregulated medications and of providers that are not regulated within the UK.
‘Any clinician who ascertains that a young person is being given drugs from an unregulated source should make the young person and their family aware of the risks of such treatment.
‘Specifically, no clinician should prescribe outside their competence, nor should GPs be expected to enter into a shared care arrangement with a private provider, particularly if that private provider is acting outside NHS guidance.
‘The review has been told that a
‘Worried parents have been misled ’
‘Ministers must now act urgently’
number of young people have sought private provision while on the waiting list for GIDS, [the Gender Identity Development Service] and about families trying to balance the risks of obtaining unregulated and potentially dangerous hormone supplies over the internet with the ongoing trauma of prolonged waits for assessment.
‘Feedback from the lived experience focus groups presents this as “a forced choice rather than a preference”.’
Dr Cass was appointed to lead a review into NHS England’s gender identity development services in 2020, after a sharp rise in the number of patients questioning their gender. Whistleblowers had raised concerns about the standards of care offered by GIDS at the Tavistock and Portman NHS Foundation Trust.
The claims ultimately saw the Tavistock clinic closed and two replacement regional hubs in London and Liverpool opened this month.
Dr Cass’s review made 32 recommendations in her final report.
Dr Webberley declined to comment