The Daily Telegraph

‘Children must not be rushed to transition’

Major NHS report warns mental health may be bigger factor for young people

- By Daniel Martin DEPUTY POLITICAL EDITOR

CHILDREN who believe they are transgende­r may actually have mental health issues, a landmark report is set to find this week.

It is expected to advise that children should not berushed on to a path to change gender, and that they receive counsellin­g which addresses the mental health issues they may have rather than being put on drugs.

Dr Hillary Cass, a paediatric­ian, will tomorrow unveil her long-awaited review into how transgende­r children are supported and the medical treatment they receive.

It comes amid concern that children are being allowed to change gender in school without their parents’ knowledge or consent, and after the routine prescripti­on of puberty blockers was banned by NHS England.

The Telegraph understand­s that the report will find that children who think they are trans disproport­ionately have mental health issues, a difficult family situation or have suffered from abuse. They are also more likely to be neurodiver­se.

It is expected to suggest that these children need counsellin­g to tackle these problems holistical­ly, rather than them automatica­lly being put on a path to change gender.

The report is expected to warn that it is wrong to assume it is in the best interest of children who think they are trans to change gender, and urge extreme caution over the use of drugs such as puberty blockers and cross-sex hormones to facilitate this, even once someone is over 18 years old. The review is also said to express concern about a significan­t rise in the number of young girls wanting to become boys, and say this group needs more support.

Yesterday, Downing Street said the Government would act on the basis of the report to ensure children and adolescent­s are kept safe.

The Prime Minister’s spokesman said: “We have talked about the importance of children and adolescent safety and wellbeing being paramount.

“That is part of previous work such as the NHS announceme­nt to end the routine prescripti­on of puberty blockers, it is behind our robust and clear guidance to schools, [and] it is categorica­l that social transition­ing is not a neutral act and no one should be forced to use preferred pronouns or accept contested beliefs as fact.

“We’ve also said there’s more to do in this area and we will look at the review when it’s published.”

The spokesman added: “The Government has taken a number of steps in this area, recognisin­g the effect that social transition­ing can have on children and adolescent­s, and we’ve made clear that single sex spaces must be protected.”

The interim Cass report in 2022 said that children being allowed to socially transition in schools – changing their name and pronouns, and being allowed to use the toilet and changing rooms of the gender they identify as – was “not a neutral act”. It also raised concerns about the NHS’S gender identity and developmen­t service at the Tavistock and Portman NHS trust in London.

Dr Cass’s final report is expected to conclude that there could be many complex reasons a child may think they are in the wrong gender.

Dr Cass’s report is understood to say that prepubesce­nt children should not be put on the same “pathway” as older adolescent­s who wish to identify as the opposite gender.

It is expected to warn that children may experience “psychologi­cal” repercussi­ons as a result of being allowed to change their name and pronoun to the gender of their choice.

Last month, the NHS announced an immediate ban on prescribin­g puberty blockers to under-18s unless they are part of a clinical trial. Ministers said the “landmark decision” was in children’s “best interests” and would help to ensure youngsters who feel their gender is not the same as their sex are treated using medical evidence.

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