NHS ordered to reveal fates of 9,000 trans children

THE NHS must reveal the fate of 9,000 transgender young people treated by the controversial Tavistock clinic, the Health Secretary has said in the wake of the Cass Review.

The landmark report published yesterday found adult gender clinics had refused to disclose whether transgender people who started their treatment as children later changed their minds about transitioning, or went on to suffer serious mental health problems. Victoria Atkins, the Health Secretary, met Amanda Pritchard, the chief executive of NHS England, yesterday to tell her “nothing less than full cooperation by those clinics in the research is acceptable”.

Writing in The Telegraph, Ms Atkins says she has had enough of “a culture of secrecy and ideology over evidence and safety”.

The Cass Review called for an end to the prescribing of powerful hormone drugs to under-18s and warned that under-25s should be cared for with “extreme caution” and not hurried down a medical pathway. Ms Atkins says that she expects private clinics to also follow these recommendations, and is looking into ways the Department for Health and Social Care can block doctors abroad prescribing puberty blockers to children in Britain.

The Telegraph understands that NHS England has now written to the chief executives of the hospital trusts that operate the adult clinics demanding that the data is handed over as well as instructing an end to appointments for under-18s. The health service will also undertake an external review of all its transgender services. The review, led by Dr Hilary Cass, a paediatrician, said that the lack of “robust data” on what has happened to the 9,000 children who were treated by the gender clinic at the Tavistock between 2009 and 2020 was “unacceptable”.

Those children then went on to continue their treatment at adult clinics.

Research led by the University of York had been due to look at the longterm outcomes of children treated by the Tavistock. It was expected to provide insights into the clinic’s work, including the number treated with puberty blockers and cross-sex hormones, how many people detransitioned and how many had a “co-occurring mental health diagnosis” or a “diagnosis of autistic spectrum disorder”. The review had been given the power to access medical records.

Dr Cass told the NHS it was “hugely disappointing” that the clinics would not engage in research that would help to inform the future treatment of children who believe they are transgender.

THE final report of Dr Cass’s review is an historic moment for our understanding of how to care for children who are struggling with difficult questions about who they are.

I am hugely grateful to Dr Cass’s dedicated team for their detailed and considered work on such a contentious area of healthcare. I commend those brave voices who spoke up to raise the alarm about how treatment was diverging so far from guidance – a culture of secrecy and ideology over evidence and safety. Today, I’m saying “enough”. We simply do not know the life-long impact of these medical interventions on young minds and bodies to be clear that they are safe.

We’ve also seen a marked change in the age and sex of those seeking help. I am greatly troubled by the rapid rise in the referral of teenage girls and the stressors that Dr Cass highlights such as social media and degrading pornography. Action is already being taken to protect our children. NHS

England is stopping children under 18 from being seen by adult gender services with immediate effect.

This builds on progress made earlier this year to end the routine prescription of puberty blockers at the new regional services. An urgent update on cross-sex hormones clinical policy must now follow.

I have written to the Chief Executive of NHS England to seek assurance on this and the need for swift delivery across Dr Cass’s recommendations. I want to ensure we prioritise continuity of care and support up to the age of 25 with a follow-through service for young people at a potentially vulnerable stage in their journey. It is disgraceful that adult gender clinics have not co-operated with the vital University of York research to link data on children at the Tavistock so that we can understand their journey.

This Government took the unprecedented step of changing the law to make this possible. There can be no further delay on their full participation. I know that NHS England will use all the powers at their disposal to compel this if they have to.

I am clear in my expectation that private providers must fall in line too. I have instructed officials to work on changes to close down routes that allow puberty blockers and cross-sex hormones to be prescribed to children for gender dysphoria from abroad.

We need clinicians from across disciplines in the NHS to come together in the new services to build better, more holistic care teams. Teams that treat the whole child and all of their needs.

Children and young people must have healthcare that is caring and careful. Their safety and well-being comes before all else. I’ll do everything I can do deliver on these changes.