Scottish Government responds to NHS England’s ban on puberty blockers
SCOTLAND’S NHS has said it will decide what treatments are “appropriate” after England’s health service will cease prescribing children puberty blockers.
The UK Government said it welcomed NHS England’s “landmark decision”, adding it would help ensure care is based on evidence and is in the “best interests of the child”.
Puberty blockers, which pause the physical changes of puberty such as breast development or facial hair, will now only be available to children as part of clinical research trials.
At present, children in Scotland aged 12 and over are able to get puberty blockers after being assessed.
A Scottish Government spokesperson said it was “engaged with NHS England on its planned study into the use of puberty blockers in young people’s gender identity healthcare, and discussions are ongoing to determine what future engagement is appropriate.”
The NHS England policy document, published yesterday, said: “We have concluded that there is not enough evidence to support the safety or clinical effectiveness of (puberty blockers) to make the treatment routinely available at this time.”
It follows a public consultation on the issue and an interim policy, and comes after NHS England commissioned an independent review in 2020 of gender identity services for children under 18.
That review, led by Dr Hilary Cass, followed a sharp rise in referrals to the Gender Identity Development Service (Gids) run by the Tavistock and Portman NHS Foundation Trust, which is closing at the end of March.
In 2021/22, there were more than 5000 referrals to Gids, compared to just under 250 a decade earlier.
The clinic has come under repeated scrutiny. In February 2022, Dr Cass published an interim report saying there was a need to move away from one unit and recommended the creation of regional services to better support youngsters.
She also pointed to a lack of longterm evidence and data collection on what happens to children and young people who are prescribed medication.
She added that Gids had not collected routine and consistent data “which means it is not possible to accurately track the outcomes and pathways that children and young people take through the service.”
Following the Tavistock’s closure, two new NHS services will now open in early April, situated in London’s Great Ormond Street Hospital and Alder Hey Children’s Hospital in Liverpool.
The NHS has said children attending these clinics will be supported by clinical experts in neurodiversity, paediatrics and mental health, “resulting in a holistic approach to care”.
Health minister Maria Caulfield said: “We have always been clear that children’s safety and wellbeing is paramount, so we welcome this landmark decision by the NHS.
“Ending the routine prescription of puberty blockers will help ensure that care is based on evidence, expert clinical opinion and is in the best interests of the child.”
The consultation on the future of services received more than 4000 responses, including around a quarter from members of the public, 22% from patients, 21% from parents, 10% from trans adults and 5% from clinicians.
John Stewart, national director of specialised commissioning at NHS England, said: “Given that the debate is often very polarised, so too were the responses to the consultation.
“Many people said the policy didn’t go far enough in terms of still allowing potential access (to puberty blockers) through research, and others saying clearly they disagreed fundamentally and that these should be routinely available to everyone who believes they need it.”
Regarding the new clinics, he said: “This is just the first step in building a regional model, where our aim is to establish between seven and eight specialist centres including the north and the south hubs over the next year to two years.”
Around 250 patients are expected to be transferred to the new clinics from Gids when they open.
Some 5000 more children and young people are currently on the waiting list for referral into the new clinics.