NOW SHUT DOWN GENDER CLINIC

Critics call for action after devastating new findings

SCOTLAND’S national gender identity service for children is facing calls to be shut down amid new evidence about the youngsters it has been treating.

An appraisal of the service, run by the Sandyford clinic in Glasgow on behalf of the NHS in Scotland, has revealed previously unpublished findings that have alarmed experts worried about the growing number of young people receiving medical treatment for gender dysphoria.

The appraisal centres on those referred by the Sandyford to endocrinologists at the Royal Hospital for Children in Glasgow for puberty suppressing drugs.

The number of youngsters experiencing distress or uncertainty about their gender has soared in recent years. In the past 12 months more than 600 under-18s were seen by the Sandyford clinic.

The appraisal covers those referred for ‘puberty suppression’ drugs and ‘gender affirming hormones’ between 2011-19.

In the UK, gonadotropin-releasing hormone agonists, which are considered a reversible intervention, are used. These drugs allow people more time to explore their gender iden- tity, while preventing the physical changes of puberty.

A total of 91 youngsters aged eight to 17 were referred to paediatric endocrinology during this time, two-thirds of them ‘birth assigned females’.

In line with the global rise of youngsters experiencing gender dysphoria, annual new referrals between 2016-19 rose from 22 to 73. But researchers noted that gender dysphoria was not the only condition many of the children had.

A total of 37 per cent had mental health conditions such as anxiety or depression and 23 per cent had autism. These rates are far higher than in the general population.

Seventy-nine of these youngsters were prescribed puberty suppressing drugs. They ranged in age from nine to 18. Six came off the drugs within 18 months.

The study also found that 41 youngsters went on to be prescribed ‘gender affirming hormones’, aged 16 to 18.

These are feminising hormone therapy drugs which contain oestrogen or masculinising hormone drugs which contain testosterone.

Worryingly, only six out of 64 young people who were eligible for fertility preservation completed the process, a ‘low uptake’ which ‘demands further exploration’, the researchers warn.

The paper reveals details about the service that have never been publicly released before.

Despite concerns raised by campaigners about the Scottish gender service in the wake of revelations about England’s gender identity service for young people run by the Tavistock clinic in London, there have been no audits of the service published by the NHS.

NHS England is shutting the Tavistock clinic, after a review found a single national service was ‘not a safe or viable long-term option’ and that other mental health issues were ‘overshadowed’ when gender was raised by children referred to the clinic.

It has struggled with long waiting times and will be replaced with new regional centres linked to mental health care and GPs.

That is a change experts say should also happen in Scotland.

Stephanie Davies-Arai, director of campaign group Transgender Trend, said: ‘This reveals exactly the same issues as the Tavistock clinic in London: an over-representation of teenage girls, autistic adolescents and those with mental health problems.

‘The fact that there is such a low uptake of fertility services only shows that these children are not old enough to fully appreciate the sacrifices they are making by taking this treatment.

‘As with the Tavistock, the majority of children who take blockers then progress to cross-sex hormones, rendering them infertile.

An independent review of the Sandyford service, similar to the Cass review of the Tavistock, is long overdue.’

A former Tavistock patient Keira Bell went to court saying she had not been challenged enough about her decision at 16 to take drugs that began her transition from female to male, a decision she later regretted.

Dr Hilary Cass, who led the Tavistock review, said there was a lack of understanding about why the type of patients the clinic was seeing was changing, with more female to male patients and more autistic children. These findings are similar to the Scottish service.

The research, led by Dr Andreas Kyriakou of the department of paediatric endocrinology at the

‘Same issues as the Tavistock’

Royal Hospital for Children in Glasgow and published in the European Journal of Paediatrics, states: ‘Mental health problems remain one of the major coexisting concerns in transgender young people, as more than one-third of those attending our clinic have a diagnosis of a mental health disorder.

‘Our study confirms the disproportionate number of young people with autistic spectrum traits, much higher than expected in the general population.

‘This joint clinic has clear benefits for young people and their families. Young people will meet with specialists in clinical psychology and paediatric endocrinology, have monitoring investigations as well as receive treatment in one visit.’

It adds that specialist centres should continue to offer services to children with gender dysphoria.

A spokesman for the campaign group For Women Scotland said: ‘The parallels with the ill-fated Tavistock are stark.

‘Endocrinologists are halting children’s puberty with experimental drugs that are increasingly linked to serious problems such as limiting bone density and brain development. It is essential the Scottish Government acts immediately to close Sandyford and focus on holistic treatment and good mental health.

‘Not to do so would be gross medical negligence and likely to attract, as is happening in England, legal cases from former patients.’

SNP ministers have told NHS Scotland to draw up guidelines for the care of people experiencing gender dysphoria by December next year.

A Scottish Government spokesman said: ‘The Sandyford young people’s gender service offers a range of support for young people and their families. Decisions on the type of treatment to prescribe are rightly for clinicians to make in consultation with patients following specialist assessment.

‘In Scotland, the Sandyford young people’s gender clinic within NHS Greater Glasgow and Clyde is the only service to provide specialist support for those aged under 16 experiencing distress and/or uncertainty about their gender identity.

‘For a very small number of young people this may include assessment by paediatric endocrinology, if assessed as necessary by specialist clinicians.’