Boys were “coached” what to say to receive puberty blockers on the NHS, the service’s damning review chief has claimed.
Respected pediatrician Dr Hilary Cass, who today published a scathing 400-page dossier on NHS gender care for young people, said children who questioned their gender had been told not to reveal a history of abuse for fear that Doctors will avoid offering medications.
“Let’s not forget that these young people are on a waiting list and feel that if they don’t say the right thing to receive puberty blockers, all is lost,” he told the British Medical Journal.
“They are instructed on what to say and what not to say.”
Cass said this included not disclosing circumstances of serious abuse or if they had concerns about their sexual identity.
“They are told not to say that they are not sure about their sexuality, not to say that they have been abused, because at that moment there is a lot at stake,” he said.
Respected pediatrician Dr Hilary Cass, who today published a scathing 400-page dossier on NHS gender care for young people, said children had been told not to reveal their history of abuse for fear doctors would avoid offering puberty blockers.
According to a study cited by the Cass review, up to one in five children attending gender services have been physically or sexually abused (file image)
Dr. Cass did not reveal who was training the children to give them answers to guide them about puberty blockers.
However, in their report the private clinics were criticized for pressuring GPs to hand out the medicines.
Dr Cass explained that this fear among children of disclosure was yet another reason why NHS gender services for young people needed an overhaul.
“They can feel confident that you’re not abandoning them because you’re not putting them on puberty blockers at that time and they won’t be able to transition later in life if that’s right for them,” he said. saying.
“We need to take the urgency out of it.”
Evidence from Cass’s own review suggests that children attending gender services are more likely to have suffered abuse, although she acknowledges that data on this issue is naturally limited.
According to a study cited by the Cass review, up to one in five children who attend gender services have been physically or sexually abused.
According to the research, up to 67 percent had experienced some form of neglect or abuse.
One of the few reviews on this topic was an analysis of the first 124 cases seen by the now-closed Gender Identity Development Service (GIDS) at Tavistock and Portman NHS Foundation Trust.
It found that one in six children (15 per cent) referred to GIDS had suffered physical abuse.
Their review found that there is no strong evidence to support the use of puberty blockers, which stop physical changes such as breast development and facial hair growth.
NHS gender treatment is “built on shaky foundations” and relies heavily on clinical guidelines that are not backed by science, she said.
The consultant pediatrician has found doctors have not adequately assessed the short and long-term impact of treating confused children, in an alarming departure from medical standards.
Calling for more rigorous research into the potential harms and benefits of social and clinical interventions, he described current data as “totally inadequate” and said young people have been “let down”.
Previously, the NHS distributed drugs to children struggling with their gender identity in a bid to “buy them time” to consider their options and “explore their developing gender identity” before moving on to more permanent forms of treatment, according to the now missing health service. guide.
NHS England withdrew use of the drugs last month ahead of Cass’s final review after finding a lack of evidence on their “safety or clinical effectiveness”.
Children who already take drugs Patients taking medication through the NHS will be able to continue their treatment until completion.
The health service also plans to launch a clinical trial of the drugs before the end of the year, meaning they could return eventually.
However, private clinics in England currently face no restrictions on continuing to distribute puberty blockers, a loophole that campaigners have called for to be closed.
Dr Cass’s study, originally commissioned almost four years ago, has made 32 recommendations to reform NHS trans services to improve the care children receive.
