Six new gender identity clinics are to open across England by 2026, NHS chiefs announced today.
Regional centres with union two existing clinics, as part of a review of gender services for children and young people.
Health chiefs said the centres would focus on providing a more “holistic” approach, including support for mental health and children with conditions such as autism.
More than 5,700 under-18s in England and Wales are currently waiting to be treated at two specialist centres, which became operational last April.
The clinics, based at Great Ormond Street Hospital in London and Alder Hey Children’s Hospital in Liverpool, replaced the scandal-hit Tavistock and Portman NHS Foundation Trust.
Dr Hilary Cass said the length of the waiting list to access gender services had “significant implications” for children and their families.
London’s Great Ormond Street Hospital is one of two hospitals that replaced the scandal-hit Tavistock and Portman NHS Foundation Trust.
NHS England has committed to transforming its gender identity services following the publication of the landmark Cass Review in April this year.
The review concluded that children receiving NHS transgender treatment had been put on a path to irreversible change despite scant medical data.
The movement also follows a ban on the routine prescription of puberty blockers to children with gender dysphoria.
The health service said today that all new referrals to specialist gender services must be made through mental health or paediatric services to ensure each child or young person has had a thorough assessment of their needs.
The new services will have no minimum age requirement, to ensure that parents of very young children receive support through NHS services when needed.
In addition to children and young people’s services, NHS England has also published plans for a review of adult gender services.
Dr Hilary Cass said she was “pleased” the NHS was planning to “fully implement” its recommendations, but warned the process ahead was likely to be “challenging”.
He added: “I am pleased that NHS England is planning to fully implement the recommendations of my review and the next important step will be the most challenging: making it a reality.
‘The vision of the Review – as reflected in the implementation plan – is to increase the services available to gender questioning young people that take a holistic approach to care that addresses the needs of each individual and that establish a complete package of care that can be delivered as close to home as possible.
‘The creation of a new regional provider collaboration will also bring in leaders from professional societies, education and research, to ensure these services continue to develop in line with evidence and best practice to support children and young people.’
Professor James Palmer, NHS medical director for specialist commissioning, said: ‘Rolling out new specialist hubs in every region of England will be critical to improving and expanding NHS gender services for children and young people, to ensure they receive holistic, responsive and evidence-based care, and the Cass Review is the backbone on which our rollout plan is based.
“It is clear that we also need to focus attention on our adult services. Waiting times for care are too long and care experiences are too variable.
‘The review should address bad experiences, but also learn from good experiences of care.
Puberty blockers, which stop the physical changes of puberty such as breast development or facial hair, will now only be available to boys as part of clinical research trials. Pictured, Tavistock and Portman NHS Foundation Trust, which has been accused of rushing boys onto puberty-blocking drugs by former patients who feel they have not been given enough attention
‘It is vital that we listen to patients and staff, some of whom have raised concerns with Dr Cass, and this review will be a further opportunity for them to be heard.
“There is still much work to be done, but we are already making progress on several of Dr. Cass’ recommendations, and our plans released today lay out how we will establish services that deliver the care patients and their families need to thrive.”
Previously, the only NHS clinic offering gender services for children was the Tavistock and Portman NHS Trust in London.
He was criticised for his approach, which relied heavily on medical intervention, using puberty blockers to delay the onset of puberty, despite a lack of evidence that the medication had a positive impact.
Its services had already been rated as inadequate by inspectors in January 2021.
Dr Cass’s review also found that GPs were “pressured into prescribing hormones” by patients who had seen a private doctor.
The nearly 400-page report issued a stark warning about “the use of unregulated medicines and from unregulated suppliers within the UK.”
And Dr Cass said GPs should resist attempts by private providers to prescribe puberty blockers or hormones, “particularly if that private provider is acting outside NHS guidelines”.
