Review finds that the NHS failed to treat transgender kids in the tumultuous debate about gender identity.

A long-awaited assessment has discovered that the NHS is treating vulnerable children who seek sex care in response to a string of “exceptional toxicity ” about transgender rights in Britain.

The separate report, published on Wednesday, says young people with gender dysphoria are being treated in a program underpinned by “remarkably poor ” research, deficiencies in mental health care and “unusual” medical practice.

The assessment, led by renowned paediatrician and former head of the Royal College of Paediatrics and Child Health, Dr. Hilary Cass, warns that the “polarization and stifling of conversation ” by adults has hindered the advancement of medicine and science in the area, with medical practitioners scared to openly discuss their opinions.

According to the statement, doctors are pursuing life-changing care on young folks despite a glaring absence of supporting facts, while experiments had been deliberately “exaggerated or misrepresented by people on all sides”. Addressing the youngsters directly impacted by failures, Dr Cass said: “Research has let us all down, most notably you. ”

According to a campaigner for children, the report, which was created in response to a significant rise in the number of children and young people seeking gender support from the NHS, should be seen as a “watershed time ” that will grant Britain the opportunity to overcome the barriers already in place.

The assessment, which has taken almost four years to complete, even found that:

There are few other areas of medicine where doctors are so hesitant to openly discuss their opinions, where users of social media are vilified, and where name-calling is a manifestation of the worst forms of bullying, according to Dr. Cass in the report’s introduction. This must stop. ”

She described the challenges she encountered while working on the review, including engaging with groups that are both interested in gender equality and those who want a more cautious perspective, and she added,” The surrounding noise and increasingly toxic, ideological, and polarized public debate have made the work of the review significantly harder and does nothing to benefit the children and young people who may already be subject to significant minority stress.

In the end, we need to find a way to put the hostility aside in order to reach a common understanding and to find the best possible path forward for children, young people, and their families. ”

The report, which was requested in 2020, highlights issues that affect every aspect of child care, starting from the moment they first ask a question of their gender until the point of receiving medical care.

Dr. Cass claimed that children who needed medical attention were not receiving more help managing their mental health issues or even receiving counseling to work through their questions.

She said she had grown “increasingly worried about the numbers of young people in distress, on a waiting list, not getting the appropriate services, at risk”. “And that ’s not OK. It’s just not acceptable, ” she added.

The report, which spans nearly 400 pages, makes 32 recommendations for how to ensure that children who are unsure of their gender receive a standard of care that is “safe, holistic, and effective, ” such as screening for neurodevelopmental conditions like autism and a mental health assessment.

In addition to the recommendations in the review, NHS England is requested to establish a “full programme of research ” to examine the characteristics and outcomes of each and every young person who uses gender services.

Dr. Cass also urged the NHS to review its policy regarding giving children masculinizing or feminizing hormones starting at age 16, arguing that there should be a “clear clinical rationale ” for providing hormones at this age rather than waiting until they turn 18 before doing so.

While NHS England last month stated that children who were subject to puberty blockers would no longer be subject to research trials, 16-year-olds can still receive hormones in the form of testosterone or oestrogen.

According to the review, young people between the ages of 17 and 25 should receive a “follow-through ” service for care rather than transitioning to adult services, while those who have not yet reached puberty should receive a “separate pathway ” so they and their parents or carers are “prioritised for early discussion with a professional with relevant experience”.

The NHS also needs to take a “more cautious approach ” when it comes to social transitioning – ie where someone might change their pronouns, name and/or clothing – for children, she said.

Following the revelations of a well-known scandal at the Tavistock and Portman Foundation Trust, which was sued in 2019 because it was suspected that children were receiving puberty-blocking drugs without reliable data or evidence, the review into services was started.

Concerning the topic of puberty blockers, Dr. Cass claimed she was disappointed by the lack of research on the long-term effects of taking hormones at an early age.

Children who endured lengthy waits for NHS care were even turning to private services and able to order “unregulated and potentially dangerous hormone supplies over the internet, ” according to reviewers.

In 2020, Dr. Cass was asked to review gender identity services ( GIDS ). The review was set up in response to a number of factors, including a rise in Tavistock and Portman NHS Foundation Trust referrals from just under 250 in 2011/2012 to more than 5,000 in 2022, according to NHS England at the time.

Figures from the final report reveal that children’s referrals to GIDS increased significantly from 2014, with young women accounting for the majority of the new referrals.

Professor Steve Turner, president of the Royal College of Paediatrics and Child Health (RCPCH), said the review was a “massive undertaking ” and the college will “closely consider the report’s recommendations”.

Growing demand for gender identity services has caused a long wait for children with gender-related distress, leaving these young people in particular underserved and vulnerable, he said.

More resources are obviously required to meet the holistic health needs of this young generation. ”

Mark Russell, chief executive of The Children’s Society, said: “This report should mark a watershed moment; an opportunity to break through the current barriers and create a world in which all children’s safety and well-being are at stake.

“The message is clear: every child, regardless of their gender identity, deserves to have the right support at the right time. ”

Robbie de Santos, director of campaigns and human rights at LGBT+ rights organisation Stonewall, said:“ What is important, above all, is that trans and gender-diverse children get the quality healthcare that they need and deserve. ”

Néanmoins, NHS England expressed its satisfaction with the review and promised to implement a comprehensive plan, but it has already written to regional NHS leaders to halt providing gender clinic visits for people who have not yet turned 18 years old.

Prime minister Rishi Sunak said: “We’ve seen a sharp rise in recent years of children, particularly adolescent girls, questioning their gender.

“ I welcome Dr Cass ’ expert review which urges treating these children, who often have complex needs, with great care and compassion.

We should exercise extreme caution because we simply do not know how long medical treatment or social transitioning affects them.

We quickly changed schools and our NHS in response to Dr. Cass ‘ interim report, which set the stage for the routine use of puberty blockers, and we will continue to make sure we take the necessary steps to protect young people. Children’s health and well-being must come first. ”