England’s National Health Service (NHS) has drafted new guidelines for treating transgender youths following the release of the Cass Report’s ‘independent review of gender identity services for children and young people’.
According to a report in The Telegraph, the guidelines, which are under public consultation, call for tighter controls on the treatment of under 18s questioning their gender. This follows the recent closure of the Tavistock gender identity clinic for children, after a review found that its services were ‘not a safe or viable long-term option’ for children seeking care.
The Telegraph reports that the guidelines warn doctors about encouraging transgender children to change their names and pronouns because most are just going through a ‘phase’. This follows advice from the Cass Report, led by Dr Hilary Cass, that children who change their names, pronouns and the way they dress could experience ‘significant effects’ with regard to ‘psychological functioning’.
The NHS guidelines differ from the ‘affirmative care’ model favoured by the Tavistock clinic where those claiming to be transgender were encouraged to embrace their new gender identity.
In contrast, the NHS proposes that doctors take a ‘watchful approach’, mindful that evidence reflects that ‘in most cases gender incongruence does not persist into adolescence’. Social transition should, however, be considered for those diagnosed with gender dysphoria and in cases where transition will prevent ‘clinically significant distress’ and when the person is ‘able to fully comprehend the implications of affirming a social transition’.
In another departure from the ‘affirmative care’ model, the NHS proposes a ‘holistic’ attitude to treatment by including specialists in ‘paediatric medicine, autism, neurodisability and mental health’ in their clinical teams as opposed to only therapists and endocrinologists as was the case at Tavistock.
The Telegraph reports that the implementation of a holistic approach takes into consideration that a ‘significant proportion of children’ referred to gender clinics for gender dysphoria experience neurodevelopment issues or social anxiety disorders.