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Scotland stops prescribing puberty-blocking hormones for minors as gender identity service faces scrutiny

London — Scotland’s only gender identity clinic has suspended prescribing puberty blockers to new patients under 18, mirroring steps taken by English health authorities after a landmark study found that young people had been disappointed by “remarkably weak” evidence medical interventions in the field of gender care.

The report, commissioned by Britain’s National Health Service, also found that the “toxicity” of the debate around gender identity meant doctors were operating in fear.

Dr. Hillary Cass, who led the study that produced the 388-page report released earlier this month, said “we don’t have strong evidence” that puberty blockers can be used safely. safety to prevent changes occurring during puberty.

“It is unusual for us to give young people potentially life-changing treatment without knowing what happens to them as adults. This poses a particular problem because we have not had follow-up until adulthood to know what that means,” Cass told CBS News partner BBC News.

Puberty blockers suppress the release of hormones responsible for puberty. They may be prescribed to children who are unsure about their gender to stop physical changes such as facial or breast hair growth.

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“The next step is to work with the Scottish Government and academic partners to generate evidence that allows us to provide safe care to our patients,” Emilia Crighton, director of Glasgow Region Public Health, said in a statement. . “We echo the view of Dr Hilary Cass that the toxicity around public debate is impacting on the lives of young people who seek care from our service and is not serving the teams who work hard to care for and support them We understand the distress that gender incongruity can cause and, although all referrals to endocrinology are suspended, we will continue to give anyone referred to the youth gender service the psychological support they need while. we review pathways based on results.

Scottish Trans, an advocacy group, said it disagreed with the decision to suspend puberty blocker prescriptions for minors, which it said “was taken in a context where the The reality of trans people’s experiences and lives is questioned almost daily in some media and political circles.

“This makes us concerned that the decision was influenced by this context rather than solely by consideration of the best interests of trans children and young people,” Scottish Trans said in a statement, adding that between 2011 and 2023, only 87 young Scots have been prescribed puberty blockers.

“The exceptionally rare and cautious choice of prescribing a puberty blocker, made for a small number after enormous expectations, is wrongly described by some as trivial and rushed. Nothing could be further from “We are saddened that this change will result in some young people not being able to access the care they need at all, or having to wait even longer to get it,” Scottish Trans said.

Before the publication of the Cass review, the NHS announced in March that it would stop prescribing puberty blockers to under-18s in gender identity clinics in England. In the UK, new young patients can still get a prescription for hormone blockers, but only as part of a clinical trial.

Cass’ review calls for better research into medications and their long-term effects, as well as the characteristics of children seeking treatment.

“The reality is that we have no strong evidence on the long-term outcomes of interventions aimed at managing gender-related distress,” she wrote in the journal.

She encouraged a holistic assessment of patients, taking into consideration issues that may not be related to their gender identity, including screening for conditions such as autism to address “diagnostic shadowing” that might occur when gender issues are raised.

“What unfortunately happened to these young people was that because of the toxicity of the debate, they were often ignored by local services who were very nervous about seeing them,” Cass told the BBC. “So rather than doing the things they would do for other young people with depression or anxiety, or perhaps an undiagnosed autism spectrum disorder, they tended to pass them straight to the service GID (Gender Identity Disorder).”

The Cass study was commissioned following a sharp increase in referrals to gender identity services in the UK, from around 250 per year to more than 5,000 in 2022.

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