What’s Up With Gender-Affirming Care In The U.K.?

What’s Up With Gender-Affirming Care In The U.K.?

Gender dysphoria clinics across the U.K. are facing inquiries following concerns raised about the care they provide to the LGBTQIA+ community. 

According to The Guardian, The National Health Service of England (NHS England) announced it would be setting up a review of how seven specialist services deliver care, following alarming reports from past and present staff. 

This announcement also follows the publication of the Cass report last week which made suggestions on how the U.K.’s health system should restructure the way in which trans youth receive care, Pink News reports. 

So what is the Cass report? It’s an NHS-funded report which commissioned pediatrician Dr. Hilary Cass to research one of England’s first youth gender clinics in 2020. Results, released four years later, recommend sweeping adjustments in gender affirming health services, particularly for minors.

Dr. Cass was also formerly the president of the Royal College of Pediatrics and Child Health, and prior to being appointed by NHS England, she served as Chair of the British Academy of Childhood Disability between 2017 and 2020. 

In 2022, an interim report recommended a gender dysphoria clinic located in Tavistock be closed. Cass’s recommendations expand upon the 2022 reports’ concerns and emphasizes taking a “holistic approach” to gender affirming care. It also urges those providing care to exercise “extreme caution” in prescribing puberty blockers to minors. Since the release of the report, there has been increased discussion over gender-affirming care for individuals under the age of 25.  

In her report, Cass writes that hormones should be available for those aged 16 and up, but only if a clinician has a “clear clinical rationale” for this decision. She also claims that research for the clinical treatment of trans people is of “poor quality,” and without reliable evidence. 

However, the report has since received ample backlash from families with trans kids and experts. According to Pink News, many have questioned “whether the evidence behind the report is robust enough.”

The NHS’s new investigation will probe seven gender dysphoria clinics to decipher whether practices and services offered are serving or hindering its clients. 

However, discourse on Cass’s report is muddled. Whether the report and new investigations are serving to better the quality of gender-affirming care, or begin to diminish the practice is yet to be seen. According to The Guardian, Mermaids, a charity that supports trans, non-binary and gender-questioning youth stated that Cass’s report “recognizes the current system is failing trans youth.” Other speculation finds Cass’s proposed limits on medical treatments like puberty blockers to be too restrictive.  

In a statement made on the report Cass said “The central aim of gender care should be to help young people to thrive and achieve their life goals. The immediate goal must be to address distress and any barriers to participation in everyday life.”

“What I am recommending is an expansion of capacity distributed across the country, grounded in pediatric services and delivered in a consistent way,” she continued. “A much more holistic offer of care that considers the child as a whole person and not just through the lens of their gender identity.”

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