[Cherie]

Who would have thought that experimenting with drugs on confused children was a bad idea

Children have been let down by a lack of research and "remarkably weak" evidence on medical interventions in gender care, a landmark review says.

The Cass Review, published on Wednesday by paediatrician Dr Hilary Cass, calls for gender services for young people to match the standards of other NHS care.

She says the "toxicity" of the debate around gender meant professionals were "afraid" to openly discuss their views.

NHS England says it has already made significant progress in making changes.

The Cass Review, which looked at gender identity services for under-18s, was commissioned by NHS England in 2020 after a sharp rise in the number of patients referred to the NHS who were questioning their gender.

It was announced after whistleblowers raised concerns about care at the Gender Identity and Development Service (Gids) - which was the only specialist gender clinic for children and young people in England and Wales.

Gids closed last week, four years after it was rated as "inadequate" by inspectors.

What does trans mean and what does the law say?
Leaked emails reveal child gender service concerns
Trans treatment waiting list a ‘death sentence’
Regional hubs have now opened in London and Liverpool in an effort to move away from a single-service model and to tackle long waiting lists, which are currently around four years long.

Cass told BBC Radio 4's Today programme that clinicians had been worried about having "no guidance, no evidence, no training".

She said "we don't have good evidence" that puberty blockers are safe to use to "arrest puberty", adding that what started out as a clinical trial had been expanded to a wider group of young people before the results of that trial were available.

"It is unusual for us to give a potentially life-changing treatment to young people and not know what happens to them in adulthood, and that's been a particular problem that we haven't had the follow-up into adulthood to know what the results of this are," she said.

In the weeks leading up to the review's publication, NHS England announced puberty blockers - which Dr Cass defines as hormones that "stop the progress of puberty" - would no longer be routinely prescribed, and should only be given to gender-distressed children as part of clinical trials.

Details of these trials are yet to be announced.

Clinics overseen by NHS Scotland can continue to prescribe for children puberty blockers.

Some private clinics will also continue to do so, with Dr Cass warning families need to be "made aware" of the risks of "unregulated treatment".

The Cass Review's conclusions are documented in a 388-page report, which makes 32 recommendations on how gender services for children and young people should operate.

It calls for better research into the characteristics of children seeking treatment and to look at outcomes for every young person.

In essence, Dr Cass says children have been "let down" by a failure to base gender care on evidence-based research.

"The reality is we have no good evidence on the long-term outcomes of interventions to manage gender-related distress," she writes.

She is clear that children and young adults using the services deserve the highest standards of care and research, which are expected elsewhere in the NHS.

Her report adds that representatives from the regional centres should form a national group to oversee ethics, training and to ensure everyone receives "the same high standards of evidence-based care".

https://www.bbc.com/news/health-68770641.amp