AThe heart of the controversy was on how to meet the needs of young people who skeptical about their gender was the great rise in referrals to Tavistoc Previously, the only dedicated clinic in England and Wales that treats children with sexual dysfunction.
The clinic was closed one month before Cass review In young sexual identity services, commissioned by NHS England and its leadership of the British pediatrician Hilry Cass, who found that the children were “failed” by NHS amid a “Sam” public speech.
Ha Recommended report A major transformation in treatment away from medical intervention towards a more comprehensive approach to care, including treatment and treatment coexistence Mental illnessNeurological issues or family issues, and are provided by a network of regional centers instead of focusing in one place.
Cup effect
Fourteen months later and the si height in referrals NHS Care stopped, as the numbers showed a sharp decrease from up to 280 a monthly referral in Tavistock to between 20 and 30 months this year, which is 10 of the previous average.
James Palmer, and There is a number of factors behind the decline. Youth It can only be referred to the service of young sexes through mental health or pediatricians, instead of GP.
Palmer also believes that the reduction is partially due to the “change in philosophy” that a cup brought about hormone treatments. Her review concluded the presence “Significantly weak evidence” Which – which Puberty blockers (Described to give young people who suffer from distress and dysphagia about their bodies for their time to consider their next step) and hormones through sex (which improves the welfare of young people (which they harm notes or the appearances of the people
The Cup pushed a temporary ban on the use of drugs that prevent puberty, which were extended indefinitely by the Minister of Health, last December. Sex hormones through sex may be described with children between the ages of 16 and 18 years in rare cases, but in practice none of them have been since the review.
“There is also an effect – not quite measured – by changing the situation in this country and around the world,” Palmer added. He claims that Cass review was clear, so that the social transition is not “neutral” and that better information is needed about the results of children who do this, as well as support parents and schools. “But there is also an influence from the global political environment that has become less acceptable for converts and young people asking sex.”
Palmer, a neurosurgeon through the background, says that waiting times for the new centers “still important” and that it will take up to three years to work through a “great accumulation” inherited from Tifstock, and services continue to face strong criticism of young people and their parents.
According to NHS England, the waiting list for the new centers reached its climax in December 2024 by more than 6400, and was reduced to a little more than 6000. There are now three open regional centers in London, Bristol and northwestern England, with the ability to see about 25 patients per month, and the fourth is expected to open in eastern England this year.
Once all the seven regional centers are opened, Palmer says, “We will reach where we want, which is individuals, as soon as that [gender] The contradiction begins to be truly fixed, even at an early age, he will be able to reach the NHS service. “
Although the opinion is still different from the best ways to meet the needs of this weak group of young people, critics of what Palmer describes as a “change in philosophy” argues that falling in referrals to NHS services hide the real numbers that seek to intervene, with intervention, with intervention, with Many families turn into private service providers And the hidden economy to reach drugs to help them live as a different gender.
Palmer accepts long waiting for help “affects how individuals who deal with their care, and of course, some people take desperate steps to go to service providers that are not subject to organization and search for hormones.”
A clinical trial for puberty, which Cass recommended, was created by an independent research team at King’s College London, which it takes through moral and organizational approvals.
The Experts Committee will reports to the streets in July, after considering a similar ban on the hormones of cross -sex hormones from 16 to 18 years old, with probably initial signals.
Long waiting and legal challenges
The Guardian spoke to a group of parents about their concerns about treating their children since the publication of the Cass report.
Some said that they felt more hopeful since a cup focus on evidence-based care, and they were happy to see the basic issues that were highlighted in its report-such as bullying, nervous diversity and gravity arising from the same sex and shock-which is first dealt with in regular sessions with a psychologist.
Others said that this change in culture did not reach the services of adults, as the older teenagers were treated, adding that they were the same cohort that was subject to the same societal factors that were reviewed by Cass.
Some parents were especially frustrated because other European countries conducted similar reviews of the evidence for hormone treatments, but they reached various conclusions that support their use of young people.
They are also concerned that employees in the new centers do not seem to be experienced in the field of gender care, with what they felt was a limited understanding of how time decisions were about hormonal therapy. For example, gender hormone pathways have not been discussed.
A family stated that it was warned in a center that reaching hormone treatment unilaterally could lead to a referral protection by GP and even the police report.
Another said that it is not fair that Nats England had transferred 200 young men who actually receiving puberty or sexual treatment for sex in Tavistoc to the Nutingham clinic where their hormonal therapy was continuing, while this other young option was not provided.
For 18 -year -old milk, who lives in Midlands with his family and is about to start a certificate at Russell University, there is “value for sure” in comprehensive support, as defined by the priority cup. But he says that the conversation treatments lose their value if young people feel that they are forced to “prove themselves” deserve to reach hormones.
Ben joined the youth services waiting list at the age of fourteen, but he was transferred to the NHS waiting list earlier this year after reaching 18 years, and he did not get an appointment. Instead, his family reached adulthood and then testosterone from an online clinic.
“I can understand that for a person who was not in my position, it is clear that this is a great decision for a young man to make the young man, and it is necessary to have guarantees in their place, but to completely remove hormones access, it will have a negative impact on many young people for the rest of their lives.
“While the use of unorganized private service providers has more risks than access to health care through NHS, the risks are much greater as young transients are left without access to health care at all, as is the case for many who cannot pay for private health care.”
Some young people who were previously treated in the new centers have found their way to Private Gender Plus, a clinic to treat youth and adults, the only service in the UK capable of describing cross hormones to 16 to 18 years, in line with NHS England’s directives through the care quality clinic.
Its manager, Dr. Aidan Kelly, said: “I hear that there is a large leakage rate [from the new hubs]This is not surprising because the base of the evidence for group therapy that helps young people who suffer from gender speech defect is weaker than that for hormonal interventions. They feel that NHS has abandoned them, and therefore they are waiting for age to serve adults. “
Adult service Reviewed by NHS EnglandIn response to detailed concerns raised by Cass after reviewing its youth, including waiting lists “out of control”, insufficient approval processes, and a limited explanation of the risks involved in treatment.
In 2024, the first full year of Gender Plus, it took 874 referrals, 343 of them under 18 years old, and expanded in locations in London, Birmingham Wids and Dublin, with 20 employees, many of them previously worked in NHS Services. Among those between the ages of 16 and 18, gender confirmation hormones were identified after the completion of six months of evaluation.
Gender Plus is facing a judicial review at the end of June, which was provided by the former NHS SO Ivanz, who also incited measures against Tavistock in 2019, challenging CQC decision to grant registration in the sexual clinic in addition to the clinic hormone in January 2024, and the following decision to grant this clinic in a distinct qualification in December 2024 after its first inspection.
Kelly suggests that NHS England is assumed that by depriving young people from accessing medical paths, they will simply “surrender.”
“There is no evidence of this, and in fact there is evidence that it hurts.”
Last year, the Guardian newspaper reported that experts warn that increasing numbers of less than 18 years were I go to the economic hidden drugs. Some of these young people have become political active. In March, the group of activists crossing the turbulence better disrupted a trustee in the streets, highlighting that he had not consulted with young transients before making decisions about their treatment but spoke to other groups that oppose the care that looks at sex.
NHS England says that the most cautious approach agreed upon by Cass includes regular dates with a doctor, a set of treatment options, from one to one, in groups and with the family, as well as treating mental health problems, including medications if necessary.
In building new services, efforts were made to allow doctors to continue their daily job away from media lights. But Palmer says that he is concerned that “the polarized debate in the newspapers” does not realize that there are many young people “who are really affected by the dysfunction of hardship and distress that can follow the contradiction between the sexes and need to obtain NHS service care.”
