Scottish government advised to halt puberty blockers

The Scottish government has been advised to formally pause puberty blockers until further research has been carried out.

The advice is one of several recommendations from a team looking into how the Cass review on gender services for children and young people could be applied in Scotland.

Other suggestions include ensuring a lead senior clinician takes overall responsibility for each young person’s care and that work on a regional service for children should begin immediately.

Neil Gray, the Scottish health secretary, said the report’s findings would now be considered and used in “reforming and improving” gender healthcare across the country.

The Cass review was published in April by paediatrician Dr Hilary Cass, and called for gender services for young people to match the standards of other NHS care.

A number of conclusions – including saying medical justification for treatments like puberty blockers was “remarkably weak” – proved politically contentious, with Dr Cass saying some critics were spreading misinformation about her work.

At the time of publication it was criticised by the Scottish Greens, who at that stage were part of the Scottish government.

Public Health Minister Jenni Minto told MSPs on 23 April that although the Cass review looked at services provided by NHS England, the findings would also be carefully considered in Scotland.

Glasgow’s Sandyford Clinic took the decision to stop new patients aged 16 or 17 receiving other hormone treatments until they were 18, a decision that was criticised by the charity Scottish Trans.

The new findings suggest this decision – taken by NHS Greater Glasgow and Clyde – should became formal government policy in the future.

The report stated: “The use of puberty-supressing hormones – commonly referred to as puberty blockers – should be paused until further clinical trials can be undertaken.

“NHS Scotland will continue to engage in the forthcoming UK study.”

The Scottish government was criticised for releasing its response on the day after the general election.

Scottish Conservative deputy leader Meghan Gallacher described the move as a “cowardly attempt to sneak this out when everyone’s gaze is elsewhere”.

She added that it was “not good enough” that MSPs would have to wait weeks before questioning the government.

The findings – carried out by a multi-disciplinary team commissioned by the Chief Medical Officer for Scotland – also found that each care plan should include “a full assessment of the child’s needs, both psychological and physical.”

Professor Graham Ellis, Scotland’s Deputy Chief Medical Officer said the team had examined the Cass report from a “clinical perspective” while remembering that all children should grow up “safe, respected and supported.”

He added: “At the heart of this question are children and young people in distress, and our ambition must remain focused on meeting their needs with holistic, person-centred care as close to home as practical.

“The Cass Review identified the need to ensure that gender identity services for young people are more closely aligned with other areas of clinical practice, and that responsibility for the full range of services required should extend beyond specialist services.”

Mr Gray said the Scottish government would provide a further update on the newest report, and possible implementation in Scotland, after the Scottish Parliament’s summer recess.

Like other parts of the UK, Scotland has seen a surge in the number of young people questioning their identity or experiencing gender dysphoria.

The Sandyford is the only specialist service for under-18s in Scotland, with a freedom of information request from BBC Scotland News revealing that at the end of 2023, 1,100 patients were on the waiting list for the centre.

In Scotland, 43 patients will continue to receive either puberty blockers or “gender affirming hormones” such as testosterone or oestrogen, as they were prescribed the treatments before the April decision was made.