Highly anticipated, a report concerning transidentity represents a turning point in England. A pediatrician calls on Wednesday for a change of approach in the care given to young transgender people, advocating the greatest caution in particular due to a lack of “reliable data” on hormonal treatments.
The study was commissioned by the public health system, the NHS, in 2020 in the face of a sharp increase in the number of children and young people questioning their gender and presenting to care services seeking help.
The phenomenon has given rise in recent years to highly publicized legal battles and the decision to close the only specialized public establishment, after overwhelming testimonies reporting caregivers under pressure and rushed treatment. It must be replaced by regional centers.
The subject of trans identity is very divisive in the United Kingdom. The author of the report, pediatrician Hilary Cass, deplores “an exceptional toxicity of the debate”.
“There are few other areas in healthcare where professionals are so afraid to openly discuss their opinions, where people are vilified on social media and where name-calling echoes the worst bullying behavior. This must stop,” she wrote.
In her 400-page report, the former president of the Royal College of Paediatrics and Child Health presented 32 recommendations on Wednesday, which should shape new NHS services in England for children and young people questioning their gender identity or exhibiting gender dysphoria.
Disappointment for young people
The document calls for a comprehensive approach that must “include screening for neurodevelopmental status, including autism spectrum disorders, and mental health assessment.”
Health services are urged by the report to exercise “extreme caution” when prescribing hormones. There “should be a clear clinical rationale for providing hormones” before the age of majority.
For 17-25 year olds, according to the report, each regional center should have a follow-up service “in order to ensure continuity of care and support [aux jeunes] at a potentially vulnerable stage in their journey.”
For prepubescent children, an “even more cautious” approach must be adopted. Those who change their pronouns or first names from a young age could feel even more stress with the arrival of puberty and therefore the urgency to take hormonal treatments.
At the basis of the debate, Hilary Cass is concerned about “the poor quality of published studies” and the absence of “reliable data” on transidentity among young people: “Research has abandoned” young people.
A former manager of the public specialist Tavistock, which closed, told Times Radio that children were sometimes prescribed puberty blockers “after one or two appointments”. The team “allowed itself to be seduced by transgender ideology,” criticized David Bell.
Last month, the NHS in England announced it would no longer prescribe puberty blockers to minors who want to change their gender.
Conservative Prime Minister Rishi Sunak welcomed the report: “Extreme caution is needed, […] because we don’t know the impact” of puberty blockers or hormonal treatments.
The report made headlines in the media, and particularly pleased the conservative press. “Finally the voice of reason on trans dogma,” welcomes Daily Mail.
The government and conservative media are very critical of the demands of transgender defense associations. The authorities also recently recommended safeguards for schools faced with children asking to be identified as a gender different from theirs.
London blocked a project adopted in Scotland which aimed to facilitate the recognition of gender change from the age of 16.
Hilary Cass addresses, in the introduction to the report, the young people she met and who asked to have access, as quickly as possible, to puberty blockers and hormones.
“I am aware that you must be disappointed,” she wrote. But “you cannot make life-changing decisions without being able to weigh the risks and benefits they present now and in the long term.”