Scottish Health Officials Press Pause on Puberty Blockers for Children

Following the publication of a damning report on the dangers of gender transition procedures for children, Scotland is officially halting the prescription of puberty blockers and hormone drugs to minors. Scotland’s sole gender for clinic for minors, the Glasgow-based Sandyford Sexual Health Service (SSHS), officially announced on Thursday that it will no longer be referring children under the age of 18 to pediatric endocrinology to be prescribed puberty blockers or hormone drugs.

“This service update follows research from NHS [National Health Service] England and the publication of the Cass Review while we work with the Scottish Government to engage in research with NHS England that will generate evidence of safety and long-term impact for therapies,” the SSHS announcement reads. “While this pause is in place, we will continue to give anyone who is referred into the Young People Gender Service the psychological support that they require while we review the pathways in line with the findings.”

The SSHS decision to “pause” prescribing puberty blockers and hormone drugs to children is in line with new guidance from National Health Service Greater Glasgow and Clyde (NHSGGC). “On clinical advice, both NHS Greater Glasgow and Clyde and NHS Lothian deferred starting new patients on these treatments in mid-March 2024 in response to the position taken by NHS England and while the publication of the Cass Review was awaited,” NHSGGC said in a statement. “Following the publication of the Cass Review and having also received the support of the Chief Medical Officer for Scotland, Sir Gregor Smith, the health boards formally paused treatment.”

Last month, NHS England formally halted prescribing puberty blockers and hormone drugs to children, explaining, “Puberty blockers … are not available to children and young people for gender incongruence or gender dysphoria because there is not enough evidence of safety and clinical effectiveness.” NHS England warned that hormone drugs “cause some irreversible changes” and “may cause temporary or even permanent infertility.” The agency further noted, “There is some uncertainty about the risks of long-term cross-sex hormone treatment.”

Instead of such prescriptions, NHS England explained that children diagnosed with gender dysphoria will have a range of psychological therapies available to them, including family therapy, individual child psychotherapy, parental support, or counselling, and “regular reviews to monitor gender identity development.” NHS England explained of its new guidance, “Most treatments offered at this stage are psychological rather than medical. This is because in many cases gender variant behaviour or feelings disappear as children reach puberty.”

Earlier this month, the U.K. government published the much-anticipated Cass Review, a nearly-400-page report compiled by esteemed pediatrician Dr. Hilary Cass on the practice of gender transition procedures for children. Cass worked on the report for four years. “The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” the report declared. “This is an area of remarkably weak evidence.”

The groundbreaking report found that gender transition procedures for children are largely based on biased and even low-quality research. Additionally, the report clarified that there is “no evidence” that gender transition procedures prevent or reduce the risk of suicide, despite the common claims of many gender transition advocates; the prescription of puberty blockers and hormone drugs to minors may actually be dangerous; the majority of children diagnosed with gender dysphoria suffer from a host of often-neglected psychological co-morbidities; and the practice of gender transition procedures has been largely guided by “toxic” debate and discourse.

As evidenced by Scotland’s change of course on puberty blockers and hormone drugs, the Cass Review is already bringing about what U.K. officials are calling a “fundamental change” in the gender transition industry. In the course of compiling her report, Cass investigated the Gender Identity Development Service (GIDS) at the Tavistock clinic. Her findings led the pediatrician to recommend that the government shut down the clinic immediately, almost two years before her final report was due. In particular, Cass was disturbed by the Tavistock staff’s trend of placing children as young as 10 years old on regimens of puberty blockers or hormone drugs with little or no psychological oversight, sometimes after as few as three counseling sessions. Cass noted with alarm that about 96% of children referred to Tavistock were prescribed puberty blockers.

“We echo the views of Dr. Hilary Cass that toxicity around public debate is impacting the lives of young people seeking the care of our service and does not serve the teams working hard to care and support them,” NHSGGC’s Director of Public Health Dr. Emelia Creighton said in a statement. “The findings informing the Cass Review are important, and we have reviewed the impact on our clinical pathways. The next step from here is to work with the Scottish Government and academic partners to generate evidence that enables us to deliver safe care for our patients.”

NHS Lothian’s Executive Medical Director Tracey Gillies said, “The Cass Review is a significant piece of work into how the NHS can better support children and young people who present with gender dysphoria. Patient safety must always be our priority, and it is right that we pause this treatment to allow more research to be carried out.”

Meanwhile, U.S. health officials have continued promoting gender transition procedures — including puberty blockers and hormone drugs — for children. Last year, a report named the U.S. an “outlier” in the field of protecting children from harmful gender transition procedures after France, Sweden, Finland, Norway, and the U.K. issued warnings against prescribing children puberty blockers and hormone drugs. A Freedom of Information Act request earlier this year resulted in Rachel Levine, assistant secretary of the U.S. Department of Health and Human Services, admitting that his claims that gender transition procedures for children are “life-saving” and “necessary” were based entirely on a two-page document citing a single study conducted by an LGBT activist organization.