Health chiefs are reviewing a service which gives transgender children drugs to pause puberty.
The country’s top health organisation, NHS England, is investigating issues around hormone-blocking drugs prescribed to under-18s to ‘pause’ their adolescence and prevent changes to the body like breasts or facial hair.
Children as young as 10 are being referred for hormone-blocking drugs, despite concerns they could cause emotional problems and long-term effects on the brain and body which are not yet known.
Pictured above is the UK’s Gender Identity Development Service which saw almost 1,200 children under 15 referred to its service last year. 63 under-15s were sent on to its endocrinology clinic, of whom the majority took powerful puberty-blockers
The UK’s Gender Identity Development Service (GIDS) saw almost 1,200 children under 15 referred to the service last year, with 63 under-15s sent on to its endocrinology clinic, of whom the majority took powerful puberty-blockers.
The NHS England review of its specifications for the GIDS was scheduled to go ahead this year.
But outgoing mental health minister Jackie Doyle-Price revealed to Parliament last month that it will look at the ‘ethics’ of the service, which offers some treatments to children which may be ‘irreversible’.
In comments which have not previously been reported, Mrs Doyle-Price said: ‘It is important to note that this aspect of service has grown quickly, and it has done so in an absence of public scrutiny.
Outgoing mental health minister, Jackie Doyle-Price, said that she would be working on a proper review of the service which could be potentially harmful to youngsters
‘I can understand why there will be some public concern about it, so I would like to reassure the House that I am working with NHS England to do a proper review of the research around this service and the ethics of it to establish a proper framework for consent, recognising that we are looking at treatments that may have long-term consequences.’
The ongoing NHS England review comes as Tavistock and Portman NHS Trust, which runs GIDS, is considering doctors seeing children who think they are transgender over Skype in order to cope with the surge in demand, which has led to a two-year waiting list.
Puberty blockers are said to give children ‘breathing space’ to decide if they wish to be a different gender, by preventing distressing changes to their body such as their voice getting deeper or breasts growing.
If they then decide they want to, at 16 they can begin the physical transition from male to female, or female to male, using the ‘cross-sex’ hormones oestrogen or testosterone.
Or they can change their mind and come off the hormone-blockers before reaching a further stage, at which time puberty would happen normally.
Mrs Doyle-Price told Parliament, before losing her ministerial job in Boris Johnson’s new Cabinet: ‘It is important to recognise that, compared with services internationally, the service is very much at the conservative end of provision, which has led to it being criticised as far too conservative by some aspects of the lobby in favour of more services.
‘However, where we are dealing with children who have not reached the age of majority, and where some of the treatments they may go through may be irreversible, the whole issue of consent is clearly important.’
Children who take puberty-blockers and then cross-sex hormones could damage their bodies, which may make it impossible for some to have children in later life.
They are told about this in advance and given counselling on options for freezing sperm or eggs so they could have a child through a surrogate, for example.
GIDS has seen five clinicians resign, stating that they felt under pressure to refer youngsters for treatment including hormone-blockers without thorough assessment of their cases.
Marcus Evans was a governor at the Tavistock and Portman NHS Trust before quitting over concerns that children were not being given enough guidance before taking puberty-blockers.
He said: ‘It is good timing for NHS England to be reviewing GIDS as we need people from outside the trust to look at the research behind these medications and their impact.
‘These children can have complex problems and the whole process needs to be slowed down so they have time to look at possible causes of their feelings about gender.
‘When people are under pressure, they tend to isolate one solution, which is to take hormone-blocking drugs. There needs to be much more thought before providing powerful drugs which change bodies and can have profound psychological effects.’
Dr Polly Carmichael, pictured above, is the director of the GIDS service and said that she looked forward to the opportunity to reappraise evidence in light of ‘increasing interest’
Dr Polly Carmichael, director of GIDS, said: ‘It is timely that the service specifications are due for review. We welcome the opportunity this provides to reappraise the evidence in light of increasing interest in this complex field.’
On the Skype plans, a spokesman for the Tavistock and Portman NHS FT, said: ‘Any use of technology would only be used where appropriate and would be just one part of a whole range of interventions and consultations – all based on providing the best clinical care for every young person.’
An NHS spokesman said: ‘The NHS’s approach to gender dysphoria services is clinically led and must be based on consideration of all available research evidence and international standards for best practice.
‘Specialist services should continue to look at the evidence and listen to different views as they continually develop their services.’