Scotland suspends use of puberty blockers in major U-turn

Scotland is to suspend the use of puberty blockers as a result of the Cass Review, in a major about-turn from the SNP.

The Sandyford Clinic in Glasgow said that it would also no longer prescribe “gender-affirming hormones” to under 18s.

The move follows intense scrutiny of methods at the Sandyford, which has been branded the “tartan Tavistock”, following the publication of the review by Hilary Cass, the esteemed paediatrician.

The SNP had previously said the Scottish NHS would take time to review her findings, suggesting many parts of the damning Cass report for NHS England did not apply to Scotland.

As recently as Monday, ministers insisted there would be no “snap judgments” over whether to follow Cass and they backed clinicians prescribing the drugs, saying they followed “very high standards”.

Maree Todd, an SNP health minister, claimed puberty blockers “were never routinely prescribed” in Scotland.

However, Dr Cass’s report warned that there was no credible evidence to suggest that puberty blockers were effective or safe. She could also not rule out that they could contribute to psychological or physical problems in later life, including infertility.

The move could lead to a rift with the SNP’s coalition partners the Scottish Greens, who had criticised aspects of the Cass Review and support “affirmative” gender healthcare, and also LGBT lobby groups it has close ties to.

The decision means that under 18s will no longer be referred for prescriptions of puberty blockers or hormone treatments.

Young people could previously be prescribed puberty blockers, which stop physical changes, before then being put onto oestrogen or testosterone in an effort to align their bodies with their gender identity.

In a statement issued by the Sandyford’s young person’s gender service on Thursday, it said it had “paused” referrals to endocrinologists for puberty blockers “for any new patients assessed by our Young Person’s Gender Service”.

It added: “Patients aged 16 to 17 years old who have not been treated by Paediatric Endocrinology, but who are still seeking treatment for their gender incongruence, will no longer be prescribed gender-affirming hormone treatment until they are 18 years old.”

The suspension will not apply to existing patients on the drugs, which is in line with the ban announced last month by NHS England.

The youngest known patient to be prescribed puberty blockers after being seen at the Sandyford was just nine years old.

Almost 100 children aged 16 or under were referred to endocrinologists for possible puberty blocker prescriptions by the Sandyford between 2016 and 2023.

Meghan Gallacher, the Scottish Conservatives deputy leader, said: “This long-overdue decision should have been taken weeks ago when NHS England put a pause on the prescribing of puberty blockers.

“The SNP Government have been dragged kicking and screaming towards taking the necessary action to safeguard vulnerable youngsters after days of shameful silence and dithering in response to the Cass Review – presumably to placate the gender zealots in the Scottish Greens.

“Humza Yousaf repeatedly passed the buck – insisting it was up to clinicians to decide on the efficacy of puberty blockers and saying he wouldn’t be rushed in to responding to Cass – when it was clear decisive action was required.”

Trans charity ‘saddened’

The charity Scottish Trans, which the Scottish Government funds, said the move was the “wrong decision” and would “harm trans children and young people”.

Vic Valentine, manager of Scottish Trans, said: “We’re saddened that this change will result in some young people being unable to access the care they need at all, or having to wait even longer for it. We want every child or young person to get the individualised care that’s right for them at the time that’s right for them. We don’t think this decision will make that possible.

“We note that the announcement mentions the potential for further research into the use of puberty blockers, in partnership with NHS England. There is widespread concern that neither the research programme, nor how it will be designed, are finalised yet.

“We call on the Young People’s Gender Service and the Scottish Government to urgently prioritise resourcing high quality, ethical research, to make sure that no child or young person is denied the care they need.”

The Sandyford statement said: “This service update follows research from NHS 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.

“We are committed to providing the best possible clinical care for young people accessing and understand the distress that gender incongruence can cause.

“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.”