Clinical Advisory Network on Sex and Gender
NHS England are currently consulting on a draft service specification for the new youth gender clinics set up in response to the Cass Review. The deadline is 2 November. A service specification is important because it sets out what a service should provide and eligibility for access to the service. It is meant to be […]
Rachel Cashman highlights the severe conflict of interest in the NHS Sussex investigation into inappropriate prescribing practices for minors. She argues for an independent inquiry, citing previous failures in safeguarding and leadership within NHS governing bodies. The urgency lies in restoring public trust and ensuring child safety over ideological conflicts.
It’s good to hear that there will be a review of private prescribing of cross sex hormones for under 18s, but what is long overdue is a review of prescribing to under 18s within the NHS. It is scandalous that the current NHS policy to prescribe these has not been updated since the Cass Review finding of no good quality evidence of benefit, as well as increasing concerns about irreversible and harmful long term effects.
The Australian Doctors Federation urges health professional bodies to reconsider the “gender affirmative treatment” model for youth, citing evidence from reviews like the UK Cass Review. Concerns about puberty blockers and hormone treatments’ risks have led several countries to restrict their use. The Federation advocates for psychosocial support as the first-line intervention.
On May 1, the US Department of Health and Human Services released “Treatment for Pediatric Gender Dysphoria: Review of Evidence and Best Practices,” which was commissioned by a Trump administration Executive Order. This comprehensive review assesses current evidence on treating paediatric gender dysphoria, emphasizing the importance of compassionate, evidence-based care tailored to children’s and adolescents’ needs. It highlights the risks of paediatric medical transitions, questioning their benefits and critiquing the “gender-affirming” model of care used in the US. The review also discusses ethical considerations, advocating for psychotherapy as a safer alternative. It aims to inform policymakers, clinicians, and families amid growing international concern about paediatric medical transitions.
The National Institute of Health and Care Research (NIHR) is funding the PATHWAYS trial on puberty blockers for children with gender incongruence, pending ethical approval. CAN-SG opposes the trial, citing serious ethical concerns, including unclear benefits and potential harms such as injury to fertility and cognitive development. The UK regulations mandate a trial only if its benefits outweigh its risks and emphasize the protection of vulnerable groups. CAN-SG argues that more research is needed on psychosocial interventions before considering puberty blockers, aligning with recommendations from the Cass Review. CAN-SG has written to the trialists, the oversight board and the regulators to express concerns, seeking proper ethical oversight.
On March 6, 2025, the Clinical Advisory Group on Sex and Gender (CAN-SG) hosted a panel to review the progress following Dr. Hilary Cass’s 2024 review of gender identity services for children. The Cass Review highlighted the weak evidence supporting medical interventions for gender dysphoria and emphasised psychological therapy as the preferred management approach. Hannah Barnes discussed the history and closure of the Gender Identity Development Service (GIDS), pointing out missed opportunities and the lack of meaningful patient data. Other panelists emphasised the need for psychotherapy, addressing misinformation, and ensuring ethical considerations in treatment pathways for young patients, while acknowledging the challenges of implementing the Review’s recommendations.
In July, the British Medical Association (BMA) Council voted to oppose the Cass Review recommendations on transgender healthcare for children and young people, prompting an open letter signed by over 1000 members criticising this decision. The BMA reversed its decision in September, adopting a position of “neutrality”.
The recent decision by NHS England to ban routine use of puberty blockers is a positive step to protect children. Concerns remain about private providers, cross-sex hormones for 16-18 year olds, lack of research, and care for detransitioners. We hope the Cass final report will provide further clarity, but regardless of what is in the final review, the principle of evidence-based care for gender questioning youth has been established by Cass.
Recently released documentation of internal discussions between members of the World Professional Association for Transgender Health, including authors of WPATH’s Standards of Care, reveal profound ignorance and lack of concern for the harms and lack of evidence for gender medical and surgical interventions, and a shocking disregard for medial ethics. The WPATH Files Leaked internal […]
A group of professionals in Scotland formed ScotPAG to address the impact of gender ideology in public services. They aim to understand the situation, engage with authorities, and raise awareness. Facing challenges from professional bodies and government, they plan to use FOI requests and build alliances to push for transparency and influence policy.
James Esses, trainee psychotherapist, had taken UKCP to court for discrimination against him for expressing gender critical beliefs which led to him being expelled from his psychotherapy training course. (You can get more information about his case here.) Today Esses announced he had reached a settlement with UKCP and, although he was not able to reveal […]
Medical, legal, and cultural debate over the practice of youth gender transitions has come to the birthplace of the Dutch Protocol The following is an extract from an article on the Society for Evidence Based Gender Medicine’s website about the beginnings of discussion and debate in the Netherlands about the practice of gender transition in […]
Against the weaponisation of youthful suffering An article by a child psychiatrist on the abuse of “suicide risk” in promoting medical intervention for children who identify as trans was recently published in The Critic. The author wrote: When a child identifies as trans, the spectre of suicide is frequently raised by campaigners — sometimes in […]
A response from the Clinical Advisory Network on Sex and Gender to Dr Helen Webberley’s open letter to Dr Hilary Cass, Chair of the Independent Review of Gender Identity Services for Children and Young PeopleC Dr Helen Webberley’s challenge to Dr Hilary Cass recycles the inaccuracies and misconceptions that have resulted in far too many […]
By Stella O’Malley:- When journalist Hannah Barnes carried out an exposé on the Tavistock for Newsnight in 2019, she was so shocked at what was uncovered that she took time out from working at the BBC to write her book, Time To Think: The Inside Story of the Collapse of the Tavistock’s Gender Service for […]
On 27 January 2023 The Guardian newspaper published the following letter by Dr David Bell, former staff governor at the Tavistock and Portman NHS foundation trust, on its Gender Identity Development Service. https://www.theguardian.com/society/2023/jan/27/gender-identity-treatment-needs-greater-caution When considering the interim report by Dr Hilary Cass on gender identity services for children and young people, your article overemphasises the […]
The closure of the Gender Identity Development Service (GIDS) at the Tavistock has attracted significant public and media attention. Closure resulted from the Cass Review of children and young people’s gender services in England. The interim report recommended a new service model which acknowledges multiple routes in and out of gender dysphoria. Elevated rates of same-sex attraction, autism spectrum disorders, mental health issues, and looked […]
CAN-SG welcome this important intervention by Dr Hilary Cass and support her recommendations that gender questioning young people need a comprehensive patient and family centred service, run by experienced providers of tertiary paediatric care to ensure a focus on child health and development with strong links to mental health services. We support her view that the […]