Most trans children just going through a phase, advises NHS
Most trans children just going through a phase, advises NHS
Most children identifying as transgender are simply going through a “transient phase”, new NHS guidance states.
Doctors caring for youngsters distressed about their gender have been told that it is not a “neutral act” to help them transition socially by using their preferred new names or pronouns.
The draft guidelines say doctors should “carefully explore” all underlying health problems, including mental ill health, amid concerns that the NHS is rushing children on to irreversible puberty-blocker medication.
The new “watchful approach” adopted by the NHS is a significant change of course from the “affirmative” approach advocated by campaign groups, including Mermaids.
The NHS England document states: “The clinical management approach should be open to exploring all developmentally appropriate options for children and young people who are experiencing gender incongruence, being mindful that this may be a transient phase, particularly for prepubertal children, and that there will be a range of pathways to support these children and young people and a range of outcomes.
“A significant proportion of children and young people who are concerned about or distressed by issues of gender incongruence, experience co-existing mental health, neurodevelopmental and/or family or social complexities in their lives.”
The NHS is reviewing its treatment of trans children following a damning interim report by Dr Hilary Cass, a former president of the Royal College of Paediatrics and Child Health.
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It is shutting the gender identity development service at the Tavistock and Portman NHS Trust in north London after Cass raised concerns that it was not safe.
NHS England’s draft guidance states that there is “scarce and inconclusive evidence to support clinical decision-making” for children with gender dysphoria. It stresses that “in most cases gender incongruence does not persist into adolescence” among younger children. “The clinical approach has to be mindful of the risks of an inappropriate gender transition and the difficulties that the child may experience in returning to the original gender role upon entering puberty if the gender incongruence does not persist into adolescence,” it reads.
The guidance says that for older teenagers, social transitioning should be considered only as a last resort.
It says: “Social transition should only be considered where the approach is necessary for the alleviation of, or prevention of, clinically significant distress or significant impairment in social functioning and the young person is able to fully comprehend the implications of affirming a social transition.”
The Tavistock clinic will close in spring and care is being handed to regional children’s hospitals that aim to provide a more evidence-based approach and will bring together mental health, autism and hormone treatment services.
The new guidelines, which are open for public consultation until December, have been drawn up to provide a model for these new gender services.
The Tavistock clinic has treated about 19,000 children with gender dysphoria since 1989 and is England’s only service for under-18s distressed about their gender identity.
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