THE Scottish Conservatives have called on NHS Scotland to undertake an “urgent evaluation” of gender identity services following the publication of the Cass Review last week.
The review, led by consultant paediatrician Dr Hilary Cass, looked into the provision of gender identity services for children and young people within the NHS in England.
In her final report Cass made a series of recommendations, including advising “extreme caution” in prescribing puberty blockers and hormones to under-18s due to a lack of “high quality” research into their long-term effects.
She also called for the immediate creation of more regional gender identity hubs in order to meet increasing demand and said the “exceptional toxicity” of public debate surrounding transgender identity was doing nothing to help young people seeking treatment.
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The review only looked at gender identity services in NHS England, which are also used by Welsh children.
However, the Scottish Conservatives immediately called for the review’s findings to be considered in Scotland.
In a letter to NHS Scotland chief executive Caroline Lamb, Scottish Tory MSP Meghan Gallacher criticised the Scottish Government’s reaction to the report.
“Whilst this review was conducted in England and Wales, many of its points are just as relevant and important here in Scotland,” she wrote.
“And I believe it provides the opportunity to have serious and open discussions about what happens next.
The silence from the Scottish Government over the Cass Review recommendations is deafening.
— Meghan Gallacher MSP (@MGallacherMSP) April 15, 2024
That’s why I’ve written to Caroline Lamb, Chief Exec of NHS Lanarkshire to seek clarity on their position. pic.twitter.com/adWwVplSIX
“The Scottish Government has been slow to respond to the recommendations from the Cass review as well as concerns regarding lack of sufficient evidence for medical interventions such as puberty blockers.
“I believe urgent evaluation must be undertaken to ensure the wellbeing of young people in Scotland isn’t going to be less protected than their counterparts south of the border.
“Therefore, can I ask what engagement NHS Scotland has had with the Scottish Government following the publication of the Cass report and if all evidence available that puberty suppressing hormones are safe could please be published”.
In March, NHS England that it would no longer be prescribing puberty blockers to under-18s outside of clinical trials.
However, NHS Greater Glasgow and Clyde – who run Scotland’s only gender identity service for children and young people from the Sandyford clinic in Glasgow – is continuing to assess whether patients are suitable for puberty blockers, although stresses that they are currently used in small numbers.
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NHS Scotland is already reviewing gender identity services for both children and adults as thousands languish on waiting lists for a first appointment.
Following the publication of the Cass Review, the Scottish Government has pledged to “consider” its findings.
However, two transgender academics in Scotland have warned “politicisation” of the report’s recommendations cannot be allowed to guide decision making in Scotland and that criticism of the report should not be dismissed.
The report has been criticised for excluding contributions from those with lived or professional experience of gender identity services in England, with one senior psychiatrist telling The National that “ignorance of gender dysphoria medicine was framed as a virtue”.
Some transgender organisations have also claimed that studies were excluded from Cass’s report due to “practically impossible” standards of research, which are not the norm in other fields of medicine.
Of 50 available studies on the use of puberty blockers on teenagers only one was deemed “high quality”.
New Zealand-based transgender health specialist Dr Rona Carroll said this reflected on the challenges of conducting “high quality” research in the field and the “longstanding underfunding of trans health research more generally”.
“The majority of evidence presented in most medical guidelines would not be classed as high quality,” she said.
“This is not unique to transgender healthcare.”
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