UK will investigate adult trans health clinics following controversial review on trans youth

A controversial new report on gender-affirming healthcare has compelled the U.K. National Health Service (NHS) to demand data from all seven of its adult gender clinics. The NHS has also ordered the clinics to deny services to any clients younger than 18. The actions have concerned transgender healthcare advocates.

The NHS’ orders follow the recent release of the Cass Review, a 400-page review of oft-cited research on gender-affirming care for minors. The review concluded that there’s little reliable evidence showing positive outcomes from such care, but outraged trans activists say it excluded hundreds of studies showing such outcomes.

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“We will be launching a review into the operation and delivery of the adult GDCs [gender dysphoria clinics], alongside the planned review of the adult gender dysphoria service specification,” said a letter written by NHS England’s National Director John Stewart, according to The Telegraph.

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Stewart wrote that the NHS will “review the use of gender-affirming hormones through a process of updated evidence review and public consultation, similar to the rigorous process that was followed to review the use of puberty suppressing hormones” in the Cass Review. Many of NHS’ adult gender clinics refused to provide data for the Cass Review, the review stated.

Trans rights advocates predicted the Cass Review would give conservative political leaders a pretext for ending gender-affirming care for minors and younger adults. Indeed, the review urged “extreme caution” before giving minors puberty blockers or hormone replacement therapy and championed the use of psychological therapy instead. The review also said that “life-changing” decisions on gender-affirming care should be put off until adulthood since the brain continues maturing into the mid-20s.

“The long term plan for the NHS utilizing the Cass Review is to ban gender-affirming care up to [age] 25,” queer civil rights lawyer Alejandra Caraballo wrote via X. “They’re going to force 18-25 into wrap around care that will deny access to hormones. This was never [about] kids. They don’t want trans people to exist period.”

The NHS’s Gender Identity Development Service (GIDS) was established in 1989 and eventually moved to the Tavistock and Portman NHS Foundation Trust. However, former Tavistock psychiatrist Dr. David Bell released a whistleblowing report in 2018 alleging that clinicians at the since-shut-down youth gender identity clinic felt pressure to quickly approve children, including those with serious mental health issues, for gender-affirming care.

NHS England announced in 2022 that it planned to close the Tavistock clinic and instead offer gender-affirming care in a larger number of local clinics. Its announcement acknowledged that an increase in youth seeking treatment for gender dysphoria had overwhelmed Tavistock and led 2,000 adolescents to be referred to adult clinics to reduce waiting times.

However, the Cass Review concluded that the NHS has still provided inadequate care to “gender incongruent” children. The review urged clinicians to take a more “holistic” approach with such patients, including more support for treating concurrent mental disorders and psychotherapy to help minors explore their gender identities.

Trans journalist Erin Reed eviscerated Cass’s findings, saying the report included concepts rejected by more than 60 mental health organizations, including the American Psychological Association.

“It is important to note that gender affirming care saves lives, and there is plenty of evidence to show for it,” Reed wrote, citing numerous studies proving that such care significantly reduces suicidality. She added, “The largest and most influential medical organizations support trans care.”

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org. The Trans Lifeline (1-877-565-8860) is staffed by trans people and will not contact law enforcement. The Trevor Project provides a safe, judgement-free place to talk for youth via chat, text (678-678), or phone (1-866-488-7386). Help is available at all three resources in English and Spanish.