The National Health Services announced Tuesday that U.K. gender clinics will no longer prescribe puberty blockers to children.
Puberty blockers will now only be available to minors who are participating in clinical research trials. The ruling follows a public consultation of the issue and a 2020 NHS England-sanctioned independent review of gender transition surgeries and hormone therapy for minors.
“Ending the routine prescription of puberty blockers will help ensure that care is based on evidence, expert clinical opinion and is in the best interests of the child,” Health Minister Maria Caulfield said in a statement to The Independent.
Conducted by pediatrician Dr Hilary Cass, the investigation came amid a surge in youth referrals to the Gender Identity Development Service (Gids) operated by the Tavistock and Portman NHS Foundation Trust. Cass’s report, which concluded that there wasn’t sufficient evidence to support gender “treatment” to such a large number of patients, prompted the shutdown of the facility. Gids is set to finally close at the end of the month.
Gender-transition advocates claim puberty-blockers merely “pause” the onset of bodily changes such as breast development in girls or facial hair in boys, leaving no lasting effects. However, some research suggests that the “pause” leaves children permanently altered as their bodies fail to develop adequate bone density and other secondary characteristics associated with puberty.
In June, NHS announced as an interim policy that it would not routinely offer puberty-blocking drugs to children at gender identity clinics, citing lack of evidence about long-term complications. Outside of a research setting, NHS said the drugs would be administered on a case-by-case basis. With Tuesday’s decision, the policy became fixed.
“Outside of a research setting, puberty-suppressing hormones should not be routinely commissioned for children and adolescents,” NHS said at the time.
In 2020, England’s High Court ruled that young teenagers likely do not have the maturity to consent to receiving puberty blockers.
“It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers,” the court said. “It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blockers.”
The court acknowledged that these invasive interventions, widely recommended to gender-dysphoric youth in America’s medical industry, are experimental and could yield serious long-term damage.
“We recognise that clinicians may well regard these as cases where the authorisation of the court should be sought prior to commencing the clinical treatment,” the court said.
England’s Court of Appeal later reversed the decision in 2021, arguing that doctors are allowed to prescribe puberty-blocking drugs to children under 16 without parental approval.
For the last few years, the NHS has been ahead of the curve in voicing the potential drawbacks of the gender-affirming model. In 2022, the NHS pitched plans for a new clinical approach that for younger children would “reflect evidence that in most cases gender incongruence does not persist into adolescence,” according to the Telegraph.
Doctors, the institution said, should be mindful that gender dysphoria in youth might be a “transient phase”.
When a prepubescent child has already socially transitioned, “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,” it added.
Meanwhile, the U.S. has barreled toward transitioning kids without question while rejecting more cautious strategies such as counseling or watchful waiting.