New children's gender clinics to open after year’s delay

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New gender clinics for children are due to open after a year-long delay ready for a waiting list of thousands as the only NHS service for young people closes its doors.

Around 250 patients, who were being treated at the Gender Identity Development Service (Gids) run by the Tavistock and Portman NHS Foundation Trust, will have responsibility for their care officially transferred to the new clinics from April 1.

Some 5,000 children and young people are on the waiting list for referral to the new clinics in the north and south of England.

An initial aim had been for clinics to be up and running by spring 2023 but this was pushed back amid what NHS England described at the time as the “complex” set-up of the “completely new service”.

The new hubs will be led by London’s Great Ormond Street Hospital and Alder Hey Children’s Hospital in Liverpool.

Ahead of their opening, health minister Maria Caulfield said the clinics will include “experts on safeguarding, neurodiversity and mental health to ensure children are protected”.

NHS England hopes they will be the first of up to eight specialist centres as part of the north and south hubs over the next two years and described their opening as “just the first step in establishing a new model which provides holistic support for children and young people and their families”.

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In 2020, the Care Quality Commission (CQC) rated Gids inadequate, stating that the service was difficult to access with young people waiting over two years for their first appointment.

The regulator also said staff did not develop holistic care plans for patients, with “significant variations in the clinical approach of professionals” and no clarity in records as to why decisions had been made.

The closure of the service at the Tavistock – which had come under repeated scrutiny – was prompted by a review which stated a need to move away from one unit and recommended the creation of regional services to better support young people.

The review, led by Dr Hilary Cass, followed a sharp rise in referrals to Gids, with more than 5,000 referrals in 2021/22 compared with just under 250 a decade earlier.

Children will no longer be prescribed puberty blockers at gender identity clinics, the NHS confirmed earlier in March

Dr Cass’s interim report, published in February 2022, pointed to a lack of long-term evidence and data collection on what happens to children and young people who are prescribed medication.

She added that Gids had not collected routine and consistent data “which means it is not possible to accurately track the outcomes and pathways that children and young people take through the service”.

Her final report is expected in the coming weeks.

In March, NHS England confirmed children will no longer be prescribed puberty blockers at gender identity clinics.

The drugs, which pause the physical changes of puberty such as breast development or facial hair, will now only be available to children as part of clinical research trials.

The government welcomed the “landmark decision”, adding it would help ensure care is based on evidence and is in the “best interests of the child”.

As the new clinics open, an NHS England spokesperson said: “In line with the Cass Review, NHS England took the decision to close the Tavistock and set up a fundamentally different and improved approach to children and young people’s gender services.

“This transition is a complex piece of work, but this is just the first step in establishing a new model which provides holistic support for children and young people and their families.

“Our focus is on ensuring continuity of care as we establish the new service, and all patients waiting will be offered a local mental health assessment, with extra national resource provided to ensure the best possible support.”

Mermaids, a transgender youth support charity, said it is concerned that young people’s “voices and experiences have been dismissed in what has become a heavily politicised process”.

Transgender Trend, which said it advocates for evidence-based treatment of children experiencing gender-related distress, described the closure of Gids as “good news” and added that “it remains to be seen whether the new gender hubs will follow the recommendations of the Cass Review and provide a service in line with normal standards of paediatric care”.

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