The National Health Service England (NHS) is shutting down the Tavistock transgender clinic by spring 2023 after a review concluded it is “not safe” for children..It will move young people who believe they're transgender to regional centres, according to NHS England..A more “holistic” approach to treating individuals will look at other mental health or medical issues patients may have..The Cass review interim report behind the NHS decision found doctors felt “under pressure to adopt an unquestioning affirmative approach” to people questioning their gender identity..At Tavistock, it discouraged the normal process of clinical assessment of young people in favour of the “unquestioning affirmative approach.”.Tavistock is the only place providing gender identity services for young people in England..The pediatrician leading the independent review is Dr Hilary Cass, a past president of the Royal College of Paediatrics and Child Health..Earlier this year, the Cass review found Tavistock was “not a safe or viable long-term option” for young people..In response to the Cass review, the NHS England said “given the urgent requirement to stabilize current service provision” it will start two “Early Adopter” services operated by children’s hospitals..The two children’s hospitals, one in London and one in the North West, will take Tavistock patients and those on waiting lists by next spring when Tavistock will be closed..Cass recommended “rapid” research on puberty blockers by young people..Cass said there is currently “insufficient evidence” on the long-term effects of puberty blockers..Puberty blockers have been given to children as young as 10 years old in England..In 2020, the NHS England commissioned the Cass review because of concerns there was “scarce and inconclusive evidence to support clinical decision making.”.Tavistock and Portman NHS Foundation Trust run the Gender Identity Development Service, which had more than 5,000 patients in 2021-2022 and long waiting lists compared with 250 patients just 10 years ago..The NHS England said there were “marked changes” of patients born male who felt they were in the wrong body and needed to transition to female in their early teenage years. .The primary concern was doctors seemed too quick to affirm a new gender identity without examining other mental health or medical issues..Cass recommends using more than the single provider model, which is Tavistock..The NHS wants a more holistic approach to treating vulnerable children and young people..“[NHS needs to] establish regional services that work to a new clinical model that can better meet the holistic needs of a vulnerable group of children and young people,” said the NHS England spokesperson. .“Staff should maintain a broad clinical perspective in order to embed the care of children and young people with gender uncertainty within a broader child and adolescent health context,” said Cass..“The ongoing work of Dr Cass’ review, alongside our experience in establishing the Early Adopter services, will help shape the development of the new model of care, national standards, and a new national service specification against which regional services can be commissioned,” said the NHS England spokesperson..“We will engage and consult fully on this service specification in due course.”
