Cass Review report calls for pause on use of puberty-suppressing hormones

A senior clinical team, commissioned by the chief medical officer for Scotland, considered all 32 recommendations of the Cass Review into gender identity services for children and young people in NHS England. The team assessed to what extent they were applicable in the context of Scotland, and whether they could be implemented in Scotland’s health service.

Recommendations of the multi-disciplinary team included:

• a lead senior clinician, preferably a consultant, should take overall responsibility for each young person’s care
• each care plan should include a full assessment of the child’s needs, both psychological and physical
• as elsewhere in the UK, the use of puberty-supressing hormones – commonly referred to as puberty blockers – should be paused until further clinical trials can be undertaken. NHS Scotland will continue to engage in the forthcoming UK study
• work to design a regional service for children and young people should begin immediately, and services should ultimately be provided as locally as possible, based in children’s health services, with strong links between secondary and specialist services.

The conclusions of the report will now be considered by the Scottish government – both in relation to how current services should be delivered to ensure service continuity, as well as on how these services should be commissioned in the future to ensure sustainable person-centred care.

Deputy chief medical officer Professor Graham Ellis said: “The Cass Review was established to make recommendations on how to improve NHS England gender identity services for children and young people. Through this review we have aimed to set out which recommendations could apply to Scotland, and how they might be implemented.

“At the heart of this question are children and young people in distress, and our ambition must remain focused on meeting their needs with holistic, person-centred care as close to home as practical.

“The Cass Review identified the need to ensure that gender identity services for young people are more closely aligned with other areas of clinical practice, and that responsibility for the full range of services required should extend beyond specialist services. This will be essential as we seek to always provide the best possible care.

“In responding to the Cass Review, the multi-disciplinary team looked at the recommendations from a clinical perspective, always remembering that we have a responsibility to make sure that all children and young people grow up safe, respected and supported.”