Scotland's under-18s gender clinic pauses puberty blockers

Anonymous young person in the countryside
[Getty Images]

Scotland's NHS has paused prescribing puberty blockers to children referred by its specialist gender clinic.

The Sandyford clinic in Glasgow also said new patients aged 16 or 17 would no longer receive other hormone treatments until they were 18.

It follows a landmark review of gender services for under-18s in England.

Dr Hilary Cass's review said children had been let down by a lack of research and there was "remarkably weak" evidence on medical interventions.

NHS England confirmed it would stop prescribing puberty blockers in March.

The drugs work by suppressing the release of hormones that cause puberty and are often prescribed to children questioning their gender as a way of stopping physical changes such as breast development or facial hair.

Like other parts of the UK, Scotland has seen a rapid rise in the number of young people questioning their identity or experiencing gender dysphoria.

The only specialist service for under-18s is the Sandyford clinic in Glasgow, where people can self-refer or can be referred through their GP.

Figures released to BBC Scotland News under a freedom of information request, showed that at the end of 2023, 1,100 patients were on the waiting list.

As of last month, fewer than 100 children were prescribed puberty blockers in England.

In Scotland, 43 patients will continue to receive either puberty blockers or "gender affirming hormones" such as testosterone or oestrogen.

Sandyford clinic in Glasgow
Pro-trans activists protested outside the Sandyford clinic in Glasgow last month [BBC]

The decision to pause both these treatments for new patients goes further than the changes announced by NHS England.

Hormones now cannot be accessed in Scotland until a patient is 18 while in England they can be prescribed "around the patient's 16th birthday".

In mid-March, following NHS England's position, NHS Greater Glasgow and Clyde (NHSGGC) and NHS Lothian deferred starting new patients on treatments.

Now the Glasgow health board says patients have been formally notified of the changes.

It said existing patients currently receiving treatment will not be affected.

Dr Emilia Crighton, NHSGCC's director of public health said: "The findings informing the Cass review are important, and we have reviewed the impact on our clinical pathways.

"The next step from here is to work with the Scottish government and academic partners to generate evidence that enables us to deliver safe care for our patients."

Vic Valentine, of Scottish Trans and the Equality Network, said pausing puberty blockers was the wrong decision and said it would "harm trans children and young people".

A statement said: "This decision has been taken within the context where the reality of trans people's experiences and lives is questioned almost daily in some of the media and some political circles.

"This makes us worry that the decision has been influenced by that context rather than solely through consideration of the best interests of trans children and young people."

Following the announcement, the LGBT wing of the Scottish Greens launched a petition questioning the future of the party's deal with the SNP.

The Rainbow Greens published an open letter calling for an emergency general meeting to discuss the future of the power sharing agreement.

Speaking at a protest in Glasgow, Rainbow Greens co-convener Jen Bell said: "In the Bute House Agreement the Scottish government promised to dismantle the gatekeeper system and put trans patients at the heart of decisions on their own healthcare.

"Sandyford's decision breaks that promise."

Update 'in coming weeks'

Scottish Conservative deputy leader Meghan Gallacher said the decision was "long overdue" and accused the government of leaking the news to the press "before having the decency to update parliament".

She called for an urgent ministerial statement so MSPs had a chance to ask questions on the matter.

She said: "I'm beyond fed up with this lackadaisical approach to gender care. They are failing children and young people."

During First Minister's Questions, Labour MSP Carol Mochan asked Humza Yousaf if he would ensure a statement was made to clarify the government's "confused position" on the matter.

Referencing comments made by Dr Cass, the first minister said compassion to young people seeking treatment from a gender clinic had to be "at the forefront of everything we do".

He said: "It was absolutely right to allow clinicians to have conversations with the young people that they treat compassionately before the government came forward with any further statement.

"Now that we've had that confirmation, of course the health secretary or ministers will come to this chamber with the agreement of the parliamentary bureau next week or in the coming weeks to give an update on the government's position.

"There is a process of review that is very much under way."