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NHS independent review into children's gender ID services

(56 Posts)
carefulvulvadriver Tue 22-Sep-20 15:59:08

What do we know about Dr Hilary Cass? A cold hard look and analysis sounds a good thing, although I wouldnt have much faith in the CQC's inspection of the Tavistock

NHS Announces Independent Review Into Gender Identity Services For Children And Young People
22 September 2020

The NHS has today announced that Dr Hilary Cass OBE, former President of the Royal College of Paediatrics and Child Health, will lead an independent review into gender identity services for children and young people.

The review will be wide-ranging in scope looking into several aspects of gender identity services, with a focus on how care can be improved for children and young people including key aspects of care such as how and when they are referred to specialist services, and clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.

It will also set out workforce recommendations for specialist healthcare professionals and examine the recent rise in the number of children seeking treatment.

Dr Cass will then make clear recommendations for children and young people’s gender identity services reporting back next year.

The Gender Identity Development Service for Children and Adolescents is managed by the Tavistock and Portman NHS Foundation Trust.

The Care Quality Commission (CQC) is due to carry out a focused inspection of The Tavistock and Portman NHS Foundation Trust, Gender Identity Services for children and young people, during the autumn. The inspection will cover parts of the safe, effective, caring, responsive and well-led key questions and will include feedback from people using the service, parents, relatives, carers, and staff. Separately, Dr Cass will also review the service’s clinical practice with the support of the Royal College of Paediatrics and Child Health and engagement of other professional bodies to provide multi-professional insight working closely with the CQC.

The review includes an examination of the issues surrounding children and young people who are prescribed puberty blocking and cross sex hormone drugs.

Dr Hilary Cass OBE, independent chair, said: “It is absolutely right that children and young people, who may be dealing with a complexity of issues around their gender identity, get the best possible support and expertise throughout their care.”

“This will be an inclusive process in which everyone will have the opportunity to make their views known. In particular I am looking forward to hearing from young people and their families to understand their experiences.

“This review provides an opportunity to explore the most appropriate treatment and services required.”

A transparent and inclusive process for stakeholder engagement and consultation will be established to ensure that everyone who wants to can make their views known.

Dr. Michael Brady, the National Adviser for LGBT Health said: “Every child matters and children and young people who are exploring their gender or experiencing gender dysphoria, including those who are trans or non-binary, deserve the very best from the NHS.

“This is why this review is so important so that all health professionals can deliver the very best healthcare in a compassionate and understanding way.

“Throughout this process it’s critical we hear from children and young people, those who have accessed these services, their families and expert clinicians so I am pleased that Dr. Cass has put this at the heart of her approach.”

Professor Helen Stokes-Lampard, Chair of the Academy of Medical Royal Colleges said: “This is a multi-professional issue and we are pleased that a formal review is taking place to provide a comprehensive, evidence-based view on this sensitive and complex subject.”

The terms of reference for the independent review have also been published.

The independent review will present recommendations to NHS England and Improvement’s Quality and Innovation Committee.

OP’s posts: |
rogdmum Tue 22-Sep-20 16:25:57

This is very good news. Dr Cass is already undertaking a review into the use of puberty blockers and cross sex hormones in the under 18s- a wider review is very much a positive move.

carefulvulvadriver Tue 22-Sep-20 16:31:49

@rogdmum yes I think it is good news! I dont care that, like the self-ID stuff, the announcement has been buried under the latest corona virus measures. The important thing for now is it's going to be properly looked at.

OP’s posts: |
persistentwoman Tue 22-Sep-20 16:32:54

Good. It's a shame that it's taken this long but scrutiny and accountability are long overdue for these services for children. And given what has been leaked about the scandalous ability of pressure groups to determine the nature of health care for vulnerable children as opposed to clinical decisions, hopefully this will go some way to reverse this trend.

rogdmum Tue 22-Sep-20 16:34:27

They are finally going to look at:

“Exploration of the reasons for the increase in referrals and why theincrease hasdisproportionately been of natal females, and the implications of these matters.”

At long long last.

rogdmum Tue 22-Sep-20 16:35:32

Sorry, my copy & paste ran a whole load of words together!

“Exploration of the reasons for the increase in referrals and why the increase has disproportionately been of natal females, and the implications of these matters.”

OvaHere Tue 22-Sep-20 16:39:12

This sounds like good news. A proper review has been long overdue.

Clymene Tue 22-Sep-20 17:00:20

I think this is excellent news. Dr Cass has a very distinguished career in paediatrics and has particular interest in disability, including ASD.

Someone with a very good grasp of the impact of ASD on children who are intellectually able will be able to shine a light on the over representation of autistic youth with gender identity issues.

It will also hopefully put paid to that absurd assertion made by one body (GIRES I think?) who asserted that gender confirmation could 'cure' autism hmm

Clymene Tue 22-Sep-20 17:02:30

And I make the intellectually able point specifically because I believe the vast majority of autistic children who are transitioning are like my child - intellectually very able - but substantially impacted by their autism

carefulvulvadriver Tue 22-Sep-20 17:19:55

@rogdmum has pointed out the terms of reference are worth a read. They are here:

They also say: "The review will not immediately consider issues around informed consent as these are the subject of an ongoing judicial review. However, any implications that might arise from the legal ruling could be considered by the review if appropriate or necessary"

Anyone know the time scales for the judicial review?

OP’s posts: |
PearPickingPorky Tue 22-Sep-20 17:30:08

This is good news. Announced on a day where people are distracted too, wise move.

rogdmum Tue 22-Sep-20 17:31:03

The judicial review is at the beginning of Oct (6/7 or 7/8 can’t remember)- anyone’s guess as to how long the decision will take though.

unwashedanddazed Tue 22-Sep-20 17:41:38

I'm delighted this is happening at last. A youngster in my family is fast coming up to the puberty blocker decision and I hope this might provide much better information for the parents. Obviously I hope it means it they won't go forward with blockers as I believe their use is an abominable experiment which is paving the way for much misery to come.

stumbledin Tue 22-Sep-20 17:50:49

Well - have to say this could be a trojan horse. With stakeholder involvement this could be swung round to say current services not good, but doens't mean the process is wrong. sad

2020wumben Tue 22-Sep-20 17:54:34

Keira Bell has updated for one of her cases that this means that her case will be withdrawn as a judicial review is unlikely to be granted as the NHS will be undertaking independent review. The other case is still scheduled for October.

KormaKormaChameleon Tue 22-Sep-20 18:06:16

It's interesting that she's working with the Royal College of Paediatric and Child Health but not the Royal College of Psychiatrists though

NonnyMouse1337 Tue 22-Sep-20 18:45:24

This sounds very promising. I'm glad to see such a review going to take place. Fingers crossed there will be some sensible analysis for the best long-term interests of the children involved in this process.

moptophairshop Tue 22-Sep-20 19:44:18

This is indeed good news as a thorough review is clearly long overdue. The number of resignations at GIDS, the rising numbers of detransitioners and the worrying influence of charitable bodies can no longer be ignored. The scope of the review looks like it will consider all aspects. Also it's great that Dr Cass has a background in ASD given the skewed profile of the female patients, particularly in very recent years.

Has this come about as a response to Kiera's proposal for the judicial review? Did they anticipate a potentially disasterous outcome and decide to do the review themselves?

wellbehavedwomen Tue 22-Sep-20 20:40:04

I'm really, really glad he has a background in ASD. That's been one of the most troubling aspects, given the various reasons that ASD young people are likelier to feel uneasy in their own skin in adolescence than the average (and let's face it, adolescence is a really hard time for almost everyone).

Whatever the outcome, this will hopefully result in better, more evidence-based care. Which is what everyone should want.

ArabellaScott Tue 22-Sep-20 21:49:04

Glad to hear this. Let's hope it's a proper review, not an educatory consultation type of thing.

I do seem to be going on about that today. Don't think I'll ever actually get over it.

Antibles Tue 22-Sep-20 22:05:32

Cautiously optimistic of light being shone, but hoping that there are some gender critical people among those stakeholders.

Just throwing in a request that when the reason for the disproportionate number of females getting ROGD is examined, the factor of the increasingly pornified sex that is nowadays expected of them - and that they might very reasonably want to opt out of via a 'gender' change - might also be considered.

moptophairshop Tue 22-Sep-20 22:20:15

It bodes well that they want to centre the voices of children and families involved, this is such an important thing to do. Let's just hope that the voices and experiences of detransitioners are listened to as well. It would be extremely imbalanced and unrepresentative if they were ignored.

DisappearingGirl Tue 22-Sep-20 22:26:19

Here's some info on Dr Hilary Cass

DisappearingGirl Tue 22-Sep-20 22:29:01

And Dr Hilary Cass's Twitter thread talking about this

BatShite Wed 23-Sep-20 01:40:32

The people on that thread apologising for the 'anti-trans' hate Hilary will apparently get, as she will be 'making positive trans posts' or something along those lines. Quite presumptious eh..and I doubt this will be on twitter anyway primarily..oddly enough!

Hopefully this is being gone into without any bias to start off with. As a review should. I am sure it is, and those claiming its about improving waiting list times for puberty blockers and such are hugely mistaken.

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