NHS / NHSE - NEW - Interim service specification: Interim specialist service for children and young people with gender incongruence

So they can’t be sued if they don’t prescribe, but take onboard any child taking PBs or XHormones for “clinical research”? So - passing the buck?

Who is in charge of regulating the private GPs and other prescribers? Who can stop this occurring outside NHS remit?

Children will still be prescribed puberty blockers, they'll just be included in the clinical trial.

How does a change in safeguarding standards usually work? I assumed there would be something like an equality impact assessment to justify the change and show evidence of why its safe.

"As in draft doc, NHSE ‘strongly discourages’ families from sourcing puberty blockers or hormones from unregulated sources or on-line providers that aren't regulated by UK regulatory bodies. But, there's no longer a call for mandatory safeguarding reporting in these circumstances.
That last sentence is worrying"

My guess is that it's a political move to avoid an ideological pile on? Currently all aspects of Social Care have been captured by trans extremism. It won't be until the harms to children are clearly evidenced & documented that they'll take a referral seriously. Currently they're just dismissed as transphobia. Incredibly frustrating but this is the approach Cass has taken. Not getting into debates with political activists, simply insisting on data / research driven medical care for vulnerable children.

As in draft doc, NHSE ‘strongly discourages’ families from sourcing puberty blockers or hormones from unregulated sources or on-line providers that aren't regulated by UK regulatory bodies. But, there's no longer a call for mandatory safeguarding reporting in these circumstances.

That last sentence is worrying.

It was on the 6 o’clock news on radio 4.

To be fair to NHSE it’s not their role to issue guidance or regulate private services.

I’m cautiously optimistic about the new guidance. My concern will be who is commissioned to run the new clinics and how much of them will have come from Tavi and other previously captured groups. But overall there does seem a change in focus.

We need the government now to look at the regulation of private clinics now.

As others have said, GGP is generally recognised by GPs as bargepole territory and their divergence from what will now be standard NHS practice will reinforce that and hopefully limit other private providers who are less notorious following in their footsteps.

BBC article on this here https://www.bbc.co.uk/news/uk-65860272 It’s made the front page though won’t get much notice below everything else this evening.

Thank you, I'll have a read of that now.

It makes it less likely that NHS GPs will co-operate with the Wobblies as the tide is turning on prescribing hormones to children. I see more Wobbly related GMC and civil cases if they continue to prescribe puberty blockers. They will have to do better assessments to cover themselves

Boom.

The triumph of incongruence over dysphoria - Eliza Mondegreen

I read WPATH discussion on changing terms from dysphoria to incongruence the other day. I think it was a recent thing. Will look for it.

So obvious, the lawyers have had a look and shut it down. I am glad, for the children and their families, for the NHS staff and the public purse that would have been finding this.

Why would you want to prevent the collection of data that would demonstrate the value of treatment you are confident is 'clinically necessary'? Surely you'd be celebrating the chance to show the world how lifesaving these treatments are?

It is horrifying that this research doesn't already exist, given that GIDS have been prescribed puberty blockers to children in the UK since 2016. But they did not collect any follow up data. The evidence base should already exist, either demonstrating that these treatments confer benefit, or that they don't, and also demonstrating what, if any harms are being done.

Mermaids should be howling about the fact that this data hasn't already been collected and analysed instead of suggesting that research shouldn't happen now.

It's a positive step in stopping medical experimentation on children. It also locates their health care in the medical / mental health fields, away from the very self interested adult groups who've had such a dangerous influence.

And if they must be administered as part of effective research then the long term impact of the off label use of these drugs on children will eventually be demonstrated. Too late for those who's brain, bone, fertility, good health development have been harmed of course, but it's a start.

I think NHS Wales used to refer children to the Tavistock GIDS, so there might be a few people still on that list who would be covered. I believe the Welsh gender service is developing a separate children's service. Mark Drakeford said something weird in the Senedd about not necessarily following the Cass Review as Wales was following its own evidence (sorry I can't remember the exact quote) which is very odd, as if Wales had some different evidence I'm sure Hilary Cass would be very keen to see it...

I can't see anything in the document suggesting it covers Wales. I'd be very surprised if it did.

It does seem odd that the private sector is allowed to sterilise children...what is our government thinking?

The cynic in me says they are doing this to avoid future lawsuits and also the high cost of providing ‘gender care’ to potentially lifelong patients.
The private sector will be cheering, they can basically carry on unchecked.

Thank you, Good news for the Welsh. I have hope that, after Isla, Scotland is waking up, and the pushback against self id by amazing women has made a foundation that other things can be built on.

England and Wales

Is it just NHS England? Iirc it's devolved.

I felt similarly. It's good news in the sense that some adults have finally taken a look at what was a disastrous service and tried to put more consistent clinical guidelines in place that aren't purely about activism.

As some else says this is also good news for parents who want a return to watchful waiting and don't want a nightmare battle on their hands.

The NHS seem to be safeguarding themselves against the accusations of improper care and treatment on their watch but the loopholes do mean a proportion of children remain unprotected if their parents are determined and /or wealthy enough.

Can we unpack the terminology which has bothered me for a while now.

'Gender Incongruence'.

Incongruence is 'the state of not being suitable or not fitting well with something else'.

We should absolutely not be doing any experimentation on people who 'do not fit with their gender'. Beause that basically means girls who don't like wearing dresses or boys who do.

This is a quite recent shift, does anyone know where it first came about. I first heard it from the Dutch Study interview in Episode 66 of The Wider Lens.

I don't understand why private GPs can continue to prescribe things that have been judged to be experimental and which sterilise to children?

I presume there will be a surge in demand for private GPs.

Also the social transition position seems woolly and I wonder what it would mean for schools?
Should they only support social transition if parents have discussed it with a clinician?