I work in research. Pharma companies are usually v reluctant to put cancer drugs into children because they dont want to assume the risk, because the market is too small to make the risk worthwhile. Even getting them to include children in clinical trials is a struggle.
But lo and behold, in the lucrative growth trans market, pharma companies are only too happy to make their drugs available for off label usage in children. Because the risks are low (huge lobbying behind it) and there are profits to be made.
It is entirely out of step with the rest of healthcare. The new approach proposed by Hilary Cass is not new, it is just how things are done in the rest of medicine.
Challenging case? Discuss in a multi disciplinary team meeting.
Shaky evidence base? Proceed with caution. Gather long term follow up. Bring in clinical trials.
Political pressure involved? Be very wary of 'patient advocate groups' check motivation and funding. Keep appropriate distance.
Children involved? Work on the basis of minimal effective intervention. Be vv wary of long term effects.
GIDS is a total anachronism. And it is fucking dangerous. I have had this conversation with friends who are health care professionals, and some are so captured they will not concede this, despite it being glaringly obvious.