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

[ChristinaXYZ]

https://www.england.nhs.uk/wp-content/uploads/2023/06/Interim-service-specification-for-Specialist-Gender-Incongruence-Services-for-Children-and-Young-People.pdf

Good summary by Hannah Barnes on twitter

https://twitter.com/hannahsbee/status/1667160027151364098

I've just come on to post this! This sounds v good news

Here's a threadreader summary of Hannah's thread for people who aren't on Twitter (or who like me find it easier to read text in a block rather than lots of different tweets);

threadreaderapp.com/thread/1667160027151364098.html

What does it mean for the Wobberleys?

This sounds very sensible in the focus on psychological approaches. Caution on social transition is good.

What about inviting kids for follow up who have already taken PBs via Tavi over the past few years? That way they can see what the long term outcomes have been (after all Tavi know what they prescribed and when) without doing lots more research and needing to put more kids on PBs experimentally?

Have they also changed the requirement that PBs must be taken before cross sex hormones can be given? What about the kids already on that pathway currently on PBs, will that be stopped immediately?

I assume this very welcome news doesn't affect what the private sector can do. Will Gender GP still be able to carry on regardless? I genuinely don't know the answer.

What does it mean for the Wobberleys?

A surge in demand from those who believe the only treatment for gender distress is PBs and CSHs?

Ahhhh just read this in the Hannah Barnes thread, one heck of a loophole.

Maybe. It doesn't stop the prescribing PB's.

It does make it difficult to legally defend doing so if there are adverse outcomes.

So potentially they might find themselves unable to get insurance.....

There's a loophole. If you started giving your child blockers that were prescribed/obtained from outside the NHS, the NHS may continue them - and for some reason prescribing or obtaining puberty blockers from dodgy sources to give to a minor is no longer a safeguarding issue or reportable.

Its a disaster for child rights and safeguarding imo.

There is also the other issue that because GGP are private they also technically should be working with the NHS GP practice the young person is under the care of.

There are many NHS GP's (who know the back story of GGP) who refuse to do this.

That's really awful. So parents can sterilise their children against medical advice and that's not an issue.

Bloody hell

Sounds like the NHS are trying to wash their hands of this issue, but not actually safeguard more broadly.

I agree but where parents do not want puberty blockers for their child or generally want to put the brakes on it does protect them from idealogues in schools and social services. And if the child is still lsitening to them with one ear if gives a point of discussion that the NHs does not think puberty blockers are a good idea.

A major problem has been parents who are best placed to safe-guard their kids being rail roaded by schools threatening to report to social servivces etc. Maybe even clinicians doing so if the parents don't give their conscent. And now that won't happen. Parents can move to protect their own kids.

I agree that trans identifying kids of woke parents might still not be protected.

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?

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 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.

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

England and Wales

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.

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.

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

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

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...

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.

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.

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.

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.