I've been reading up on this. NHSE's equality impact assessment is here:
https://www.england.nhs.uk/wp-content/uploads/2023/06/Equality-and-health-inequalities-impact-assessment-on-interim-service-specification-for-Specialist-Gender-Inco.pdf
In January 2023 the High Court agreed that not every child or young person referred to a specialised gender incongruence service will have the protected characteristic of ‘gender reassignment’. The Court agreed that children and young people who are referred to such a service do not – at the point of referral or while they remain on the waiting list - share the protected characteristic of ‘gender reassignment’ as a class or cohort of patients.
The whole cohort of patients cannot be treated as “proposing to undergo” a process (or part of a process) for the “purpose of reassigning” their sex “by changing physiological or other attributes of sex” as a class or cohort. To apply such a definition to these individuals is to make assumptions upon the aims and intentions of those referred, the certainty of those desires and their outward manifestation, and upon the appropriate treatment that may be offered and accepted in due course. This is particularly likely to be true in the case of very young children.
However, as the Court found and as NHS England accepts, many children and young people will individually have the protected characteristic at the point of referral or while on the waiting list, although determining that will involve a case-specific factual assessment.
The case they refer to is one of the fox batterers spectacular failures:
https://www.judiciary.uk/wp-content/uploads/2023/01/AA-ORS-v-NHS-Commission-Board-Judgment-160123.pdf
The judge said:
132 Not every child referred to the children’s GID service will have the protected characteristic of gender reassignment. Dr Cass in her report describes those being referred as “gender questioning children and young people” who “seek help from the NHS in managing their gender-related distress”. Some of these may present with symptoms of gender-related distress, for which they may in due course receive psychological help. They may not, at the time of referral, have taken any settled decision to undergo any part of a process of changing any attribute of sex (to use the language of the 2010 Act). This is particularly likely to be true in the case of very young children.
133 But there is no reason of principle why a child could not satisfy the definition in s. 7, provided that they have taken a settled decision to adopt some aspect of the identity of the other gender. Many of the children referred to children’s GID services will have taken such a decision. Determining whether any particular child has the protected characteristic of gender reassignment will involve a case specific factual assessment.
134 In this case, there is good evidence about the position of the two child claimants. AA’s circumstances are set out in para. 36 above. She has changed her name to a girl’s name. She attends school as a girl. She has now been living as a girl for more than 2 years. She wishes to receive medical treatment to delay the onset of male puberty. She has taken a decision to adopt some aspects of the identity of the other gender. At the present time, it would be an abuse of language to describe this decision as other than settled.
135 AK’s circumstances are set out in para. 37 above. At the age of 10, she expressed the desire to be known as a girl, have a girl’s name, wear girls’ clothes and have her hair long. She has been referred to the children’s GID service and the thought of going through male puberty distresses her. Again, she has clearly taken a settled decision to change aspects of her gender identity.
136 In my judgment, both AA and AK very clearly satisfy the definition in s. 7(1) of the 2010 Act. They have the protected characteristic of gender reassignment.
Looking at this, I think a child who said they identified as the opposite sex and wanted to change their name, pronouns, dress and hair, would be considered to have the PC of gender reassignment.