This is the reply I got from my Labour MSP.
Thank you very much for taking the time to write to me regarding the prescription of puberty blockers to children with gender dysphoria, and for drawing my attention to this research paper.
As you will know, the final report of the long-awaited Cass Review was published on Wednesday, which has identified a number of significant issues around the provision of gender identity services for children and young people until now. Whilst the scope of the independent inquiry conducted by Hilary Cass was limited to NHS service provision in England specifically, it is clear that its findings will have wider implications for gender identity service provision in the rest of the UK and beyond, and that current practices in Scotland must be reviewed in light of her recommendations in order to ensure that treatment provision in Scotland evolves in-line with current best practice, to ensure the very highest standard of care for the vulnerable children and young people who access these services.
I am particularly concerned by points highlighted by the Cass Review that aspects of the affirmative approach taken to care provision to date have not been evidence-based, including the prescription of puberty blockers to children and young people under the age of 18. Cass’ final report makes clear that in her professional opinion, a medical pathway for treatment will only be appropriate in a minority of cases, where it should be accompanied by psychological and psychosocial support. I am further aware that concerns have been raised by David Bell, the former governor of the Tavistock Clinic in London, that a similar, affirmative approach to treatment is currently being followed at the Sandyford Gender Service in Glasgow, and that puberty blockers are reportedly still being prescribed there. I believe that treatment provision in Scotland should now be reviewed as a matter of urgency in the light of the recommendations made by the Cass Review – I welcome that the Scottish Government has committed to look into the way that service provision in Scotland is currently run, and will monitor the situation going forward to ensure that this promise is upheld.
It is clear from the report’s recommendations that an evidence-based, multidisciplinary and holistic provision of care is needed, and that it is crucial that this is available to the children and young adults who need it in a timely fashion. The report highlights that a lack of NHS capacity in this specialism and the resultant long waiting times have caused gender questioning children and young people in England considerable further distress at an already challenging developmental stage in their lives, leaving them to look for support elsewhere, including online. These shortcomings could be equally applicable to the current service provision in Scotland. Just one specialist gender identity clinic – the Sandyford Clinic in Glasgow – currently caters for children and young people under the age of 18, resulting in long waiting times as well as long distances to travel for those living further away from the Central Belt. A Freedom of Information request by BBC Scotland revealed that at the end of 2023, 1,100 young patients were on the waiting list for this service, which is highly concerning given the detrimental impact on children’s’ mental health and wellbeing which was highlighted by the report. The Cass Review is clear that children and young people with gender incongruence and gender related distress deserve to receive the same standards of care as other children and young people, and the status quo is simply not good enough. Scottish Labour remains firmly committed to bringing down NHS waiting lists, and I will continue to push the Scottish Government to do so, as well as closely monitoring the ongoing developments in gender identity care for children and young people now that the Cass Review has been published.