Review of the NHS adult gender dysphoria clinics in England: terms of reference and key lines of enquiry

[IwantToRetire]

I came across this by chance and haven't read.

But in case anyone is intersted in
"The terms of reference and key lines of enquiry that form the basis of the review of adult gender dysphoria clinics in England"
you can download from https://www.england.nhs.uk/publication/review-of-the-nhs-adult-gender-dysphoria-clinics-in-england-terms-of-reference-and-key-lines-of-enquiry/

ie 2 documents:

• Terms of Reference
• Key lines of Enquiry

Ta v much - will add that to my reading list for the week ahead 👍

Thank you for sharing.

Unless I've missed it, there's a significant and important omission from the key lines of enquiry: is there evidence that surgeries and hormone treatments provide positive outcomes?

When this review was first announced, that was a key reason for doing it. For example, these were amongst the bullet points in the announcement on 10th April:

• lack of a robust evidence base; being mindful that the majority of referrals to the adult gender clinics are of natal females who are aged between 17 and 25 years, and that the historical evidence base that has informed clinical practice relates to an older cohort of natal males
• limited information on short and long-term outcomes, particularly for those individuals who transferred to adult services from paediatric services
• an increasing incidence of individuals seeking to ‘detransition’ following previous gender affirming interventions and the absence of a consistent, defined clinical approach for them.

Link to source:
https://www.england.nhs.uk/long-read/review-of-nhs-adult-gender-dysphoria-clinics/

Thanks Bonfire and IWanttoRetire. Might be time to remind them of this aim.

I wonder whether that is wrapped up in the point about reviewing the safety and effectiveness of the services? That obviously goes a bit wider, but ought (if properly interpreted) to include whether there is positive effect arising from the services. In order to assess effectiveness, they would need to consider what the purpose of the services is (we are told it is to alleviate unbearable suffering) and could then assess whether that purpose is being fulfilled, hopefully looking at a relatively long time limit not just the initial post-treatment phase.

I wondered the same, but then I couldn't see a specific point that rolled up to it.

Given it was central to the initial announcement and pivotal in the impact of Cass, it's concerning that it's now so difficult (impossible?) to see.

I agree it is concerning. But hopefully it provides enough of a hook for those with relevant evidence (eg you and others in a similar boat, plus desisters) to submit it and help the inquiry team see that “effectiveness” is something that needs to be examined broadly.

Have to say I have only had time to skim read, but cant see how it is a response to the quesitons raised by Cass.

It sounds like they are looking at a medical service that is just business as usual, and this is a standard review.

ie not a service that on one level is in limbo / dont yet exist.

NHS England will roll out up to six new specialist regional centres by 2026 to provide tailored gender services for children and young people, based on recommendations in the Cass Review.

These plans also set out that, subject to academic approval, recruitment to a clinical trial into the potential benefits and harms of puberty suppressing hormones for children and young people is likely to commence in early 2025.

https://www.england.nhs.uk/2024/08/nhs-to-roll-out-six-new-specialist-gender-centres-for-children-and-young-people/