NHS to test all gender questioning children for Autism.

[Winterwonders24]

https://www.telegraph.co.uk/news/2025/04/27/nhs-to-test-all-gender-questioning-children-for-autism/

Seems a positive step/why weren't they already situation?

Can’t read it without giving them my email address. Is there some other way to read it?

Sounds like a damn good step.

Bloody good news. Hate to support anyone in this government but have a lot of time for Wes Streeting, especially over this issue.

Hoping this link will work as it’s a ‘gift’ link?

https://www.telegraph.co.uk/gift/a57b38f88dc0e3d6

How are they going to manage that when there aren't enough psychologists in the NHS to carry out assessments now? I also know some clever teens who would be quite up for pretending to have gender issues in order to speed up their assessments!

@CautiousLurker01 The link worked, thank you.

I’m glad that there will be a more holistic assessment of the child and family instead of ignoring everything apart from the gender dysphoria.

Now that more sensible approach needs to become widespread to other countries, like Australia.

Agreed… we had a 3-5year waiting period for assessment and then had no choice but to go private because the kids had GCSEs on the horizon. However… there seem to be LOADS of NHS trained/employed teams offering these services privately so what I anticipate is that the NHS may hire them or subcontract out.

The clinic that did my DC’s assessment was initially a PT/weekend clinic operated by NHS employees in the next county because they were distressed by the wait times people referred within their NHS trust were experiencing. They even charged a really reasonable rate. They are now FT.

Archive link. https://archive.ph/sU08i

Well that seems extremely sensible.

It says screened not assessed so it is probably just initial screening rather than a full on assessment that you have to wait years for

It's a very positive step forward. Thank you for sharing, OP.

The next step is to raise awareness amongst schools, Educational Psychologists, Occupational Therapist, Speech and Language Therapists and healthcare professionals that autistic children can experience puberty as traumatic and confusing e.g. sensory issues around breast development and periods for girls, beard and genital growth for boys. Also they may feel confused and distressed about their emotions changing, what it means to "be" a girl/boy and how to navigate these changing expectations which differ so much from childhood.

It shouldn't be rocket science to these professionals but so many seem to have forgotten what they already know.

Eating disorders are also significantly above average with autism so that would be another area where screening could be offered.

Or, here's an idea: how about making it possible for parents to see a paediatrician without undue barriers and waits?!

My friend in another European country gets an automatic appointment for both kids every year with a paediatrician!

I think what Bayswater says in the article is spot on - it’s great they’re doing a more thorough investigation, but it’s also impossible to know if a child thinks they’re trans because they’ve been taught at school or at guides or wherever that children can be trans and that it’s possible to be born in the wrong body or with a ‘girl brain’ or whatever.

How can medical experts expect to get to the bottom of the issues when there is so much misinformation being fed to children from the trusted adults around them?

well, that’s vaguely encouraging

It's screening rather than assessment. In the same way that all children with eating disorders are screened for autism. It doesn't fast track the assessment in any way but it means that they don't slip through the net when it comes to consideration of autism.

All children under an eating disorders service should be screened for autism currently.

Thanks, that makes sense.

This ⬆️⬆️⬆️

Schools, scouts, guides, therapists and any other adults working with children need to be crystal clear that a) someone's sex is biological and cannot be changed b) it's normal to feel confused and distressed about "who am I and I how do I fit into the world?" during puberty and c) society places expectations and limitations on people because of their sex, but it's OK not to want to follow these.

It’s a 4 yr waiting list in our area for cahms asd assessment and they only accept children at crisis point. Many areas are a much longer wait. Where are they finding these clincial pyschologist/paeditricians and SALTs?

I'd want to know what this then leads to though

So the child is screened and I can guarantee is more than likely needing assessment and more than likely ND (usually ASD) if and when any assessment takes place.

Well then what, what is the 'treatment' for the trans identity and discomfort with themselves, because currently there is none, the method and pathway is to accept trans a a definitive thing, a legitimate thing.

Children with ND/ASD dont get support unless they're very lucky, to understand themselves when they're not trans, let alone if they are.

I'd want to know what this then leads to though

This is such a key point - from the moment I saw it, I've been wanting to come back with some thoughts which incorporate my own experience as a parent supporting my daughter. Apologies in advance for the length of this post, which I've now got some time to write.

TL:DR

IMO, it's a combination of two things that are needed a) using the Education and Healthcare Plan (EHCP) to articulate an individual child's needs and provisions, under the existing support structures and b) uplifting the clarity in the schools' statutory guidance which separates LGB from "T" (now called "gender questioning"), and references reasons such as autism that can influence becoming gender questioning, across all of child protection guidance. This would link mental healthcare into the EHCP, while also protecting children who don't yet have an EHCP.

In more detail....

For context, my daughter was diagnosed with autism at age 7 or 8 and has had an EHCP since year 5. Obviously we had to jump through a million hoops to get one and not every child who is gender questioning will already have an autism diagnosis or EHCP. We've been in the cycle of annual reviews and emergency reviews since then. She became gender questioning at the age of 13 and her periods started just after she experienced a huge mental health crisis aged 13.5. We're at varying stages of success on this journey (e.g. despite agreeing to all the EHCP changes during the annual review in Feb 2023, with further professional submission in the next annual review in Feb 2024, we didn't get any paperwork to review until December 2024... and nothing was included 🤦‍♀️... it remains ongoing), but for me, a rough outline would be as follows if a child is both autistic and gender questioning:

At an individual child level

1. If a child receives their autism diagnosis after they have become gender questioning and/or doesn't have an EHCP:

• Undertake risk assessment in school against paragraphs 205-209 of KCSIE guidance. Does school have teaching or pastoral practices which conflate or risk conflating sex, sexual orientation and gender reassignment? Are children who are, or are vulnerable to becoming, gender questioning given clear facts about sex, sexual orientation and sex-based stereotypes without conflating these? Address each risk.
• Support parent and child in securing an EHCP. This will take considerable time, so an IEP (Individual Education Plan) will be needed to call out the needs and provisions necessary to support the child in the interim.
• Provide parent with information about the Cass Report and the risks of social transition, using the KCSIE guidance as an anchor for this conversation
• Train staff on how autism can influence a child's reaction to and understanding of their body, particularly as they start to experience the emotional and physical (sensory) changes that happen in puberty. This will need to be sex-specific (periods, facial hair growth) as well as generic.
• Request an Educational Psychology assessment. Make it clear to the EP that this should be in line with safeguarding needs under paras 205-209 i.e. it should not conflate sex, sexual orientation and autism.
• In the IEP, track the child's understanding of the differences between males and females - this will help inform Speech and Language (SaLT) cognitive processing needs for the future EHCP
• In the IEP, track the child's understanding of their own body and any specific issues that cause distress or confusion - this will help inform Occupational Therapy (OT) needs for the future EHCP

2. If a gender questioning child has an existing EHCP related to an existing autism diagnosis:

• Follow the first 4 steps above
• Request an EP assessment (see above re guardrails to mitigate risk of conflation) to unpick how the child's autism is influencing their understanding about themselves in relation to their sex.
• Following receipt of the EP report, discuss this with the parent to make sure that all issues relating to any conflation of autism and gender identity have been captured. Adjust in collaboration with EP as needed until parents, SENCO and EP are satisfied that all needs are represented - additional information can be provided to the EP if available e.g. GP or CAMHS information if relevant.
• On finalisation of EP report, request an assessment from the SaLT team which includes recommended cognitive processing needs and provisions relating to an understanding of what it means to "be" male or female
• On finalisation of EP report, request an OT assessment which includes needs and provisions to help the child feel grounded in their own body e.g. exercises which start with areas of the body that don't cause the child distress and build to include these, such as cross body movements which incorporate the chest area in girls who are experiencing sensory issues with breast development
• Invite submissions from other agencies, such as GPs and CAMHS which articulate mental health needs and provisions regarding the impact of autism during adolescence

The two approaches are similar. The benefit of the latter is that it becomes legally binding and isn't specific to an individual school.

At a national level

Although the schools' statutory guidance references the Cass Report (see para 206 of KCSIE), there is no feedback loop which exists between healthcare and education. Safeguarding at a holistic level (across healthcare, Children's Services, police etc etc) is delivered under Working Together to Safeguard Children statutory guidance, which is under the auspices of the DfE.

If the Working Together guidance was uplifted to recognise the difference between being LGB and gender questioning (e.g. if it incorporated paras 205-209) this would allow for joined up care. Each agency would have its own thresholds for safeguarding, just as they do now. But at a basic level, it would:

• Provide clarity to all adults working with children that being LGB is different from being gender questioning, from a safeguarding risk perspective (this may also add clarity into the "conversion therapy" debate)
• Provide greater clarity on the impact of underlying factors such as autism, which raise a child's risk of becoming gender questioning - this will give psychiatrists, psychologists and counsellors a foundation upon which to bring in what they already know about the impact of autism during puberty (sensory issues, potential difficulties when processing sex-based stereotypes etc)
• Assist in policy and decision making when considering the balance of confidentiality and bringing parents in to the conversation - if a vulnerable child is at risk of being gro0med by outside influences to believe that they are "in the wrong body", parents should be included in the conversation
• Elevate safeguarding protections for vulnerable children to a similar status as those within Prevent. This also links to the point above regarding gro0ming. At the moment, outside influences are not given due consideration, particularly where children are being gradually separated from parents by a combination of well-meaning and activist adults. This is often taking place in schools, where teachers are positioning themselves as "safer" than "bigoted" parents

Summary

There's much more to it but hopefully that general outline makes sense. In essence, it's about using existing frameworks and existing bodies of professional knowledge to join everything together, via safeguarding. It starts with a combination of mental health care professionals and education professionals remembering what they already know about the impact of puberty on autistic children. Likewise other children who are vulnerable to believing they are in the wrong body, such as those who may grow up to be gay (and are experiencing confusion and/or shame) about their emerging same-sex attraction and children who have experienced trauma, who may wish to reinvent themselves.

Each child's journey will begin in a different place, depending on their own circumstances. Here's my daughter's at the very beginning:

https://www.transgendertrend.com/teenage-gender-identity-crisis/

I didn't expect to still be fighting to get it all included in the EHCP. Equally, I didn't know when I wrote this that it would be such an uphill battle to address the issue at a whole school level (meaning my daughter remains at risk of the influences within the school, which may yet still lead her to believe she is in the wrong body). However, I've been able to collaborate successfully enough with the autism unit at the school and others to mean that we're getting there.... slowly. It's been a pretty painful journey though. There continue to be many curve balls along the way.

Assist in policy and decision making when considering the balance of confidentiality and bringing parents in to the conversation - if a vulnerable child is at risk of being gro0med by outside influences to believe that they are "in the wrong body", parents should be included in the conversation.

I wasn't able to catch this on the edit... For clarity, I'm referring to agencies outside education here, such as therapists and counsellors. It's imperative that they recognise the impact of autism on a child's understanding of and experience of puberty. Parents have parental responsibility - shutting them out of conversations where a child is at risk could be the start of a process where the child begins to believe that their parent may cause them harm. This will be exacerbated if the therapist/counsellor affirms the child's identity.