NHS Scotland have implemented a “hold” on patients accessing puberty blockers via the Sandyford clinic. A source told Trans Safety Network that this hold was implemented as a result of “a group of clinicians from Greater Glasgow & Clyde NHS”, meaning that there will be no further referrals to endocrinology from the Gender Identity clinic service.
Trans Safety Network understand that puberty blockers — more technically known as GNRH agonists — will continue to be available for young cisgender patients experiencing precocious puberty, and this ban is restricted to young trans patients. We also understand that this ban has been implemented for some weeks now ahead of the release of the Cass Review.
According to our source, young people who have already been prescribed GNRHas will continue to on their existing course of care, and there may be an option in the future for young trans patients to access GNRH agonists as part of a clinical trial.
The mechanism of action of GNRH agonists is well known and understood. They have been prescribed to prevent precocious puberty in young people since the 1980s. They have been used in the UK to forestall puberty in for young people with gender dysphoria during an assessment period while capacity to consent to cross sex hormones develops since 2011 in the UK. Trans Safety Network are concerned that in the last 4 years, since access to puberty blockers has been starkly reduced in the UK there has been a massive increase in the number of suicides of children and young people accessing trans healthcare services.
Responding to this situation, trans health academic and Lecturer in Community Development, Dr Ruth Pearce said:
"NHS Greater Glasgow and Clyde appear to be acting on the basis of political expediency, rather than medical expertise, academic evidence, or the lived experiences of service users. This is a deeply irresponsible decision that will endanger the lives of young people whose hope of accessing care has been cruelly revoked, and deepen trans people's distrust of the NHS. I have no doubt it will also be celebrated by same journalists and politicians who have ignored or even embraced the staggering methodological and ethical flaws in the Cass Review. This is an appalling outcome for young people, and a bad day for medical science."
The Cass Review has been condemned by professional healthcare bodies in Canada, Australia and Aotearoa-New Zealand, and widely criticised for prioritising unpublished anecdotal and hearsay evidence against puberty blockers over published and peer reviewed observational clinical data over large patient cohorts considered by the Cass Review research team as of “low quality” because it didn’t use blinded trials. The proposition of blinded controlled trials have themselves been criticised as unethical and impractical for use in trans healthcare provision.
Trans Safety Network have contacted Sandyford Gender Identity Clinic for comment.