MSPs ask Humza Yousaf for child rights assessment in wake of Cass Review

"Clarity is urgently needed" on how the Scottish Government will respond to the Cass Review on gender identity services for children, MSPs have told Humza Yousaf.

The first minister has said Scottish health boards will give "the utmost consideration" to the 400-page report by paediatrician Dr Hilary Cass.

It recommends "extreme caution" in the use of hormone treatments for children and young people experiencing gender incongruence.

And it warns that using puberty blockers to prevent the development of secondary sex characteristics in adolescents could damage their bone density.

Cass, who carried out the review for NHS England, said this area of medicine is carried out on a "remarkably weak" evidence base and said a medical pathway is not appropriate for all patients.

She found the "toxic" and "polarised" debate around gender identity had led to clinicians feeling "fearful".

And she said a lack of strong evidence raises problems around the issue of informed consent.

Bosses at the specialist Sandyford clinic in Glasgow have announced the suspension of hormone treatment referrals for new patients under the age of 18.

Before that news emerged on Thursday, Yousaf said that: "When it comes to the prescribing of medicine, clinicians are best placed, not politicians, government ministers or myself as first minister."

Public health minister Jenni Minto said it would "not be appropriate to respond quickly".

Now the cross-party Education, Children and Young People Committee has called for "clarity" over what the government intends to do. 

Writing to Yousaf, convener Sue Webber MSP said: "The recent publication of the Cass Review has brought to light significant concerns about the way in which trans, non-binary and gender questioning children and young people access gender identity services in England, and the evidence that underpins current practices. 

"The committee recognises that there will undoubtedly be parallels between services in England and those currently provided to children and young people in Scotland. 

"Clarity is urgently required as to how the Scottish Government intends to take forward the report’s findings in a Scottish context."

The letter comes after Parliamentary Business Minister George Adam dismissed calls for a ministerial statement on the matter, telling the Scottish Parliament: "The Cass Review deals with services in NHS England, not in NHS Scotland. It is therefore clearly not the responsibility of the Scottish Government to respond."

Webber said the report "raises many other complex, and sometimes competing, children’s rights considerations which require urgent exploration" under the United Nations Convention on the Rights of the Child. 

These include rights to healthcare, non-discrimination, best interests, development, to express a view, freedom of expression and privacy.

She told Yousaf: "The committee believes a comprehensive Children’s Rights and Wellbeing Impact Assessment should be undertaken to ensure these matters are explored fully and to ensure the rights of all children and young people across Scotland are safeguarded. 

"Further, the committee believes that a clear timeline should be provided for a Scottish response to the Cass Review, so that children and young people, parents/carers and clinicians can be reassured that the significant issues raised by Dr Cass will be fully considered and acted upon in Scotland without delay."