Puberty blockers ‘should be paused’ for children in Scotland, recommends senior clinical team

A senior clinical team, commissioned by Scotland’s chief medical officer, has recommended a pause on puberty-suppressing hormones for children until further clinical trials can be undertaken. 

In April, NHS Scotland paused puberty blockers for new patients aged 16 or 17 in response to Dr Hilary Cass’s review into gender services for under-18s in England.  

The review found children had been let down by a lack of research and there was "remarkably weak" evidence on medical interventions. 

The clinical team, which assessed to what extent the recommendations in the review were applicable in a Scottish context, has submitted a number of suggestions to the Scottish Government. 

It has also recommended a lead senior clinician, preferably a consultant, take overall responsibility for each young person’s care and every care plan should include a full assessment of the child’s needs, both psychological and physical. 

Immediately beginning work to design a regional service for children and young people, and ultimately establishing a service as local as possible has also been suggested. 

Deputy Chief Medical Officer Professor Graham Ellis said the Cass Review had “identified the need to ensure that gender identity services for young people are more closely aligned with other areas of clinical practice” and the “responsibility for the full range of services required should extend beyond specialist services”. 

The Scottish Government will now consider the recommendations and update Holyrood after recess.  

Ellis said: “The Cass Review was established to make recommendations on how to improve NHS England gender identity services for children and young people. Through this review, we have aimed to set out which recommendations could apply to Scotland, and how they might be implemented.  

“At the heart of this question are children and young people in distress, and our ambition must remain focused on meeting their needs with holistic, person-centred care as close to home as practical.  

“The Cass Review identified the need to ensure that gender identity services for young people are more closely aligned with other areas of clinical practice, and that responsibility for the full range of services required should extend beyond specialist services. This will be essential as we seek to always provide the best possible care.  

“In responding to the Cass Review, the multi-disciplinary team looked at the recommendations from a clinical perspective, always remembering that we have a responsibility to make sure that all children and young people grow up safe, respected and supported.” 

Cabinet Secretary for Health and Social Care of Scotland Neil Gray said: “The Scottish Government welcomes the multi-disciplinary team’s report, which has carefully considered the Cass Review’s recommendations and how they apply to Scotland. The conclusions of the report will now be considered and used to improve gender identity healthcare for children and young people. The Scottish Government will update Parliament after summer recess.   

“We remain absolutely committed, not just to ensuring ongoing support is available, but to reforming and improving gender identity healthcare across Scotland.”