Not a single trans young person has been referred to a hormone specialist this year

·4-min read

Not a single trans young person has been referred to a hormone specialist by the NHS this year, it has been revealed.

According to FOI data obtained by the i, no trans person under the age of 17 approved for treatment by the NHS Gender and Identity Development Service (GIDS) has been granted an appointment with an endocrinologist since December 2020.

The data – supplied by the Tavistock and Portman NHS Foundation Trust, the trust overseeing GIDS – revealed 171 patients received an initial referral to a hormone specialist in the year from 1 March, 2019 to 4 March, 2020.

Susie Green, CEO of Mermaids, told i that trans youth and their families have been “left in limbo” while waiting for treatment, adding some people have been “pushed to the brink” by the long wait for care.

A December 2020 High Court ruling essentially made it so that any trans person under the age of 16 could only receive puberty blockers with a court order.

This was partially overturned in March, when it was ruled that parents could consent to treatment on their child’s behalf, before it was completely quashed on 17 September by the Court of Appeal.

After the successful NHS appeal, it was ruled that it had been “inappropriate” for the High Court to “provide the guidance” that trans youth can’t consent to puberty blockers.

The original verdict had stated that trans under-16s would need to be able to understand the nature of hormone replacement therapy and gender-affirming surgery to be prescribed puberty-blocking medication.

However, it was deemed “highly unlikely” under-13s would be competent to give consent and was “doubtful” children aged 14 and 15 could understand the “long-term risks and consequences”, meaning a court opinion would be needed for each case.

The September ruling said that the notion that trans young people should go before a judge to access medication “should have been dismissed” outright.

The judges also said that there is no “real distinction” between trans youth being Gillick competent to take puberty blockers and under-16s using Gillick competence to access contraception.

High Court ruling meant trans kids had healthcare taken away ‘swiftly and brutally’

In April, NHS England announced plans to establish an independent review body to assess the prescription of puberty blockers to young people.

The review group was established to ensure that Tavistock’s GIDS carried out an enhanced clinical review of each patient, assessed the risks and benefits of treatment and there had been a “robust process for providing parental consent and child assent”.

Green said the charity was told the “assessment framework would be in place within a few months” after the December ruling. However, she claimed that by September, they had “only just got confirmation of the panel beginning to review cases”.

“We’ve got kids who are sat here, who, in December 2020 were on the verge of being sent through to endocrinology,” Green told the i. “The suspension of all treatment and cancellation of their access to care was swift and brutal, and parents are reporting little or no information as to when they can expect their children’s treatment to be restarted.”

She added: “This is causing so much pain for trans kids around the country, as time slips by without any progress.”

​​A spokesperson for Tavistock told the i that new structures are in place to “enable referrals to endocrinology to resume soon”.

“We will be working with our commissioners and partners to consider any further adjustments following the Court of Appeal ruling,” they added.

Young trans people forced to wait for years to see a gender specialist

According to the GIDS website, there were 2,748 total referrals to the service in the UK in 2019-20, with 2,565 referrals coming from England alone. BMJ reported “more than 4,600 young people” were on the waiting list for GIDS.

GIDS has recorded 2,383 people being referred to the service between 2020 and 2021.

The service’s website said GIDS is currently seeing young people “referred in 2018” for their first appointment, meaning trans youth have a years-long wait before receiving crucial gender-affirming treatment.

Speaking at an academic conference in March, Dr Jay Stewart, CEO and co-founder of trans charity Gendered Intelligence, said the December 2020 ruling harmed the mental wellbeing of trans youth.

Dr Stewart said young trans people who worked with the charity felt a “lack of control” over their lives as a result of the judgement.

“Young people have described it as offensive that they do not have appropriate autonomy over their bodies and their choices,” he said.

He also warned that there’s a real risk trans youth will “internalise” a harmful message sent by the High Court’s ruling, and this shame could have “lifelong” consequences for young people.

“Our young people have described how the judgement has made them feel that the world hates them, and the danger is that this message could get internalised as, ‘there’s something wrong with me and I deserve to be punished.'”

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