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Reviews / 2024

Independent reviewPublishedChildrenEngland

Independent review of gender identity services for children and young people

Dr Hilary Cass · work from 2020 · published 2024

What this was

Independent review of NHS gender identity services for children and young people. It found a weak evidence base, a service that had not kept up with a rapid rise in referrals, and a need for ordinary, holistic children's healthcare around gender-related distress.

Why it sits in the hub

It is a contested review with direct consequences for services, research and puberty-blocking medicines. It also repeats older themes: follow the evidence, do not leave a specialist service isolated, and do not lose sight of the whole child.

Findings

  1. Finding 1

    The evidence for medical interventions in this group of children was weak, and the single national service could not cope or provide holistic care.

    Children and safeguardingData and early warningMedicines and devices

  2. Finding 2

    Many of the young people referred had wider mental health and social needs that the pathway did not address.

    InequalitiesMental health safety

Recommendations in this hub

Paraphrase of the public recommendations, not the official text.

  1. 1In progressNHS England

    Replace the single gender identity development service with regional services embedded in children's healthcare.

    Children and safeguardingIntegration and neighbourhood care
  2. 2AcceptedNHS England

    Restrict puberty-suppressing hormones to research settings until the evidence is stronger.

    Children and safeguardingMedicines and devices
  3. 3In progressNHS England and NIHR

    Build a research and data infrastructure so outcomes are actually followed up.

    Data and early warningLearning from harm