On the surface, last summer’s headlines about the Tavistock Gender Identity Development Service for children and adolescents sounded definitive, with the National Health Service ordering the clinic’s closure after it was found “not safe” for patients. That harsh verdict was supposed to be the end of an era and the start of a fresh approach to working with gender-distressed children and young people.
It wasn’t. This weekend, the Telegraph reported that the number of children prescribed puberty-suppressing drugs has doubled since the National Health Service promised to curb the practice last summer, with at least 100 children initiating the controversial treatment between July 2022 and October 2023.
Last summer, in the wake of a damning independent review, the NHS announced that “puberty blockers will not be made routinely available outside of research,” “except in exceptional circumstances on a case-by-case basis.” These changes would kick in when the new youth gender services opened and when researchers had developed a new clinical trial to study the effects of puberty-blocking drugs on children and adolescents with early-onset gender dysphoria.
But the launch of the new youth gender services has been repeatedly delayed and the clinical trial the NHS outlined has not yet materialised, leaving thousands of young patients in limbo.
Last month, Kathleen Stock reported on the struggle to reorganise youth gender services in England and Wales — and pointed out the difficulties of designing a clinical trial that would meet basic standards of medical ethics, given the serious risks and unknowns and dubious benefits. An NHS research trial manager Stock interviewed described the idea of such a trial as “completely insane.”
Over the past few years, the evidence supporting puberty suppression has taken one hit after another. The NHS’s website now warns that “little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria” and that effects on mental health, brain development, and bone density are also unknown.
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