The National Health Service in England decided to close the country's only youth gender clinic in favor of a more distributed and comprehensive network of medical care for adolescents.
Thousands of patients have been served by the Tavistock clinic in London since it opened in the 1990's. Long wait times, insufficient mental health support, and the number of young people seeking gender treatments are some of the concerns raised by the review.
Some European countries with nationalized health care systems have seen a change in medical practice. The lack of data on long-term safety and outcomes of medical transitions is a concern for some doctors there.
Doctors specializing in gender care for adolescents have differing opinions about the reforms in Europe. Although many agree that more comprehensive health care for trans youth is needed, as are more studies of the treatments, they worry that the changes will fuel the growing political movement in some states to ban such care completely.
We need to keep care individualized while maintaining safety standards for everyone. The incoming president of the World Professional Association for Transgender Health is a plastic surgeon who is trans. People on the ground are the ones who need to make these decisions.
The N.H.S. said current patients at the Tavistock clinic could continue to receive care there before being transferred to two new hubs at children's hospitals. The new clinics will make sure children are adequately treated for trauma and mental health issues. Clinical research on gender medication will be carried out by the specialists.
The head of the external review of the country's youth gender identity services wrote a letter to the head of N.H.S. England last week saying there were critical unanswered questions about puberty blockers.
Puberty blockers are intended to give younger patients time to make important decisions about their medical care. Dr. Cass wondered if adolescents were given the support to reverse course if they chose to.
More than 5,000 patient referrals were received by Tavistock in the next two years. Over the past 10 years, the types of patients seeking referrals have changed. Children who were assigned male at birth were the focus of the clinic. Two-thirds of its patients were female last year.
It's not clear why the number of patients has gone up so much.
Many questions remain about how the changes will affect care for young people, and that's what the advocates in Britain want you to know.
Susie Green is the chief executive of the advocacy group for trans and gender-diverse youth. You will have to wait two and a half years for your first appointment. There has been distress caused to young people by that.
The group was concerned about whether mental health services would be prioritized over medical care. She said that gender diversity shouldn't be seen as a mental disorder.
Ms. Green said that they don't want any more barriers to be put in place.
A lawsuit was filed against the clinic in 2020. She said she was put on puberty blockers at 16 and had her breasts removed at the age of 20.
The high court ruled that children under the age of 16 weren't mature enough to consent. The judges ruled in September of last year that it was for clinicians to decide if a patient could give informed consent.
The N.H.S. commissioned a doctor from London to conduct an external review after employees at the clinic raised concerns. The interim report was released in February.
Sweden's national health service decided this year that gender-related medical care for young people should only be provided in exceptional cases. To collect more data on side effects and long-term outcomes, adolescents who receive treatment will need to enroll in clinical trials. Last year, it was the same thing.
The director of the country's National Board of Health and Welfare said in a February interview that they can't see this as just a rights issue. Patient safety and precision must be seen in the judgement. We need to be certain that we are giving the right treatment to the right person.
Some European countries have put limits on the care of trans people, but their approach is much more open than those in the U.S. A recent Alabama law made it a felony for doctors to give hormones to children. Parents who allow their children to receive gender treatments have been investigated for child abuse. The states are fighting with civil rights groups.
Changing standards in Europe could bolster the idea that gender treatments are dangerous for young people.
Dr. Goepferd is the medical director of the gender health program at the hospital. They said that more services are necessary. Our challenge here is that.