This decision is grounded in concerns about the absence of long-term evidence supporting the safety and efficacy of "gender-affirming care" treatments for minors. The move marks a pivotal point in the ongoing discourse on the appropriate treatment for children struggling with gender confusion.
The NHS in England has prohibited the use of puberty blockers for children seeking treatment for gender dysphoria, citing insufficient research. Puberty blockers, also known as gonadotropin-releasing hormone analogues (GnRHa), are a category of drugs that inhibit sex hormones in adolescents by continuously stimulating the pituitary gland. These will now only be accessible to children in restricted circumstances, such as clinical trials.
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The NHS's website stated, "Puberty blockers (gonadotrophin-releasing hormone analogues) are not available to children and young people for gender incongruence or gender dysphoria because there is not enough evidence of safety and clinical effectiveness."
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Previously, NHS England had directed the Tavistock and Portman Trust, a London-based gender identity clinic, to cease operations due to safety concerns. This shift follows several studies conducted in European countries that demonstrate "gender-affirming care" not only fails to benefit children with gender dysphoria but often exacerbates their mental health issues. In 2020, the NHS initiated a review, concluding that "all children being referred for treatment will from April instead attend two new clinics" rather than receiving treatment at more medical facilities.
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According to a recent report, "Some European countries, such as Finland, Norway, and Sweden, have been exercising increased caution," highlighting that countries that adopted “gender-affirming care” long before the United States are now retreating from the practice.
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In January, the NHS first revealed its intention to take this step while also taking measures to closely monitor the use of puberty blockers on minors. NHS England also announced the creation of an oversight board to investigate the effects of puberty blockers:
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NHS England has established a new national Children and Young People’s Gender Dysphoria Research Oversight Board which has now approved the development of a study into the impact of puberty suppressing hormones ('puberty blockers') on gender dysphoria in children and young people with early-onset gender dysphoria. More information on the Board and the study can be found in the consultation report.
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The report further stated:
The Service will adopt a holistic, multi-disciplinary integrated approach to assessing and responding to an individual’s needs in view of the range of co-presentations that may typically present in this patient cohort, and the range of complexities relating to gender identity development. The most appropriate clinical pathway in the best interests of the child or young person will be determined through an integrated multidisciplinary team (MDT) approach, fully involving the child or young person and their family.
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Maria Caulfield, a junior health minister in the U.K., praised the decision, stating that “Ending the routine description of puberty blockers will help ensure that care is based on evidence, expert clinical opinion and is in the best interests of the child.”
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The U.K.'s departure from “gender-affirming care” is a significant stride, potentially signaling similar actions from other countries that have previously advocated these treatments for children. The upcoming years will be crucial in shaping the understanding and approach towards providing the best care for children experiencing gender dysphoria.
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