UK NHS plans to test transgender children for autism and ADHD

Children who identify as transgender will be tested for autism and ADHD at NHS gender clinics, it has been reported.

The Telegraph said that each child referred to a gender clinic will be assessed for neurodevelopment conditions such as autism and ADHD (attention deficit hyperactivity disorder).

It follows recommendations from the Cass Review of gender services for children and young people, which led to a UK ban on prescribing puberty blockers to under-18s experiencing gender dysphoria.

The review also found a link between gender dysphoria and condition such as autism and ADHD.

Under new proposals for gender clinics which will soon go to a full public consultation, the NHS will also assess children's mental health, their relationship with their family and whether they experience same-sex attraction.

The Cass Review, carried out by paediatrician Baroness Hilary Cass, recommended a more holistic and evidence based approach to how young people with gender dysphoria are treated, shifting away from the more medical stance practiced by the controversial Tavistock Centre, which was forced to close in March 2024.

Instead, two new NHS Children and Young People's Gender Services clinics opened in April last year at Great Ormond Street in London and Alder Hey Children's Hospital in Liverpool. Another centre opened at the end of last year at University Hospitals Bristol, one of six new regional centres planned by 2026.

An NHS spokesperson told Yahoo News UK: “As part of NHS England’s commitment to implement advice from the Cass Review, we have recently gone out to stakeholder testing on a proposed revised specification planned to replace the interim service specification for the Children and Young People’s Gender Service.

“We will soon be going to full public consultation on this draft specification which sets out the new holistic assessment framework that was described by Dr Cass in her report.

“NHS England has recently changed the referral pathway so child patients can only access gender services that we commission if they're referred by a paediatrician or a child and adolescent mental health worker.”
What is the current NHS process for children who identify as trans?

If a child is strongly identifying with a different gender and it is causing them "significant distress", such as anxiety, withdrawal or depression, the NHS advises that they go to their GP.

Their doctor can then refer them to the National Referral Support Service for the NHS Children and Young People's Gender Service, of which there are currently three centres - in London, Liverpool and Bristol - with five more regional hubs opening by next year.

Other NHS professionals, teachers, charities and local support groups may also refer children with gender dysphoria.

After an initial assessment, the team at the gender service will work with the child and their family to manage any anxieties and will outline what support they can offer to the child's school.

The team includes a clinical psychologist, a child psychotherapist, a child and adolescent psychiatrist, a family therapist and a social worker.

If a child continues to be distressed about their gender identity, they may be seen more often by gender services, or referred to a local Children and Young People's Mental Health Service for more serious emotional issues.

The NHS said some young people "with lasting signs of gender dysphoria who meet strict criteria" may be referred for hormone therapy and could be given gender-affirming hormones alongside psychological support. These hormones can cause breast development (by taking oestrogen) and deepening of the voice (by taking testosterone).

Puberty suppressing hormones are not available to children and young people.
What is the waiting list like for children at gender services?

At the end of last year, health secretary Wes Streeting told MPs in the House of Commons that 6,237 children and young people were on waiting lists for gender services.

He said: “As in common with all NHS waiting lists, I want to see those fall. We want all of these regional centres to be up and running by 2026 and we’re working with NHS England to achieve that outcome.”

According to data sharing site TransActual UK, some young people have been on the waiting list since August 2018, while a report by PA Media last summer revealed the average waiting time was 100 weeks and that the youngest person on the list was under five years old.

The NHS says children and young people are being seen in order of their original referral date, and says the wait list is longer for the centre in London, advising people to have a second location choice as a referral there could be quicker. The NHS has a list of charities where young people can access support while they are on the waiting list.
What was in the Cass Review?

The Cass Review, published on 10 April 2024, is a report into gender services for children and young people commissioned by the NHS. It was led by Dr Hilary Cass, the former president of the Royal College of Paediatrics and Child Health.

The review found that child had been let down by a lack of research and evidence on medical interventions in gender care.

It said the care given to children and young people experiencing gender dysphoria "needs to be holistic and personal", adding that this should include screening for neurodevelopmental conditions, such as autism, and a mental health assessment.

The report also said the rationale for puberty suppressing hormones or puberty blockers remains unclear, saying there was "weak evidence" on their impact on gender dysphoria.

The Cass Review recommended a "follow-through service" for 17 to 25-year-olds rather than being transferred straight into adult services, and a "full programme of research" for every young person who presents to NHS gender services.

https://uk.news.yahoo.com/transgender-children-tested-autism-nhs-trans-110342401.html