Adult gender clinics in England ‘to face Cass-style review’ into trans care
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Adult trans care clinics in England are reportedly set to face a Cass-style review of their own after NHS England announced a review into the care they provide. NHS England is planning to set up a review of the country’s seven specialist gender identity clinics (GICs), starting with “external quality improvement experts” gathering evidence of how the clinics operate and deliver care.
The announcement comes in the wake of the publication of the Cass report on Wednesday (10 April), which made several recommendations on how to restructure trans youth services in the country. NHS England commissioned paediatric specialist Dr Hilary Cass to head the review in 2020, in response to the rising number of referrals to what was England’s only trans youth service, at the Tavistock Centre in north west London. Building on an interim report from 2022, the review recommended a “holistic approach” to trans healthcare for under-25s, which includes decentralised regional hubs that would assess patients for an “individualized care” plan.
In letters sent on Tuesday (9 April), NHS England told the seven trusts that host adult gender dysphoria clinics that there would be a review similar to one conducted by Dr Hilary Cass, The Guardian reported. “It will be external, rather than done in-house,” a source said. “It will be led by someone external. It will be fairly similar to what Cass did with children’s services, but this time it will be looking at adult services.”
The review is reportedly taking place after “concerns” were voiced to the Cass team by “current and former staff working in the adult gender clinics.” Many members of staff were reportedly concerned about “individuals with complex co-presentations and undiagnosed conditions.”
NHS England’s national director for specialized commissioning, John Stewart, and medical director James Palmer, told The Guardian that the plan was to address an “increasing incidence of individuals seeking to ‘detransition’ following previous gender-affirming interventions and the absence of a consistent, defined clinical approach for them. Detransitioning refers to the stopping or reversing of someone’s transition. It can include social or medical transition for a variety of reasons. A 2019 study for the European Professional Association for Transgender Health (EPATH) revealed that of more than 3,300 GIC patients in the UK, just 16 – 0.48 per cent– chose to detransition either socially or medically.
Meanwhile, human rights groups Amnesty International UK and Liberty have claimed that anti-trans groups are already using the findings of the Cass report to attack the transgender community. “This review is being weaponized by people who revel in spreading disinformation and myths about healthcare for young trans people,” a spokesperson told PinkNews. “It is concerning that sections of the media and many politicians continue to spread moral panic with no regard for the possible consequences for trans people and their families.”
In conclusion, the upcoming review of adult trans care clinics in England mirrors the scrutiny faced by youth services following the Cass report. As NHS England aims to ensure quality and consistency in care for all transgender individuals, it is essential to address concerns raised by staff and stakeholders while safeguarding the rights and well-being of the transgender community. The outcome of this review will likely shape future policies and practices in transgender healthcare, emphasizing inclusivity and patient-centered care.
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