HSE to consider UK’s Cass Review on gender as part of healthcare update ‘informed by best evidence’

The HSE will review a new landmark report on gender healthcare for children in the UK as part of the development of an updated clinical programme for gender healthcare services in Ireland, it has said.

The Cass Review, published on Wednesday by Dr Hilary Cass, found that thousands of vulnerable children questioning their gender identity had been let down by the NHS providing unproven treatments and by the “toxicity” of the trans debate.

The HSE said in a statement on Wednesday that the development of an updated clinical model of care for gender healthcare services will be “informed by the best evidence on clinical care for individuals who express gender incongruence or dysphoria”.

The executive said that “emerging and evolving international evidence”, including Dr Cass’s report, will be “reviewed” as part of this work.

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While the updated model of care is being developed, individuals expressing “gender incongruence or dysphoria” will continue to receive care in the community, and under the endocrinology service in the adult and paediatric centres in Ireland East Hospital Group and Children’s Health Ireland, the HSE said.

[ British Labour says it will implement Cass findings on care for trans children if it wins election ]

The HSE said fewer than 10 patients at Children’s Hospital Ireland are receiving puberty blockers.

In her report, Dr Hilary Cass found the UK’s only NHS gender identity development service used puberty blockers and cross-sex hormones, which masculinise or feminise people’s appearances, despite “remarkably weak evidence” that they improve the wellbeing of young people and concerns that they may harm health.

Dr Cass, a leading consultant paediatrician, stressed that the findings in her report were not intended to undermine the validity of trans identities or to challenge people’s right to transition, but rather to improve the care of the fast-growing number of children and young people with gender-related distress.

She said this care was made even more difficult to provide by the polarised public debate and the way in which opposing sides had “pointed to research to justify a position, regardless of the quality of the studies”.

NHS England commissioned the Cass inquiry in 2020 amid rising concerns over care provided by the Tavistock and Portman NHS mental health trust’s gender identity development services (Gids). The services treated about 9,000 children and young people, with an average age at referral of 14, from 2009 to 2020.

The inquiry led to the NHS’s closure of Gids, the banning of puberty blockers and a switch to a new “holistic” model of care in which under-18s experiencing confusion about their gender identity routinely receive psychological support rather than medical intervention.

[ Thousands of children unsure of gender identity ‘let down by NHS’, report finds ]

Belong To, the Irish LGBTQ+ charity, said it will conduct an “analysis” of the Cass Review “to better inform our understanding of care for trans young people”.

“In Ireland, we have an opportunity to learn from the UK’s Cass Review, to learn from international best practice guidelines, and to create a safe model of healthcare for trans young people in Ireland.”

The charity said for trans young people and their families, accessing healthcare is like “knocking on a closed door, as here in Ireland, we currently have no healthcare service at all for young trans people”.

“This needs to be urgently rectified to allow young people and their families access to vital care, supports and information to help them make decisions about what is best for them,” a spokesperson said. – Additional reporting The Guardian

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