Achi news desk-
He added: “This may have been naive, but one of the things I was surprised by when carrying out this review is how much homophobia still exists as well as transphobia, so we have to support people to able to express and understand. their sexuality as well as their gender identity.”
Dr Cass, whose 388-page report published in April concluded that the evidence for prescribing puberty blockers and hormone treatments for sexually distressed under-18s was “extremely weak”, said it was not clear how many patients have gone on to de-bridge. in adulthood because of the lack of long-term follow-up studies and because individuals who regret “don’t necessarily come back to the NHS”.
He said: “That’s a significant problem, but I think it’s more subtle than that because for example, I spoke to a young adult who started transitioning very early – male to female.
“She’s doing well, she had puberty blockers at the earliest, she had female hormones at the earliest and she passes very well as a woman, but looking back she knows her that she is a boy with intense internal homophobia and is gay.
“But at this point in her life it’s clear she’s not going to de-transition.”
When the first NHS gender identity service was set up at London’s Tavistock clinic in 1989, it saw fewer than 10 children a year – mostly males registered for birth who identified as female.
Between 2018 and 2022, it received thousands of referrals a year for under-18s, 73 per cent of which were women registered for birth.
The Sandyford clinic in Glasgow – the only NHS gender identity service for children and young people in Scotland – has experienced a similar change and surge in demand, with more than 1000 under-18s waiting for their first appointment with waiting times of over four years and the majority of demand comes from those trying to transition between women and men.
Dr Cass told MSPs that the changing profile of this cohort makes it even more difficult to draw conclusions based on the current evidence about the long-term outcomes of adolescent inhibitors.
He added that this group of young patients must also be considered “within the wider context of what is happening to adolescents in Gen Z” – those born between the mid-1990s and the early 2010s.
Dr Cass said: “We know there are very high rates of depression and anxiety, there’s stress that previous generations didn’t grow up with in terms of social media and expectations on young people that come from that early exposure to pornography.
“We don’t know what any of these do to how you might present yourself [gender] misery Certainly for some young people, that distress or feeling that you don’t fit in with expected gender norms can come to the fore by questioning your gender identity.
“That’s why we have to take this as a new cohort and not rely on previous research, and work with young people to help them unselect all those things that could have led to that gender distress. ”
The Sandyford clinic has stopped prescribing puberty blockers and cross-sex hormones to any new patients under the age of 18 following the publication of the Cass Review, but the restriction only applies to the NHS.
Dr Cass told MSPs she had “very deep concerns” about private providers continuing to provide off-label drugs, and said self-medication by young people was “happening a lot more than we would like”.
More to follow
