Scotland Pauses Prescribing Puberty Blockers to Under-18s

Scotland’s only gender clinic for young people has paused prescribing puberty blockers for new patients under 18 years old after the National Health Service (NHS) in England banned children from receiving the gender treatment last month.

Puberty blockers are used to delay puberty changes by stopping the body from making sex hormones including testosterone and estrogen. They can be prescribed to treat gender dysphoria, the clinical term for psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity.

The Sandyford Clinic, based in Glasgow, announced that new patients aged 16 and 17 “will no longer be prescribed gender affirming hormone treatment until they are 18 years old,” the clinic wrote in an update on its website. Existing patients currently receiving treatment will not be affected.

NHS Greater Glasgow and Clyde (NHSGGC), the national health branch that oversees the clinic, said in a statement Thursday that it had contacted patients this week to advise that the prescription of puberty hormone suppressants and gender affirming hormones to young people was paused following research findings of NHS England that were published in March.

The independent report made for NHS England, which was led by Dr. Hilary Cass, a consultant pediatrician and former President of the Royal College of Paediatrics and Child Health, said that there was insufficient long-term evidence of what happens to youth who are prescribed puberty blockers. As a result, the NHS banned children in England from receiving puberty blockers, only providing the prescription to youth taking part in clinical research trials.

NHSGGC and NHS Lothian, another area in Scotland, said that “on clinical advice,” they had deferred starting new patients on these treatments in mid-March in response to the position taken by NHS England and while waiting for the publication of the Cass Review. After the review was published and with the support of the Chief Medical Officer for Scotland, Sir Gregor Smith, the health boards formally paused treatment.

Existing patients “will continue on treatment with close monitoring and support, as they wish to and as guided by individual clinical assessments within each service,” the local health agencies confirmed.

Dr. Emilia Crighton, NHSGGC Director of Public Health, said in a statement that the Cass Review findings are important, and the next step is to “work with the Scottish Government and academic partners to generate evidence that enables us to deliver safe care for our patients.” 

“We echo the views of Dr. Hilary Cass that toxicity around public debate is impacting the lives of young people seeking the care of our service and does not serve the teams working hard to care and support them,” Crighton said. 

Both the health agencies and the Sandyford Clinic said in statements that they were committed to supporting young people seeking gender treatment. 

“We are committed to providing the best possible clinical care for young people accessing and understanding the distress that gender incongruence can cause,” the Sandyford Clinic said. “While this pause is in place, we will continue to give anyone who is referred into the Young People Gender Service the psychological support that they require while we review the pathways in line with the findings.” 

TIME has reached out to NHSGGC and the Sandyford Clinic for comment and further information.