The NHS has been accused of ignoring the
Cass review recommendations on transgender care for children.
Dr Hilary Cass’s report advised that under-18s should not be rushed into treatment which they may
later regret following concerns about care at the Tavistock clinic.
However, a new NHS centre has snubbed the
Cass review in favour of discredited transgender guidance that promotes both puberty blockers and surgery without age limits.
The Nottingham Young People’s Gender Service was founded in April to give psychological and social support to children with gender dysphoria who were former
Tavistock patients and are currently taking or waiting to start
puberty blockers.
In a job advertisement for a clinical psychologist position, the centre says it is “essential” to “practice [sic] in a gender affirming manner in line with” guidance from the controversial World Professional Association of Transgender Healthcare (WPATH).
The WPATH guidelines call for removing any
minimum age to transition and lowering the age threshold for puberty blockers and surgery.
Campaigners fear the service is at risk of becoming “Tavistock version 2”.
Helen Joyce, the director of advocacy at human rights charity Sex Matters, said: “Dr Cass warned that [WPATH guidance] promoted childhood social transition without evidence that this was safe or beneficial.
“Earlier this year, leaked materials from WPATH revealed the cavalier attitude of many
gender clinicians towards patient wellbeing and informed consent.
“The point of closing the disgraced
Tavistock clinic in London was to learn from its mistakes and replace it with something better. This job ad is a deeply concerning sign that the Nottingham clinic risks becoming Tavistock v2.”
The NHS said the advert had used “old terminology” and was being amended when contacted by The Telegraph.
Dr Louise Irvine, the co-chairman of the Clinical Advisory Network on Sex and Gender, said: “It is extremely concerning that the Nottingham Young People Gender Service job advertisement indicates that it is continuing to follow the discredited medicalised ‘affirmative’ approach to children and young people with gender dysphoria.
“This flies in the face of the Cass review whose findings were supposedly accepted by NHS England and the government.
“The Cass review appraised WPATH’s latest guidelines and found they were based on very weak evidence. Court documents in the USA reveal that
WPATH actively suppressed research it had commissioned that did not have the outcomes it wanted,” she added.
The job posting, which pays upward of £53,700, went live earlier this week and was raised in the House of Commons by Nick Timothy, a Tory MP. He asked for the Government to confirm that the Cass review would be implemented across the NHS.
Afterwards, he took to X, formerly Twitter, to state that “unfortunately, the Leader of the House [Lucy Powell MP] had failed to back Cass” in her response.
The new clinic – run by the Nottinghamshire Healthcare NHS Foundation Trust – said it will care for children taking puberty blockers
aged 11 to 17.
It is understood that the service will be decommissioned once it has finished treating all former Tavistock patients.
Senior doctors at the centre are or have been members of WPATH, and have been openly critical of Dr Cass’s review, which found a lack of evidence to support prescribing puberty blockers to children and urged
caution in the treatment of all under-25s.
Dr Walter Pierre Bouman, a senior doctor at the Nottingham Centre for Transgender Health and past president at WPATH, described the review as “poorly reasoned”. He added that there was “a fine line between naivety, narcissism and psychopathy”.
Prof Jon Arcelus is another doctor at the centre and was formerly a co-chairman of the committee responsible for developing the controversial WPATH guidance.
The advert for a psychologist to work with gender-questioning children made no mention of the Cass report, despite requiring knowledge of the WPATH guidance.
The guidelines include a chapter dedicated to
eunuchs, which claims that males who identify as eunuchs can have their genitals removed.
The Cass review was highly critical of the WPATH guidance and its widespread use.
The final report said: “WPATH has been highly influential in directing
international practice, although its guidelines were found by the University of York appraisal process to lack developmental rigour.”
It added that “instead of stating that some of its recommendations are based on clinical consensus, WPATH 8 overstates the strength of the evidence in making these recommendations”.
A spokesman from Bayswater Support Group, which advocates for evidence-based care on behalf of 600 families with trans-identifying children, said: “It is alarming to hear that despite Cass and NHS England distancing themselves from WPATH due its lack of credibility, its treatment guidelines are still being referenced as ‘essential’ knowledge for working with children at one of the new centres”.
An NHS spokesman said the service “provides additional mental health support to young people already referred to endocrine services following the closure of the GIDS clinic at Tavistock – and the trust has acknowledged that old terminology was used in the job advertisement and is amending it.
“All the NHS’s new children’s gender services are being established closely in line with recommendations from the Cass Review.”
Ifti Majid, the chief executive of Nottinghamshire Healthcare, said: “The Nottingham Young People’s Gender Service has been developed in line with NHS England’s national specification.
“This psychologist position is for a specialist to work with young people, who have already been referred on to a medical pathway by the GIDS prior to the closure of that service, to deliver psychological assessment and therapies in compliance with the recommendations set out in the Cass Review.”
