England’s National Health Service ends puberty blockers for kids

[MaxPC]

BREAKING: England’s National Health Service ends puberty blockers for kids

Washington, D.C. Newsroom, Mar 12, 2024 / 18:25 pm
Doctors in England can no longer prescribe puberty blockers to children to facilitate a gender transition, according to an announcement from the country’s public health care system, the National Health Service (NHS).
“Puberty blockers … are not available to children and young people for gender incongruence or gender dysphoria because there is not enough evidence of safety and clinical effectiveness,” the NHS England website’s section on “treatment” for gender dysphoria reads after the update.
The drugs block a child’s natural developments during puberty by preventing the production of hormones, such as testosterone and estrogen. For example, they prevent height growth, a girl’s breast development, and a boy’s facial hair growth, among other things.
“Children, young people, and their families are strongly discouraged from getting puberty blockers or gender-affirming hormones from unregulated sources or online providers that are not regulated by U.K. regulatory bodies,” the website’s text reads. 
More than half of the states in the United States still allow doctors to prescribe puberty blockers to children. 
This is a developing story.

[Soloist]

https://www.england.nhs.uk/wp-content/ ... ldren-.pdf

Marked changes in the types of patients being referred which are not well understood
There has been a dramatic change in the case-mix of referrals from predominantly natal males to predominantly natal females presenting with gender incongruence in early teen years. Additionally, a significant number of children are also presenting with neurodiversity and other mental health needs and risky behaviours which requires careful consideration and needs to be better understood.

The new interim service specification proposed greater clarity on the clinical approach to social transition. It stated that the clinical approach to pre-pubertal children will reflect evidence that in most cases gender incongruence does not persist into adolescence; and that for adolescents the provision of approaches for social transition should only be considered where the approach is necessary for the alleviation of, or prevention of, clinically significant distress or significant impairment in social functioning and the young person is able to fully comprehend the implications of affirming a social transition.
The majority of respondents (67%) did not agree that the draft interim service specification provided sufficient clarity about approaches towards social transition and / or disagreed with the proposed position. Various issues were raised including the reference to the previous version of WPTAH’s standards of care which were updated shortly before the consultation launch, the need for a definition of social transition and describing exactly what the role of the NHS service should be in decision-making around social transition.

Several respondents suggested that NHS England had relied on out-of-date evidence to form the conclusion that in most cases gender incongruence or gender variance that presents in pre-pubertal children does not persist in adolescence. At the time of drafting the interim service specification, this conclusion was shared by various bodies in their
published guidelines, including the Endocrine Society’s Clinical Practice Guidelines and the World Professional Association for Transgender Health (WPATH) standards of care (Version 7) which said that “in most children, gender dysphoria will disappear before or early in puberty”. NHS England’s position was therefore consistent at the time with various professional societies. Since the interim service specification was drafted, some bodies including WPATH have refined their position on this issue. The WPATH standards of care were updated to version 8 in September 2022. While WPATH agrees that gender incongruence will be transient and will not persist into adolescence for some children, it no longer quantifies whether this will occur in the majority or minority of such children.

The Oversight Board has now given the green light for the development of a study into the impact of puberty suppressing hormones (‘puberty blockers’) on gender dysphoria in children and young people with early-onset gender dysphoria. The study will be taken
forward through the National Research Collaboration Programme in place between NHS England and NIHR, with the study team engaging with stakeholders on the study design. Subject to the usual ethical and scientific approvals, we anticipate recruitment to the study will open in 2024.

Basically, “we don’t understand why more girls are having dysphoria then boys now”
“we lack research as to if this is a phase of childhood or actual need for intervention”
They plan research going forward.

Basically it’s not as bad as the Trans community thinks nor is it as good as the right might think.
The system was overwhelmed and needs to be revamped, they need research supporting intervention in the overwhelming increase in females desiring transition.

This isn’t a rejection of gender intervention in children.

[Judas Maccabeus]

https://www.england.nhs.uk/wp-content/ ... ldren-.pdf

Marked changes in the types of patients being referred which are not well understood
There has been a dramatic change in the case-mix of referrals from predominantly natal males to predominantly natal females presenting with gender incongruence in early teen years. Additionally, a significant number of children are also presenting with neurodiversity and other mental health needs and risky behaviours which requires careful consideration and needs to be better understood.

The new interim service specification proposed greater clarity on the clinical approach to social transition. It stated that the clinical approach to pre-pubertal children will reflect evidence that in most cases gender incongruence does not persist into adolescence; and that for adolescents the provision of approaches for social transition should only be considered where the approach is necessary for the alleviation of, or prevention of, clinically significant distress or significant impairment in social functioning and the young person is able to fully comprehend the implications of affirming a social transition.
The majority of respondents (67%) did not agree that the draft interim service specification provided sufficient clarity about approaches towards social transition and / or disagreed with the proposed position. Various issues were raised including the reference to the previous version of WPTAH’s standards of care which were updated shortly before the consultation launch, the need for a definition of social transition and describing exactly what the role of the NHS service should be in decision-making around social transition.

Several respondents suggested that NHS England had relied on out-of-date evidence to form the conclusion that in most cases gender incongruence or gender variance that presents in pre-pubertal children does not persist in adolescence. At the time of drafting the interim service specification, this conclusion was shared by various bodies in their
published guidelines, including the Endocrine Society’s Clinical Practice Guidelines and the World Professional Association for Transgender Health (WPATH) standards of care (Version 7) which said that “in most children, gender dysphoria will disappear before or early in puberty”. NHS England’s position was therefore consistent at the time with various professional societies. Since the interim service specification was drafted, some bodies including WPATH have refined their position on this issue. The WPATH standards of care were updated to version 8 in September 2022. While WPATH agrees that gender incongruence will be transient and will not persist into adolescence for some children, it no longer quantifies whether this will occur in the majority or minority of such children.

The Oversight Board has now given the green light for the development of a study into the impact of puberty suppressing hormones (‘puberty blockers’) on gender dysphoria in children and young people with early-onset gender dysphoria. The study will be taken
forward through the National Research Collaboration Programme in place between NHS England and NIHR, with the study team engaging with stakeholders on the study design. Subject to the usual ethical and scientific approvals, we anticipate recruitment to the study will open in 2024.

Basically, “we don’t understand why more girls are having dysphoria then boys now”
“we lack research as to if this is a phase of childhood or actual need for intervention”
They plan research going forward.

Basically it’s not as bad as the Trans community thinks nor is it as good as the right might think.
The system was overwhelmed and needs to be revamped, they need research supporting intervention in the overwhelming increase in females desiring transition.

This isn’t a rejection of gender intervention in children.

No, but it will largely limit their use to a controlled study. My hope is that the study will be well run, free of bias, and will show that the dangers of this far outweigh the benefits. In addition it is extraordinarily expensive, unless the benefit clearly outweighs the cost, it won’t be paid for by the NHS.

[Soloist]

No, but it will largely limit their use to a controlled study. My hope is that the study will be well run, free of bias, and will show that the dangers of this far outweigh the benefits. In addition it is extraordinarily expensive, unless the benefit clearly outweighs the cost, it won’t be paid for by the NHS.

One can hope but I’m skeptical. I don’t know the political system or the state of things over there. From my friend there in Wales, it’s very similar to here.

[Judas Maccabeus]

No, but it will largely limit their use to a controlled study. My hope is that the study will be well run, free of bias, and will show that the dangers of this far outweigh the benefits. In addition it is extraordinarily expensive, unless the benefit clearly outweighs the cost, it won’t be paid for by the NHS.

One can hope but I’m skeptical. I don’t know the political system or the state of things over there. From my friend there in Wales, it’s very similar to here.

Politically, yes, but the NHS is largely driven by financial considerations, and their bean counters will have a seat at the table too.