The Cass Review, commissioned by England’s National Health Service, found that the medical evidence supporting gender care for adolescents is weak, and there is little clarity on long-term outcomes. Gender care can include a range of treatments from counselling to puberty-blocking drugs for young people experiencing gender dysphoria. The report emphasizes that while better care is needed for these individuals, there is a lack of solid evidence on how to provide it effectively.

In response to the increasing demand for gender care among young people, the NHS has announced that puberty-blocking drugs will only be available as part of clinical trials in the future. This decision was influenced by the interim recommendations of the Cass Review in 2022. The implementation of these trials and wider access to gender care have been hindered by delays, resulting in thousands of young people remaining on lengthy waiting lists for services.

Prime Minister Rishi Sunak has expressed appreciation for the care and compassion of the Cass Review, highlighting the need for caution when it comes to medical treatments and social transitioning for young individuals. The review advises against administering masculinizing or feminizing hormones before the age of 18 due to the uncertainty surrounding long-term impacts. However, on social transitioning such as changing names and pronouns, the review notes a lack of evidence on its effects and emphasizes the importance of consulting professionals for pre-pubertal children and allowing exploration for adolescents.

As part of efforts to improve gender care services, the NHS has established two new service providers in London and northwest England to replace the previous provider. The aim is to broaden the range of professionals involved in gender care and expand access to these services. Despite these changes, the backlog of cases and delays in service implementation have left several thousand young people in a state of limbo on waiting lists. The agency is working to address these challenges and ensure that young individuals in need of gender care receive timely and appropriate support.

Overall, the Cass Review calls for extreme caution in providing gender care for adolescents, particularly in the administration of medical treatments and social transitioning. The report emphasizes the need for better evidence to guide these interventions and stresses the importance of individualized and thoughtful care for young people experiencing gender dysphoria. The recommendations of the review underscore the complexity of gender care for adolescents and highlight the ongoing challenges and uncertainties in this field.

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