Scottish Government accepts findings of Cass Report on gender identity healthcare in Scotland

Key Points

Gender services for children and young people in Scotland will be delivered by paediatricians
Cass Review made recommendations on provision of transgender healthcare for under-18s
Multidisciplinary clinical team considered report’s recommendations in the context of Scottish services
Public health minister Jenni Minto says work under way to implement recommendations
Puberty blockers were paused for new patients in Scotland following a major review earlier this year
NHSGGC will now only accept gender service referrals from clinicians

The Scottish Government has accepted all the findings of a report on gender identity healthcare for young people in Scotland.

Published by Dr Hilary Cass, the Cass Review made a series of recommendations about what should change in the provision of transgender healthcare for under-18s.

Scottish Government officials had met Dr Cass several times over the course of her review “to share information” about improving care in Scotland.

Following the publication of the Cass Review commissioned by NHS England, the Scotland’s chief medical officer established a multidisciplinary clinical team to consider the report’s recommendations in the context of Scottish services.

On Tuesday, public health minister Jenni Minto confirmed that the Scottish Government has accepted all the findings of the Cass Review: Implications for Scotland report, published in July, and that work is under way to implement its recommendations.

These include:

gender identity healthcare services for children and young people being provided in paediatric clinical settings – moving it from the Sandyford Clinic in Glasgow
the provision of these services via a distributed network, or regional model, rather than on one site
an end to self-referral, with young people being referred to specialist services by a clinician, in common with other specialities.

Last month, NHS Greater Glasgow and Clyde announced that as of Tuesday, referrals to its gender services will only be accepted from a clinician.

The NHS board said the move brings gender services in line with other clinical specialties – while already require referral by a clinician.

There are currently four NHS Gender Identity Clinics (GICs); at Glasgow Sandyford, Edinburgh Chalmers, Aberdeen Cornhill and Inverness Raigmore.

Self-referral change follows puberty blocker pause

It comes after prescription of puberty blockers was paused for new patients in Scotland following a major review into gender care in April this year.

The review found the medicine was “built on shaky foundations” and children had been let down by a “toxic” public discourse.

In a statement, Minto outlined work which is under way to implement the report’s recommendations, including the publication of a new National Standards for Gender identity healthcare: Adults and young people by Healthcare Improvement Scotland.

Minto also highlighted the publication of a progress report on work to improve these services.

The new standards are part of a suite of documents published today that also includes NHS Education for Scotland’s Transgender Care Knowledge and Skills Framework and an updated Gender Identity Healthcare Protocol for adult services.

Minto said: “The chief medical officer’s report underlines the need for development of these services with children, young people, and their families. I am determined the young people using these services, and their families, are our priority and will be at the heart of all our discussions about how this care is provided.

“There is now a breadth of work underway to take forward the recommendations of the CMO’s report which illustrates our commitment to deliver improved gender identity healthcare for young people.

“In addition, the suite of documents relating to gender identity healthcare provision published today, which were developed following extensive public consultation and targeted consultation with people with lived experience, will support clinicians and a wide range of professional bodies and help drive improvement in services.”