Scotland pauses prescriptions of puberty blockers for transgender minors

Scotland’s sole clinic for treating transgender youths announced Thursday that it is pausing new prescriptions of puberty blockers for minors.

Sandyford, a health clinic in Glasgow operated by Scotland’s National Health Service, said in a statement that it is indefinitely pausing new prescriptions of the medication for people under 18 who are experiencing “gender incongruence.” Patients who are already undergoing treatment will not be affected. 

“We are committed to providing the best possible clinical care for young people accessing and understand the distress that gender incongruence can cause,” the 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.”

The announcement comes less than two weeks after a report commissioned by England’s National Health Service concluded that the medical evidence around transition-related care for minors is “remarkably weak” and that more research is needed. The report, known as the Cass Review, was funded by the NHS and independently led by prominent British pediatrician Dr. Hilary Cass.

In March, prior to the release of the full report, England’s NHS said it would stop new prescriptions of puberty blockers. 

Public health officials in Scotland cited the Cass Review for their reasoning, saying it would be working with England’s NHS to “generate evidence of safety and long-term impact for therapies.”

“The Cass Review is a significant piece of work into how the NHS can better support children and young people who present with gender dysphoria,” Tracey Gillies, executive medical director at NHS Lothian, one of the 14 regional divisions of NHS Scotland, said in a statement. “Patient safety must always be our priority and it is right that we pause this treatment to allow more research to be carried out.”

Scottish Trans, a division of Scotland’s Equality Network that focuses on trans rights, said that Scottish health officials were making the “wrong decision, and that it will harm trans children and young people.”

“This decision has been taken within the context where the reality of trans people’s experiences and lives is questioned almost daily in some of the media and some political circles,” the group said in a statement. “This makes us worry that the decision has been influenced by that context rather than solely through consideration of the best interests of trans children and young people.”

Puberty blockers — which have been used for decades to delay puberty in children who were developing too quickly — are now typically prescribed to prevent the onset of puberty for youths questioning their gender identities. The drugs also give youths greater time to decide whether to pursue more permanent treatments like hormone replacement therapy and transition-related surgeries.

Nearly all of the major medical associations in the United States have come out in favor of transition-related care, including puberty blockers, for the physical and mental well-being of transgender minors. 

Twenty-three U.S. states have enacted bans on gender-affirming care, including the prescription of puberty blockers, according to the Movement Advancement Project, a think tank that tracks policies affecting LGBTQ Americans. Health care providers in five states — Florida, Alabama, Oklahoma, North Dakota and Idaho — could be charged with a felony for providing gender-affirming care to trans minors, according to MAP.