Proposed Changes to England’s Gender Services for Young People

NHS England is holding a public consultation on the ‘Interim service specification for specialist gender dysphoria services for children and young people’, which closes on December 4.

We encourage you to complete the consultation

Read the guidance below, and complete it before Sunday 4th December.

This interim specification will be, following this consultation, in place until the Cass Review concludes. Here are some of the issues with the proposition:

  1. The proposed changes would make it harder for children and young people exploring social transition (such as changing name or pronouns) unless diagnosed with ‘clinically significant distress’ (i.e a clear move to medicalisation).
  1. It would also discourage and demonise private clinics as a pathway, potentially leading to longer wait lists in practice.
  1. Access to puberty blockers, which in practice prevent unwanted and harmful stages of physical development, would be restricted to those willing to be researched into adulthood, which in practice would also lead to more requirements for top and bottom surgeries for gender affirmation, which not all trans people may want as transition is different for everyone. This additionally ignores that puberty blockers are not an experimental treatment in the eyes of international best practice; where they have been used for those with Gender Dysphoria since the 1990s.
  1. The proposals fall far short of Self ID, which is in line with international best practice. In fact they make Self ID harder for trans and non-binary people (particularly those who are neurodivergent), especially as the binary model for transition remains and does not allow for non-binary gender affirming healthcare. As well, while capacity issues may be somewhat alleviated by the existence of two new regional Gender Identity Clinics, the proposed and existing barriers to access that help mean that those who would benefit are to be denied that help. This all runs counter to international best practice, where Self ID and gender affirmation is rightly pursued.
  1. While the proposal acknowledges issues surrounding discrimination, it does not actually provide many solutions, and the proposals themselves would mean those with unsupportive families or accommodate away from home would be left with limited referral options. As well, no provisions have been made to overcome the intersectional challenges Trans People of Colour face at all.
  1. It is also of note that unlike the previous specification, this specification only cites one much criticised study, while ignoring studies and international best practice.

Overall, these proposals as they stand would significantly benefit misinformed narratives and scaremongering about trans people. The changes proposed feed the idea that transition healthcare is something to be avoided as it is dangerous and risky to pursue rather than a positive part of alleviating the dysphoria that trans people can face.

In all, these proposals would be a step backwards in improving, let alone reforming, our broken transition healthcare system and how as a society we treat those who are trans.

As such, we urge our members and supporters, especially those who are trans, non-binary and service users or patients, to contribute to the consultation and to make their voices heard. You can find the consultation here.

As well, there is additional guidance online for completing the survey.

1. We urge you to read this thorough guidance here, which has been co-produced by Stonewall, Mermaids, Gendered Intelligence and Trans Learning Partnership.

It takes you through each question of the consultation.

2. Mermaids has summarised the proposed changes which you can find here.

For those unaware, Mermaids is a charity that specialises in supporting trans children and young people and their families.

3. Finally, Gendered Intelligence has some answers to FAQs which you can find here.