What’s happening with children’s gender care in Scotland?

NHS Scotland is reviewing gender services for both adults and children. New protocols for adults have been delayed but are expected to be published before the summer.

For children, the government says it is developing a separate pathway.

Dr Cass’s report only looked at NHS England, but in December, she gave a presentation to the Scottish government’s National Gender Identity Healthcare Reference Group, which is overseeing this work.

Factors affecting Scotland include the similar challenge experienced in England, of recruiting from a limited number of skilled and expert staff to specialist services, and the impact of this on an already stretched NHS.

The group is also considering the structure of clinical services both locally and nationally, as well as potential collaboration between the Scottish government and NHS England on its puberty hormone suppression study in children and young people.

The government’s National Services Division is continuing work formally to commission a young people’s gender identity service for Scotland, including consideration of ongoing support “embedded” at local and regional level, alongside pathways for referral to an expert national service.

Dr Cass says in England and Wales there has been what she calls ‘diagnostic overshadowing’ with too many children being referred straight to national gender services, when they may get quicker and better help elsewhere.

It’s just one of the 32 recommendations that Scottish policy-makers will take into account.

In response to the Cass report, a Scottish government spokesperson it had closely monitored Dr Cass’s review and had met her on a number of occasions to share information about improvement work in Scotland.

“While the Cass Review extends only to services provided by NHS England, we will now take the time to consider the findings of the final report in the context of how such healthcare can be best delivered here in Scotland,” they said.