NHS England has committed to reevaluating the use of cross-sex hormones for individuals over the age of 16 in response to concerns about the potential health risks associated with these drugs. This decision comes after the health service already prohibited the prescription of puberty blockers for those under 16, except in the context of medical trials. Despite this, cross-sex hormones are still being prescribed to individuals between the ages of 16 and 25, as well as to older adults.
The use of cross-sex hormones has been linked to various health issues, including infertility, irreversible physical changes, and long-term consequences for individuals who may later regret their decision to present as the opposite gender. For men transitioning to women, the testosterone-suppressing drugs used can have adverse effects on brain function and increase the risk of blood clots, cardiovascular disease, and certain tumors. Similarly, women transitioning to men may experience side effects such as high blood pressure, weight gain, and an increased risk of osteoporosis and type 2 diabetes.
Ritchie Herron, who underwent gender transition treatments in his mid-20s, expressed concerns about the long-term impact of cross-sex hormones, particularly on autoimmune function, cognitive decline, and the risk of developing Alzheimer’s disease. He emphasized the need for more research on the safety and efficacy of these treatments, pointing out that individuals who begin hormone therapy later in life may face different health outcomes compared to those who start at a younger age.
The review conducted by Dr. Hilary Cass highlighted significant failings in the care of young people seeking gender-affirming treatments, emphasizing the importance of appropriate psychosocial therapy over rushed medical interventions. In response to these concerns, NHS England has announced plans to conduct a comprehensive review of its gender services, including the use of “gender affirming hormones,” through a process of updated evidence review and public consultation. The health service also established a national multi-disciplinary team to oversee recommendations for cross-sex hormone interventions in new gender clinics set up to replace the Tavistock clinic in London.
Overall, the decision to reevaluate the prescription of cross-sex hormones reflects a growing awareness of the potential risks associated with these treatments and the need for more cautious and evidence-based approaches to gender-affirming care. Cass and her team have been a key focus of NHS England’s recent efforts to understand the transition from children’s to adult gender dysphoria services. In a letter to adult clinics, the NHS announced a systemic review to assess the outcomes of individuals who received puberty blockers and cross-sex hormones as children.
The NHS has called for a “pause” on prescribing cross-sex hormones to individuals under 18, although compliance with this request is not mandatory. Additionally, the NHS expects full cooperation from gender dysphoria clinics in a data linkage study, with separate correspondence sent to them regarding this matter.
During a House of Commons debate, Health Secretary Victoria Atkins expressed determination to address loopholes that allow private and online clinics to continue prescribing puberty blockers and cross-sex hormones to paying children. She emphasized that all options are being considered to regulate these providers and prevent them from circumventing existing laws.
Atkins echoed concerns raised by Dr. Cass about clinicians using private providers to bypass regulations, warning that clinics prescribing hormones to children under 16 could face severe penalties. The Department of Health and Social Care has requested the Care Quality Commission to reassess age thresholds in licensing conditions.
Atkins criticized gender clinics for initially refusing to cooperate with Dr. Cass, labeling it a dereliction of duty. However, she noted that they have since agreed to participate in the review of adult services, which will now include outcomes for thousands of young people transitioning from the Tavistock Gender Identity Development Service to NHS adult clinics. Please rewrite this sentence.
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