United Kingdom National Health Service publication On Thursday, it closed the country’s only youth gender clinic in support of a more decentralized and comprehensive medical network for adolescents seeking hormones and other gender treatments.
The closure followed an external review of the Tavistock Clinic in London, which has served thousands of transgender patients since the 1990s. reviewOngoing, long waiting time, inadequate mental health support, Rapidly increasing number of young people Seeking gender treatment.
The UK’s review of transgender youth services is part of a significant shift in health care practices in some European countries with national health care systems. Some doctors there are concerned not only about the increase in numbers, but also about the lack of data on long-term safety and the consequences of medical migration.
In the United States, adolescent gender care doctors have mixed feelings about European reforms. Many agree that more comprehensive health care for transgender adolescents is terribly needed, but as more research on treatments is, they change that change. I’m worried that it will fuel growing political movements in some states that ban care altogether.
“How do you draw a line to maintain personalized care while maintaining safety standards for all? That’s what we’re trying to solve,” said a plastic surgeon. Dr. Mercy Bowers, the next president of the Transgender World Association of Transgender Health Professionals, said. “It is the people in the field, not the people in Washington or the legislature, who need to make these decisions.”
The NHS said current patients at the Tavistock Clinic can continue to receive care there before moving to two new hubs in London and Manchester Children’s Hospital. The new clinic will expand the country’s gender services while ensuring that children are properly treated for autism, trauma and mental health problems. Experts also conduct clinical research on drugs of gender.
There are “very important unanswered questions” about the use of puberty blockers, said Dr. Hillary Cass, Head of External Review of Gender Identity Services for Youth in the Country. .. letter Headed to NHS England last week.
Adolescent inhibitors, which are largely reversible, aim to spend time on young patients to make important decisions about permanent medical changes. However, Dr. Cass wondered if most adolescents prescribed these medications were given help to reverse the course if they chose to do so.
Tavistock received more than 5,000 referrals in 2021 from just 250 in 2011. The types of patients seeking referrals have also changed over the last decade. When the clinic was opened, it mainly served children assigned to men at birth. Two-thirds of that last year Patience A woman was assigned at birth.
It is unclear why the number of patients has skyrocketed so rapidly and why transgender boys are driving the rise.
British transgender advocates welcomed the change, but emphasized that there are still many questions about how it affects youth care.
“We are optimistic and cautiously optimistic about the news,” said Susie Green, CEO of Mermaid, a transgender and gender-diversified youth advocacy group. “The first appointment has a two-and-a-half-year waiting list. I’ve seen it cause pain for young people.”
But Green, who has a transgender adult daughter, said the group was concerned about whether mental health services would take precedence over health care. She said gender diversity should not be treated as a mental illness.
“We don’t want to put any further barriers to access to medical interventions,” Green said.
In 2020, a former Tavistock patient, Keylabel, joined a highly public proceedings against the clinic.she Claim She later regretted that she took a puberty blocker at the age of 16 “after a series of superficial conversations with a social worker” and had her breasts removed at the age of 20.
The High Court initially ruled that children under the age of 16 were unlikely to be mature enough to agree to such medical interventions. However, the decision was revoked in September last year, and the judge ruled that “the clinician, not the court, decides whether young patients can provide informed consent.”
In 2020 employee Tavistock expressed concern about medical care at the clinic and urged the NHS to ask Dr. Cass, a London pediatrician who is not affiliated with the clinic, for an external review.Her interim report Released In February of this year.
The Swedish National Health Service has decided this year that gender-related care for adolescents should only be provided in exceptional cases where the child is experiencing obvious gender distress known as discomfort. All treated adolescents should be enrolled in clinical trials to collect more data on side effects and long-term outcomes. Finland showed a similar attitude last year.
“Our position cannot see this as just a matter of rights,” Dr. Thomas Linden, director of the National Board of Health, said in a February interview. “We need to make decisions about the safety and accuracy of our patients. We need to be somewhat confident that we are giving the right people the right treatment.”
These European countries have some restrictions on transgender care, but their approach is far more forgiving than that of some conservative US states. A Recent Alabama law Doctors have made it a felony to prescribe puberty suppressants and hormones to minors. In Texas, parents who allow their children to be treated by gender are being investigated for child abuse. both state I am involved in a legal battle with a civil rights organization.
Some American doctors were worried that changing European standards might strengthen the belief that gender treatment is dangerous to young people.
Dr. Angela Gepfard, Medical Director of the Gender Health Program at Minnesota Children’s Hospital, said: More services are needed, they said. “That is our challenge here.”
