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NHS gender care taken over by ‘secrecy and ideology’, health secretary claims

Health secretary claims surge in referrals to children’s gender dysphoria was driven by a ‘myth’

Rebecca Thomas,Aine Fox
Monday 15 April 2024 20:03 BST
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Health secretary Victoria Atkins clashes with Nick Robinson over NHS spending

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The health secretary has accused the NHS’s gender care services of being taken over by “secrecy and ideology”, as she vowed a crack down on private gender clinics.

Victoria Atkins claimed in a statement to parliament that a the huge increase in referrals to children’s gender dysphoria services was “driven by a myth” – a week after the Cass review warned children had been failed by the “polarised public debate” around the issue.

She said: “This myth that for children and young people grappling with adolescence, who were questioning their identity, their sexuality, or their path in life, that the answer to their questions was inevitably to change gender to solve their feelings of unease, discomfort, or distress.

“And this near uniform prescription was imposed on children and young people with complex needs, without full and thoughtful consideration of their wider needs – including as is set out in the report, conditions such as neurodiversity, experiences such as childhood trauma, or experiences such as mental health conditions, or indeed discovering who it is, that they may one day fall in love with.”

Her comments come in response to the Cass review, published last week,in which Dr Hilary Cass warned children had been let down by the “polorising” and “divisive” debate around gender dysphoria.

The report found there had been a lack of research and evidence on the use of puberty blockers and hormones, in a debate that it described as having become exceptionally toxic.

Health secretary Victoria Atkins said she would work to close loopholes for private online providers (Jeff Moore/PA)
Health secretary Victoria Atkins said she would work to close loopholes for private online providers (Jeff Moore/PA) (PA Wire)

Dr Cass said in her review last week: “The surrounding noise and increasingly toxic, ideological and polarised public debate has made the work of the review significantly harder and does nothing to serve the children and young people who may already be subject to significant minority stress.”

Ms Atkins also called for shadow health secretary Wes Streeting to apologise for Labour contributing to “the toxicity of the debate” on transgender healthcare. Mr Streeting said last week that his former employer Stonewall had been wrong to argue that “trans women are women, get over it”.

She told the Commons: “In order to move forward and get on with the vital work that Dr Cass recommends we need more people to face up to the truth, no matter how uncomfortable that makes them feel.

“And so I say to (Mr Streeting), I hope he has the humility to understand that the ideology he and his colleagues espoused was part of the problem.

“He talks about the culture and the toxicity of the debate, does he understand the hurt that he caused to people when he told them to ‘just get over it’

“Does he know that when he and his friends on the left spent the last decade crying culture wars when legitimate concerns were raised, an atmosphere of intimidation was created and had the impact on the workforce that he has rightly described, they were scared or worried to go into it?”

Mr Streeting told the Commons: “For the sake of all of those children, young people and now adults, but particularly those being referred into gender identity services today, we have a duty to get this right. What has emerged in the Cass review is a scandal. It is a scandal that children and young people are waiting far too long, often years for care while their wellbeing deteriorates and their childhood slips away.

“It is scandalous that medical interventions have been made on the basis of shaky evidence.”

Dr Hilary Cass has published a long-awaited report into children’s gender services (Yui Mok/PA)
Dr Hilary Cass has published a long-awaited report into children’s gender services (Yui Mok/PA) (PA Wire)

In her statement to the House on Monday, Ms Atkins pledged to work to close any loopholes which could see online providers prescribe hormones to gender-questioning children as she hit out at the “morally and medically reprehensible” practice.

She indicated the government could legislate to ban young people accessing prescriptions to gender-blocking drugs from private clinics and online.

The MP insisted “nothing is off the table” when it comes to ensuring private and online providers cannot “get around the rules”.

In her review, published last week, Dr Hilary Cass said she “understands and shares the concerns about the use of unregulated medications and of providers that are not regulated within the UK”.

The review also stated that GPs had expressed concern about being pressurised to prescribe hormones after they have been first handed out to a patient by a private provider.

In March, NHS England confirmed children will no longer be prescribed puberty blockers at gender identity clinics outside clinical research trials, and following the Cass Review the health service said it had agreed to review the use of masculinising or feminising hormones in the form of testosterone or oestrogen for children from the age of 16.

Speaking in Parliament on Monday, Ms Atkins said she shared a concern “that clinicians who subscribe to gender ideology will try to use private providers to get around the rules”.

Wes Streeting Labour shadow health secretary
Wes Streeting Labour shadow health secretary (BBC)

She warned that any gender clinic prescribing hormone blockers or cross sex hormones to people under 16 “may be committing extremely serious regulatory offences for which they can have their licence revoked and their clinicians can be struck off”.

She told MPs in the Commons: “It is morally and medically reprehensible that some online providers not registered in the UK have stated their intention to continue to issue prescriptions to children in this country and I am looking closely at what can be done to curtail any loopholes in prescribing practices, including legislative options.

“Nothing is off the table and I will update the House in due course as we progress this work at pace”.

The health secretary also confirmed that all seven adult gender clinics – six of which had refused to take part in research alongside the Cass Review – had since agreed to “fully co-operate”.

She told the MPs the initial refusal was “deplorable” and a “dereliction of their professional duty”.

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