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Wings Over Scotland | To Ministers of the Scottish Authorities

To: Humza Yousaf (Cupboard Secretary for Well being and Social Care), Shirley-Anne Somerville (Cupboard Secretary for Training and Abilities) and Clare Haughey (Minister for Youngsters and Younger Individuals)

28 April 2022

Pricey Mr Yousaf, Ms Somerville and Ms Haughey,

Cass Interim Report: Unbiased assessment of gender id companies for kids and younger folks – Implications for Scotland

As you may be conscious, the Westminster Well being Secretary has introduced an pressing inquiry into gender hormone therapy for susceptible kids, stating that the system is “failing kids”(1). Mr Javid was significantly alarmed on the pressures on employees to undertake an unquestioning affirmative strategy to transitioning and is planning an overhaul of how well being service employees cope with under-18s who current with gender misery.

We welcome this intervention because the accountable plan of action following a collection of authorized actions by whistleblowers (2) and a NICE report (3) highlighting critical considerations with the low high quality of proof for each GnRH agonists (puberty blockers) and cross-sex hormones. The not too long ago printed interim report (4) by Dr Hilary Cass, who was commissioned by NHS England to research baby gender companies, was damning, discovering the Tavistock kids’s clinic not a secure or viable long-term possibility for kids.

The politicising of a childhood situation and therapy based mostly on ideology fairly than details and proof has led to quite a few kids being harmed irreversibly by the medical occupation.

It will be silly to assume this example is confined to England. Many nations, together with Scotland, comply with the identical therapy protocol for gender-distressed kids, though after current critiques some, together with Sweden (5), Finland (6) and France (7), have now severely restricted use of medical therapies in desire for psychotherapy.

The Care High quality Fee deemed Tavistock, the London gender clinic for kids, “insufficient” and critcised it for poor report protecting (8), however at the least it held data on the ratio of male to feminine sufferers, the quantity and age of these prescribed puberty blockers, and famous the disproportionately excessive charges of sufferers with autistic traits.

The counterpart clinic Sandyford in Glasgow may give no such data (9), the truth is it’s unable to  even confirm whether it is following the sample of a reversal in primarily male sufferers to a 75% feminine one, for the easy cause that it permits kids to decide on, or omit, the intercourse recorded on their medical information. (10)

NHS Scotland additionally needed to appropriate a Freedom of Data launch and finally disclose that 51 women had been referred for elective double mastectomies. (11) Each clinics have didn’t conduct longitudinal research or present take care of detransitioners who had been mis-diagnosed, lots of whom will attest to being fast-tracked into hormone therapy and surgical procedure when good psychological well being care was extra applicable to deal with underlying points.

Our current Freedom of Data response reveals a quickly rising and disproportionate variety of gender-distressed kids in Scotland – the referral charges have grown fifteen-fold in six years (12) and 1,254 kids are both receiving therapy or are awaiting a primary appointment (13) – virtually twice the anticipated quantity given the relative inhabitants dimension with England, which has a comparable determine of seven,100. (14)

A disaster level has certainly been reached when involved GPs, unable to get solutions to easy questions from their well being board or NHS Scotland, really feel they’ve to put in writing to a nationwide newspaper outlining their worries that referring kids to a gender clinic will truly hurt, fairly than assist them (15). The political local weather in Scotland is such that docs who comply with greatest therapeutic proof fairly than affirmation of a trans id and medical therapy threat litigation for “transphobia”.

In January 2021 the then Cupboard Secretary for Well being stated “We don’t look to duplicate the work of the [Cass] assessment in Scotland and can intently take into account the findings of the assessment after they develop into obtainable” (16). Having chosen to not undertake the mandatory and basic work to analyse the proof and decide one of the best therapies, it’s wholly incumbent on the Scottish Authorities to take heed of the outcomes and recommendation of those that have.

Nonetheless, the Authorities has as an alternative cast forward with a £2 million allocation of funds this yr, primarily geared toward addressing ready occasions (17) and an replace to the Gender Reassignment Protocol (GRP) can be underway (18).

In our view, each these initiatives should be halted and reassessed in mild of the interim Cass report. The GRP replace is seeking to comply with the brand new WPATH tips (19) which aren’t based mostly on proof, comply with an affirmation-only mannequin and now additionally appear to include eunuch as a gender id (20) – one thing we hope the Scottish Authorities doesn’t want to introduce into our faculties.

There’s little level reducing ready lists to permit faster entry to a service which has been discovered to be clinically flawed and dangerous to kids. It will be irresponsible and negligent of the Scottish Authorities to proceed down this path. Dr Cass concludes that “A basically totally different service mannequin is required which is extra in keeping with different paediatric provision”.

After all, the pathway for kids confused about gender is ready lengthy earlier than they attain Sandyford’s door, in a big half as a result of Scottish Authorities’s irresponsible insurance policies in faculties which advocate affirmation-only (21).

Political lobbying teams akin to LGBT Youth are introducing materials telling younger kids they’ll change intercourse, and that is strengthened by academics who’ve obtained coaching from the identical teams – none of which have medical or instructional experience.

Pupils who’re confused about gender are receiving the message that there’s something unsuitable with their physique that must be fastened and academics are unquestioningly “socially transitioning” pupils, usually altering names and pronouns behind their mother and father backs. As Dr Cass states, these usually are not impartial interventions, and are being carried out with out medical oversight and are extremely damaging to our younger folks.

It’s crucial that political impartiality must be reinstated in faculties and lobbying teams not permitted to proceed introducing unscientific beliefs to kids, particularly organisations which have already been discovered by Scottish Ministers to have launched college steering which was “not authorized” (22).

It will be useful if the Authorities would difficulty a message just like that by the Division of Training which states dangerous stereotypes shouldn’t be strengthened and no inferences must be drawn a couple of gender id from a baby’s persona or desire for sure garments or actions, and nor ought to faculties work with exterior teams that produce such materials (23).

We hope you agree that there’s ample proof within the interim report that’s alarming and desires fast consideration, and recognize the implications for the upcoming plans to legislate for banning conversion remedy and to make Gender Recognition Certificates (GRC) obtainable for under-18s.

The joint submission from Stonewall and others (24) is of the opinion that remedy for gender-distressed kids must be focussed on understanding and studying to just accept their said gender id – in any other case it is going to be captured as conversion remedy.

That is opposite to evidenced therapeutic observe and Cass factors out there are numerous causes of a kid’s misery and lots of pathways to quite a lot of outcomes, solely certainly one of which will likely be an grownup trans id. Counsellors and therapists ought to have the ability to totally discover points and assist a baby really feel snug with their physique, with none stress of attainable criminalisation.

Even now considerations have been raised in regards to the chilling impact of the Memorandum of Understanding (25) and the probability of therapeutic outcomes being compromised by early state affirmation by the use of a GRC (26), on what might grow to be a transient trans id.

We might welcome a gathering for additional dialogue and stay up for listening to what steps will likely be applied to urgently deal with the problems raised.

Yours sincerely,

Trina Budge, Marion Calder and Susan Smith
Administrators, For Ladies Scotland

cc: Dr Sandesh Gulhane, Shadow Cupboard Secretary for Well being and Social Care
Oliver Mundell, Shadow Cupboard Secretary for Training and Abilities
Meghan Gallacher, Shadow Minister for Youngsters and Younger Individuals
Jackie Baillie, Shadow Cupboard Secretary for Well being
Michael Marra, Shadow Cupboard Secretary for Well being
Martin Whitfield, Shadow Minister for Youngsters and Younger Individuals
Jane Grant, CEO, Higher Glasgow and Clyde NHS
Gregor Smith, Chief Medical Officer
Bruce Adamson, Youngsters’s and Younger Individuals’s Commissioner, Scotland


    Interim report: PDF
  10. FOI follow-up query:
    and reply:
  12. FOI exhibiting 37 referrals in 2013:
    NGICNS doc exhibiting 559 referrals in 2019 (para12, web page 27):
  13. FOI exhibiting 1,253 at Sandyford:
    plus 1-4 17 yr olds on grownup ready checklist in Inverness:
    Strategic motion framework: PDF
    Supporting Transgender Pupils: PDF
  26. Archived:
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