Scottish Health Officials Admit Prescribing Puberty Blockers Without Full Risk Assessment

Scottish health officials have acknowledged prescribing puberty blockers to children without a comprehensive understanding of the associated risks. This admission comes in the wake of the Cass Review, which highlighted a lack of reliable evidence regarding the safety and effectiveness of these drugs for treating gender issues.

Tracy Gillies, medical director at NHS Lothian, expressed difficulty in justifying the prescription of puberty suppressants for gender-related concerns. Between 2012 and December 2023, approximately 90 to 100 children in Scotland, some as young as nine, received puberty blockers or cross-sex hormones. The use of these drugs for new patients was halted in April 2024.

Rhoda MacLeod, head of adult services at the Sandyford Clinic in Glasgow, home to Scotland's only gender identity service for children, concurred with the uncertainty surrounding these treatments. She stated, "We have reports of people saying this [puberty blockers] is beneficial, but systematically, we don't know what the benefits are and what truly the risks are."

Both clinical leaders endorsed the findings of the landmark Cass Review, published in April 2024, which led to the suspension of puberty blocker prescriptions on both sides of the border. MacLeod attributed the current situation to a rapid increase in patient referrals for gender issues in recent years.

An ongoing review of child patients on Scottish waiting lists for gender services, which have grown to over 1,000, revealed that 70% were biological girls. Half of these patients had a neurodevelopmental condition such as autism, and around a third had a diagnosed mental health disorder. MacLeod emphasized the need for a comprehensive, multidisciplinary approach to address the complex needs of these young people.

Gillies highlighted the challenges in developing a service that thoroughly examines the reasons behind a young person's gender distress while also managing long waiting lists. She noted that suppressing puberty using unlicensed drugs for gender issues likely has physiological consequences, some known and others yet to be evidenced.

Ruth Maguire, an SNP MSP, criticized the lack of curiosity about the high proportion of neurodiverse girls being referred to gender clinics. She emphasized the importance of never again administering drugs with life-changing impacts to children without fully understanding their benefits and risks.

"I want to be really clear that we never get to a situation again when we are giving children and young people drugs where we don't know the benefits or risks of them, and they have life-changing impacts."

This situation underscores the ongoing debate surrounding the use of puberty blockers in transgender youth and the need for more comprehensive research into their long-term effects. As the medical community grapples with these complex issues, the focus remains on providing appropriate care while prioritizing patient safety and well-being.