(READ) England bans puberty-blockers to most children with gender dysphoria mental illness


England’s National Health Service (NHS) joined other European nations in reversing policies regarding the treatment of children who say they feel like they are the opposite sex. That’s a classified mental illness known as “gender dysphoria.”

Under the new policy, children treated at NHS clinics will not be allowed to be prescribed puberty blockers.

An exception to the ban will be children enrolled in UK government clinical trials.

“Puberty suppressing hormones (PSH) are not available as a routine commissioning treatment option for treatment of children and young people who have gender incongruence/gender dysphoria,” writes the NHS. “We have concluded that there is not enough evidence to support the safety or clinical effectiveness of PSH to make the treatment routinely available at this time.”

Puberty blockers and other lucrative but controversial treatments have become increasingly common in the US for children who wish to change their appearance to look like the opposite sex. Advocates say the treatments help the children attain better mental health. Critics say the treatments can be dangerous and result in harm to the child’s mental and physical health.

Read about England’s new National Health Service policy below or at the link.

https://www.england.nhs.uk/publication/clinical-policy-puberty-suppressing-hormones/

Clinical Policy:

Pubertysuppressinghormones(PSH) for children and young people whohave genderincongruence / gender dysphoria [1927]

Publication date: 12 March 2024

Commissioningposition

Puberty suppressing hormones (PSH) are not available as a routine commissioning treatment option for treatment of children and young people who have gender incongruence / gender dysphoria.

Background

Gender incongruence / dysphoria is a condition where a person experiences discomfort or distress that is caused by a discrepancy between a person’s gender identity (how they see themselves regarding their gender) and that person’s natal sex (and the associated gender role, and/or primary and secondary sex characteristics). 

Diagnostic approaches have been described with reference to the Diagnostic and Statistical Manual of Mental Health Disorders Version 5 published in 2013 (gender dysphoria); and the International Statistical Classification of Diseases and Related Health Problems version 11 effective 2022 (gender incongruence).

The reason why some people experience gender incongruence is not fully understood and it is likely that the development of gender identity is multifactorial and influenced by both biological and social factors. Gender variant behaviours may start between ages 3 and 5 years, the same age at which most typically developing children begin showing gendered behaviours and interests (Fast et al, 2018). Gender atypical behaviour is common among young children and may be part of normal development (Young et al, 2019). Children who meet the criteria for gender incongruence / gender dysphoria may or may not continue to experience the conflict between their physical gender and the one with which they identify into adolescence and adulthood (Ristori et al, 2016).

Gender incongruence / gender dysphoria can become more distressing in adolescence due to the pubertal development of secondary sex characteristics and increasing social divisions between genders. Some studies have found that young people with gender incongruence / gender dysphoria may present to gender identity development services with a range of associated difficulties (e.g. bullying, low mood / depression and self-harm and suicidality).

PSH competitively block puberty hormone receptors to prevent the spontaneous release of two puberty inducing hormones, Follicular Stimulating Hormone (FSH) and Luteinising Hormone (LH) from the pituitary gland. This arrests the progress of puberty, delaying the development of secondary sexual characteristics. In England, the puberty suppressor triptorelin (a synthetic decapeptide analogue of a natural puberty hormone, which has marketing authorisations for the treatment of prostate cancer, endometriosis and central precocious puberty) is one of the puberty suppressing hormones used for this purpose. The use of triptorelin for children and adolescents with gender incongruence is off-label.

In January 2020, a Policy Working Group (PWG) was established by NHS England to undertake a review of the published evidence. As part of this process, the National Institute for Health and Care Excellence (NICE) was commissioned to review the published evidence on Gonadotrophin Releasing Hormone Analogues (GnRHa). Nine observational studies were included in the evidence review (NICE 2020). Overall, there was no statistically significant difference in gender dysphoria, mental health, body image and psychosocial functioning in children and adolescents treated with GnRHa (2020). The quality of evidence for all these outcomes was assessed as very low certainty using modified GRADE. There remains limited short-term and long-term safety data for GnRHa. GnRHa may reduce the expected increase in lumbar or femoral bone density during puberty. A re-run of the search was undertaken by NHS England in April 2023 to capture literature published after the NICE evidence review in 2020. Nine further studies were identified.

Currenttreatments

Treatment of individuals with gender incongruence / gender dysphoria is recommended to be tailored to the specific needs of individual patients and aims to ameliorate the potentially negative impact of gender incongruence on general developmental processes, to support young people and their families in managing the uncertainties inherent in gender identity development and to provide ongoing opportunities for exploration of gender identity (Ristori et al, 2016).

The primary intervention focuses on psychosocial and psychological support; for some individuals, the use of PSH in adolescence to suppress puberty has previously been a treatment option though no NHS clinical commissioning policy has been in place; this may be followed later with gender-affirming hormones of the desired sex (NHS England, 2013). If individuals fulfil additional criteria, they may have various types of gender affirming surgery from the age of 18 years through adult Gender Dysphoria Clinics (NHS England, 2013).

What we have decided

NHS England has carefully considered the evidence review conducted by NICE (2020) and has identified and reviewed any further published evidence available to date.

We have concluded that there is not enough evidence to support the safety or clinical effectiveness of PSH to make the treatment routinely available at this time. 

Links and updates to other policies

NHS England has no other policies relating to the sole use of PSH for the treatment of children and adolescents who have gender incongruence.

This document relates to the specialised service for Children and Young People with Gender Incongruence:

And to the following policy:

  • Clinical commissioning policy for prescribing cross sex hormones

This document will be reviewed when information is received which indicates that the policy requires revision. If a review is needed due to a new evidence base then a new Preliminary Policy Proposal needs to be submitted by contacting [email protected].

Equality statement

Promoting equality and addressing health inequalities are at the heart of NHS England’s values. Throughout the development of the policies and processes cited in this document, we have:

  • Given due regard to the need to eliminate discrimination, harassment and victimisation, to advance equality of opportunity, and to foster good relations between people who share a relevant protected characteristic (as cited under the Equality Act 2010) and those who do not share it; and
  • Given regard to the need to reduce inequalities between patients in access to, and outcomes from healthcare services and to ensure services are provided in an integrated way where this might reduce health inequalities.

Definitions

Gender incongruenceGender incongruence is where a person experiences discomfort or distress because there is a mismatch between their experienced gender as compared with their assigned sex and its associated physical primary and secondary sex characteristics.

Puberty suppressing hormones

Synthetic (man-made) hormones that suppress the hormones naturally produced by the body and in doing so, suppress puberty, with the aim of reducing the level of puberty-related anxiety in an individual with gender incongruence.

GRADE

Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) is a transparent framework for developing and presenting summaries of evidence and provides a systematic approach for making clinical practice recommendations.

References

World Health Organisation (2018) International Classification of Diseases 11. Available from https://icd.who.int/

Fast, A.A. and Olson, K.R. , Gender Development in Transgender Preschool Children. Child Dev, (2018).89: 620-637. doi:10.1111/cdev.1275

Ristori J, Steensma TD. Gender dysphoria in childhood. Int Rev Psychiatry. 2016;28(1):13‐20. doi:10.3109/09540261.2015.1115754 

Young, N., Jean, E., Citro, T. (2019). Acceptance, Understanding and the Moral Imperative of promoting social justice education in the schoolhouse. Delaware. Vernon Press p.40

National Institute for Health and Care Excellence (2020). Evidence Review: Gonadotrophin Releasing Hormone Analogues for Children and Adolescents with Gender Dysphoria. Available from: Nice Evidence Reviews – Cass Review.

Read more at left-leaning, pharmaceutical-funded Medscape below.

https://www.medpagetoday.com/special-reports/features/109186

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2 thoughts on “(READ) England bans puberty-blockers to most children with gender dysphoria mental illness”

  1. Well isn’t it about time the western world wake up! Bravo for the UK.
    I seriously doubt there are enough smart people in USA to see the damage this stupid policy is doing.

  2. 

    Harold Hall,

    Transgenderism and, then, GLUTTONISM
    are societal cancers :

    At every opportunity, ADVERT folks show
    Americans GROSSLY stuffing their mouth
    (( and in TV sit-coms and TV athletic/social
    events—BEHAVIOR once-considered to be
    ill-mannered/
    gauche/
    vulgar/
    NASTY to eat food in front of anyone NOT eating
    WITH you, before those Deep-State / Libertine /
    No-Sensible-Censorship / Sex-is-for-Recreational
    Purposes / Western-Wide GLUTTONS (( all of
    White Western societies were, curiously, badly
    SOCIALLY engineered at the exact SAME time ! ))
    —badly SOCIALLY engineered beginning in the ’60s,
    which GAUCHE InCIVILITY had untethered/released
    our Reptilian/Limbic/Savage brain, via West’s
    entertainment class, which had toppled ancient
    Greece and ancient Rome, by driving an otherwise
    moral citizenry towards ever-“edgy” situations/
    topics/“entertainment”—Socrates had fallen victim
    to that E D G Y-minded influence on educating youth,
    which put him at risk of state-/parental rebellion )).

    So, now, we have “The Persian Version” movie,
    directed by Maryam Keshavarz (( an Iranian-
    “American” production, and recipient of the
    Sundance award )), showing scene after scene
    of actress Layla Mohammadi stuffing various
    types of junk food into her OVER-stuffed mouth,
    as she STRUTS on U.S. streets with a look of far,
    far too much of E-D-G-Y self-satisfaction.

    Really E D G Y / N A S T Y / and G A U C H E !,
    that entire movie, as she learns that using anus/
    rectum can prevent a future ( unwanted ) preg-
    nancy—serious advice coming from her Iranian
    grandma. EDGY !

    An ALWAYS-Hungry Third Worlder might hope to
    seek an OVER-Stuffed, “Seek-a-Better-Life,”
    Glutton-Consumptive-type FOODY experience
    on the streets of an American city.

    Multi-Millions of anti-White INVADERS have
    gotten that message. Blame Hollywood and
    COMMUNISTS in U.S. federal agencies.

    -Rick

    P.S.

    Words Near : “Gluttonism,” in the Dictionary :

    glutton / glutton-for-punishment / gluttoned / gluttony / gluttonish / gluttonizing / G L U T T O N I S M / gluttonize / gluttonized / gluttonizes / gluttonizing / gluttonous Americans.

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