The United Kingdom on Wednesday indefinitely banned puberty-blocking drugs as a treatment for minors with gender dysphoria, except in clinical trials, due to an “unacceptable safety risk.”
“Existing emergency measures banning the sale and supply of puberty-suppressing hormones will be made indefinite, following official advice from medical experts,” said the United Kingdom’s Department of Health and Social Care.
Puberty blockers prevent the onset of puberty in kids and are often administered as part of a medical gender transition regimen before other sex-suppressing hormone therapy and reconstructive surgery are given. The drugs haven’t been routinely prescribed to minors with gender dysphoria in the U.K. since March.
Then, in May, the U.K. then issued a temporary ban on puberty blockers for minors with gender dysphoria after the release of the final Cass Review, an independent review commissioned in 2020 by NHS England on gender-related medical care for minors and young adults. The Cass Review (sometimes called the “Cass Report”) concluded previous studies on the topic are of “poor quality” and there is “very limited evidence on the longer-term outcomes” associated with medicalized transition.
“The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” Hilary Cass, the lead researcher, wrote in the introduction of the report.
The report noted that the number of children and young people presenting to the NHS Gender Identity Service (GIDS) has increased since 2009 and had an “exponential rise” in 2014. From 2009 to 2016, the number of adolescent females referred to GIDS rose from 15 to 1071, and the number of female children referred rose from two to 138. Meanwhile, the number of adolescent males rose from 24 to 426, and the number of male children rose from ten to 131. Prior to 2009, GIDS saw fewer than 50 children a year, and even fewer underwent medical procedures.
The U.K. government noted in its announcement on Wednesday that it is working with NHS England to implement the recommendations set forth in the Cass Review. National Review previously reported that the Cass Review recommended a “tiered approach” to intervention which “addresses urgent risk,” alleviates mental-health issues so the young person can “make complex decisions,” and develops a plan that may involve “any combination of social, psychological and physical interventions.”
The announcement also mentioned a forthcoming clinical trial on puberty-blocking drugs.
“We are working with NHS England to open new gender identity services, so people can access holistic health and wellbeing support they need,” said Wes Streeting, the United Kingdom’s Health and Social Care Secretary. “We are setting up a clinical trial into the use of puberty blockers next year, to establish a clear evidence base for the use of this medicine.”
This December, Justice Samuel Alito referred to the Cass Review during oral arguments for United States v. Skrmetti, a case about whether Tennessee’s law banning gender-related hormonal therapies and operations for minors violates the 14th Amendment.
“After the filing of your petition, of course, we saw the release of the Cass Report in the United Kingdom, which found a complete lack of high-quality evidence showing that the benefits of the treatments in question here outweigh the risks,” Justice Alito said when questioning solicitor general Elizabeth Prelogar. “And so I wonder if you would like to stand by the statement that you made in your petition or if you think it would now be appropriate to modify that and withdraw the statement that there is overwhelming evidence establishing that these treatments have benefits that greatly outweigh the risks and the dangers.”
Alito also mentioned the Cass Review when questioning American Civil Liberties Union attorney Chase Strangio and noted that it found there is no evidence suggesting gender-affirmative treatments reduce suicide. Strangio responded that “completed suicide” is “rare” but claimed that “there are multiple studies, long-term, longitudinal studies that do show that there is a reduction in suicidality.”