how the debate over puberty blockers has evolved in the UK

2024-03-29 13:00:15
During the trans Pride parade in London, July 8, 2023. NOEMIE COISSAC / HANS LUCAS VIA

Published on March 12, the decision of the National Health Service (NHS) England, the authority administering public health establishments in England, to prohibit from April 1 the regular prescription of puberty blockers to minors with dysphoria of gender (a feeling of inadequacy between their gender and their sex at birth) aroused neither surprise nor great excitement in the United Kingdom. “All trans youth deserve access to high-quality health care when they need it,” regretted with a touch of fatalism Stonewall, one of the main LGBT associations in the country.

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It must be said that the closure of the Gender Identity Development Service (GIDS), the only NHS department dedicated to the health of transgender children and adolescents, was decided in mid-2022. From then on, patients and their families feared that access to treatments blocking the onset of puberty would be very restricted.

It will only remain possible for early puberty or within the framework of highly supervised clinical trials. From the age of 16, however, young patients may be prescribed corrective hormonal treatments (to acquire the specific characteristics of the gender opposite to their birth sex).

Prescriptions considered too hasty

It was in the Netherlands, in 2000, that puberty blockers were first prescribed for young people, from 12 years old, presenting with gender disorders. These hormone blockers were initially designed to treat prostate cancer and endometriosis. The GIDS followed the movement, first on an experimental basis in 2011, then from 2014 on an unprecedented scale in Europe. Up to 2,000 young people are sent to endocrinology departments for treatment with blockers after going through the GIDS.

But in 2018, ten GIDS practitioners confided their concerns to Doctor David Bell, a doctor at Tavistock Hospital, a famous adult mental health center in north London that houses the juvenile service. These professionals believe that blockers are prescribed too hastily while the number of young patients has increased exponentially and their profile has changed: the majority are no longer children born boys, but two-thirds are adolescents, including many exhibit neurodivergences. The testimony of practitioners, compiled by Mr. Bell, leaked to the national press, criticism rained down.

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Even if it denies it, the GIDS leadership is accused of having endangered the health of young people or of having fallen under the control of protrans pressure groups. The case of Keira Bell, born a girl, went through GIDS and puberty blockers before undergoing a double mastectomy and then regretting her transition in her twenties, also damages the reputation of GIDS – even if her complaint against the service’s practices is dismissed on appeal in 2021.

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