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NHS Announces Review of Adult Gender Services Amid Concerns Over Quality of Care


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The National Health Service (NHS) is gearing up for a comprehensive review of adult gender services in response to significant concerns raised by Dr. Hilary Cass, a leading consultant paediatrician who recently scrutinized the state of gender care for children and young people. Cass's findings, detailed in a strongly worded letter to NHS England, have brought to light a series of alarming issues within the treatment of adults with gender dysphoria.

 

In her correspondence, Dr. Cass highlighted a total of 16 distinct concerns regarding the treatment being provided to adults dealing with gender dysphoria. Her letter underscores the urgent need for a closer examination of the processes and practices currently in place. As a result, NHS officials have pledged to expedite a thorough review of these services, with plans to initiate clinic inspections starting in September.

 

Dr. Cass's concerns emerged over the course of her three-year investigation into children's gender services. During this period, she was approached by numerous staff members working within adult gender clinics, who painted a bleak picture of the current state of care. According to these workers, the clinics suffer from "chaotic" administrative processes and "out of control" waiting lists, with some patients reportedly not receiving adequate explanations about the risks involved in treatment. Alarmingly, there appears to be a lack of national treatment guidelines regarding the use of hormones, and systematic follow-up processes seem to be virtually non-existent.

 

In her letter, Dr. Cass noted that patients were not always informed about the irreversibility of some of the effects of treatment. She recounted how some clinicians expressed concern that their colleagues were failing to address or challenge patients' "magical thinking," referring to unrealistic beliefs about what could be achieved through medical transition. The issues she highlighted were grave enough to prompt a response from NHS England, which has since outlined plans for a new review to be led by Dr. David Levy, a cancer specialist and medical director for Lancashire and South Cumbria Integrated Care Board.

 

Dr. Levy will head a panel of expert clinicians, patients, and representatives from the Care Quality Commission in assessing the quality, safety, and patient experience within these services. The review will also evaluate whether the existing service model remains suitable for the needs of the patients it serves.

 

In addition to the review, NHS England has revealed plans to expand services for young people, enhance workforce training, bolster research efforts, and explore options for supporting patients who wish to reverse gender treatment and detransition.

 

Dr. Cass's letter also shed light on the ideological tensions within the field of adult gender services. She mentioned that some clinicians felt the approach to care was "ideologically driven and polarised," making it challenging to question the prevailing methods or express concerns. One of the primary issues raised was the limited time allocated for patient assessments, with an expectation that patients would be placed on hormone therapy by their second visit.

 

This was particularly concerning given the complexity of many cases, which often involved histories of trauma, abuse, mental health diagnoses, and neurodevelopmental disorders such as ASD and ADHD. Cass argued that such a limited assessment period was grossly inadequate for addressing these multifaceted needs.

 

Further concerns were raised regarding a noticeable shift in the demographics of patients seeking treatment. Whereas the majority of patients were once older birth-registered males, there has been a significant increase in the number of birth-registered females in their early 20s presenting with complex needs. This shift in the patient population has added another layer of complexity to an already challenging situation.

 

In her report on children's services, published in April, Dr. Cass recommended the establishment of "follow-through services" for individuals aged 17 to 25. This recommendation was aimed at preventing young people from being abruptly transitioned into a radically different adult services model, which could be disorienting and potentially harmful.

 

The Cass report has been met with a range of reactions. It was welcomed by both the Labour and Conservative parties, as well as by NHS England upon its release. However, the British Medical Association (BMA) last month voted in favor of a motion that criticized the review and called for a pause in the implementation of its recommendations.

 

Despite this, a spokesperson for the Cass Review has defended the research standards employed in the report, suggesting that the concerns raised by the BMA do not diminish the importance of addressing the issues highlighted by Dr. Cass.

The upcoming review of adult gender services represents a critical step in ensuring that individuals with gender dysphoria receive the care and support they need in a safe and effective manner. The findings of this review could potentially lead to significant changes in how these services are provided, with the goal of improving outcomes for all patients involved.

 

Credit: NYT  2024-08-15

 

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52 minutes ago, thaibeachlovers said:

The NHS was set up to provide medical care for sick people and those that had accidents.

 

Gender change is due neither to illness nor accident, and was not even considered back when the NHS was started, so it should not be included in NHS services. At most it should just be the standard psychological course of a few weeks that is already offered.

 

It's because of issues like this that the NHS is in serious strife.

Time to get back to basics.

Medical science has advanced incredibly nice the birth of NHS. 

 

Are you suggesting treatments for such things as Parkinsons, Huntington, MND  Dementia, Prostate Cancer, etc  should not be treated under NHS?

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7 hours ago, thaibeachlovers said:

 

Did you even read my post or decide to attack me for the sake of it? Why you don't understand what I wrote is beyond me.

 

Parkinsons, Huntington, MND  Dementia, Prostate Cancer, are illnesses, and I already said the NHS exists to treat illness. Imagining that one will be happier if one gets' one's genitals chopped off is not an illness. IMO it's a delusion.

 

People are welcome to get the chop if they wish, but should not be at taxpayer expense, or occupying NHS beds.

Is ignorance an illness? If so, you could get treated on the NHS.

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21 hours ago, cowellandrew said:

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IMO the NHS management went a bit crackers doolally, nutso while I was still working in it.

The hospital I worked at had a children's hospital as part of it, and carried out surgeries on young children. The management decided that allowing FEMALE nurses ( only females nurses worked in that area ) to cuddle young children when they woke up from anesthesia was a mistake and banned them  from doing so, so the nurses had to let very young children cry in distress, and couldn't comfort them. Madness.

 

My first ward was a children's ward, but that was way back before the world went stupid. I'd never have worked in a children's ward in the 90s onward, as the whole men are evil thing was kicking off. One ( female ) manager told me in all seriousness that all men are rapists!

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9 hours ago, thaibeachlovers said:

IMO the NHS management went a bit crackers doolally, nutso while I was still working in it.

The hospital I worked at had a children's hospital as part of it, and carried out surgeries on young children. The management decided that allowing FEMALE nurses ( only females nurses worked in that area ) to cuddle young children when they woke up from anesthesia was a mistake and banned them  from doing so, so the nurses had to let very young children cry in distress, and couldn't comfort them. Madness.

 

My first ward was a children's ward, but that was way back before the world went stupid. I'd never have worked in a children's ward in the 90s onward, as the whole men are evil thing was kicking off. One ( female ) manager told me in all seriousness that all men are rapists!

All of which only happened in Trolland.

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Oh, so the men/boys that had their penis cut off and their anus reconfigured in a "vagina" were surprised that they did not actually become a woman, and that the women/girls that had their breasts cut off, and a chunk of their arm cut off and sewed to their vagina used to be did not actually become a man. 

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13 minutes ago, herfiehandbag said:

I have little time for @thaibeachloversand many of his views, and have crossed swords with him on many occasions; in fact I understand that I have the dubious honour of being on his "ignore list".

 

However in this matter I quite believe him. Such reported idiocy is entirely credible, and to simply accuse him of trolling is a particularly weak response.

Yet while the UK (and other countries) are rolling back this idiocy, it's full speed ahead in the US. 

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3 hours ago, herfiehandbag said:

I have little time for @thaibeachloversand many of his views, and have crossed swords with him on many occasions; in fact I understand that I have the dubious honour of being on his "ignore list".

 

However in this matter I quite believe him. Such reported idiocy is entirely credible, and to simply accuse him of trolling is a particularly weak response.

Unless, like me, you have experiences to the contrary.

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On 8/17/2024 at 8:12 AM, cowellandrew said:

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This happens in the U.S. of A. too.  I did not check whether I was pregnant or not on a form I had to fill in while waiting to be called in for my appointment with a doctor.   The form had a notice that all patients, whether they were male or female, were required to answer the question about pregnancy status. 


A receptionist called me to window and pointed out that I forgot to check whether or not I was pregnant.  I responded I am a male.   Yes, but you are required to check whether or not you are pregnant.   I laughed and made a comment about being sorry they were being forced by their employer deal with illogical questions on forms. 

 

I also asked if I the doctor would refuse to see me if I did not tell them if I was or was not pregnant.  When I was told the doctor would see me even if I did not answer the question, I thanked her then returned to my seat to wait to be called for the appointment.  
 

A few weeks later I returned for a follow up appointment at the same office and again had to fill in what I first thought was the same form a third time.   After completing it I realized there was no question about my being pregnant or not.   I asked about it and was told, we don't have that requirement for men any more.   

 

That response made me think, the only reason that I had answer questions on a form on my last visit was because of the pregnancy question.   That question was also not on the form that I had fill out when I went to the office and made the appointment to see the doctor.   I think that first form and the third form were the same one.  The only difference with the second form was the requirement that both men and women were required to state whether or not they were pregnant. 

 

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13 hours ago, JonnyF said:

Meanwhile nobody can get a GP appointment and there are massive waiting lists for life saving surgery.

To say " nobody" can get a GP appointment is a huge exaggeration.

 

As is saying people are on massive waiting lists for " life saving surgery:.

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22 hours ago, JonnyF said:

Meanwhile nobody can get a GP appointment and there are massive waiting lists for life saving surgery.

While I agree that the situation is not good, the actual amount of resources committed to silly things like gender services as a part of the NHS would be tiny.

The problem is actually that people have life threatening problems because they live unhealthy lives. They smoke, they eat too much bad food and do too little exercise etc. It will be impossible to provide enough medical services to keep up with the demand, without bankrupting the country.

The solution is in people's own hands- live healthy, pay to go private or wait for a free service.

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