We welcome Dr Cass’ review and are closely studying its insights in order to update our own position in consultation with professionals, our staff, trustees and most importantly with trans people and others with experience of questioning their gender.
The Cass Review notes the complex and intersecting needs that many children and young people face – in particular that children questioning their gender are statistically more likely to have complex needs (such as co-occurring conditions like mental health needs) compared to their peers. At NCB we emphasise the importance of seeing the whole child, understanding how different facets of their lives interact with each other. In fact, the situation that the review describes for NHS gender identity services is far too common for all children and young people with complex needs: a lack of quality evidence to inform practice, extremely stretched services that leave young people on waiting lists without any help, and a systemic failure to truly engage the children and young people most affected.
Additionally, as the review notes, the issue of gender identity is one in which debate is highly polarised. This can contribute to heightened distress for children, young people and those who care about them and means that an evidence-informed approach is even more important here.
We support the review’s call for expanded infrastructure and a comprehensive research programme following every young person presenting to the NHS gender services, ensuring improved access to help and advice for children and young people questioning their gender now, while providing crucial evidence for those who will do so in the future.
This approach must be a template for the step change in investment in services and coordination of research relating to children and young people with complex needs – and crucially this must be done with young people and those who care about them, rather than to them.