A lack of clinical guidance for GPs on the use of cross-sex hormones with gender-confused youngsters is a ‘ticking time bomb’, MSPs have been warned.
In a letter to Scotland’s parliamentarians, doctors said they were being asked by clinicians to give hormones to patients discharged into their care without proper guidance or supervision.
A report published in March also highlighted confusion over the clinical governance for under-16s referred by the Sandyford gender clinic for children in Glasgow to hormone specialists in other parts of the country.
‘Experimenting’
Dr Anne Williams, a signatory to the letter, said: “We are experimenting with our young people, which is dangerous, as they may have many years of their lives to discover and suffer the consequences.”
She continued: “Many GPs are very concerned that we are yet to see the bomb explode.”
Another signatory observed: “GPs are being asked to prescribe without any GP specific protocol detailing how often to take bloods and what adverse effects to monitor for.”
The GP added: “A huge concern is that data on long-term adverse effects/harm is lost as it is not being collected in primary care.”
Confusion
In March, an independent report for NHS Scotland found the governance of services for children receiving puberty-blocking drugs to be “complex and unclear”.
The review by Rhoda Macleod, Head of Adult Sexual Health Services at Glasgow City Health and Social Care Partnership, reported a “lack of clarity and understanding about where clinical governance accountability lies for this small but important patient group”.
In response to the report, NHS Greater Glasgow and Clyde, responsible for the Sandyford clinic, said: “Clear clinical governance arrangements are now in place”.
In April, the Sandyford paused the prescription of puberty-blocking and cross-sex hormones to new patients.
Cass Review
Last week, Public Health Minister Jenni Minto announced that work is underway to implement the Chief Medical Officer’s report on the Cass Review’s implications for Scotland, which advised that gender-confused children should not be given puberty blockers without further clinical trials.
While the Sandyford had already stopped accepting self-referrals from gender-confused children, young people will be seen under a regional model in paediatric clinical settings across the country.
In response to the letter from GPs, Minto told Holyrood on Tuesday that specialist centres will be responsible for “determining the support that children and young people need in that area”.
Record number of gender-confused people apply to ‘change sex’
