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Five thousand children with gender-related concerns waiting for NHS care in England | transgender

Five thousand children with gender-related concerns waiting for NHS care in England |  transgender

 


Five thousand children and teenagers with gender-related concerns are waiting for NHS treatment, but a shortage of doctors meant only 12 had been seen at a new London-based gender clinic until earlier this week.

Two newly opened gender centers, in London and Liverpool, are looking at creative ways to reduce waiting lists, such as organizing group sessions with therapists, according to Hilary Cass, the consultant pediatrician who devised the new, more holistic treatment model for children. and teenagers questioning their gender identity.

Only half of the 45 staff required have been hired to work at a London clinic that does not yet have a building, leaving patients to be seen online, according to a spokesman for Great Ormond Street Hospital, which is responsible for setting up of the hospital. The London clinic opened on April 2.

Cass's review points out that there have been significant challenges in setting up these clinics in a highly emotional and politicized arena.

Around 250 children and teenagers have moved into the care of the new London centre, which will be called the Children and Young People's Gender Service, London and the second clinic in the North West. Only a small proportion of patients are understood to have been seen so far at the north-west clinic.

Cass admitted it would take some time to sort out the long waiting list, but said Child and Adolescent Mental Health Services (Camhs) were screening children on the list to flag urgent problems and urgent risks.

She said there was no magic solution to reducing the waiting list, other than investing in Camhs and recruiting more staff to mental health services. Waiting lists would be reduced when more children and young people were seen by GPs in the country, rather than being placed on a waiting list for specialist gender services, she said.

Clinicians' nervousness about working in the field has made recruitment into new services very challenging, Cass said, describing how some health care staff were afraid to work in the field, in part because of uncertainties about the right model. of treatment and partly because they were afraid of being called transphobic. if you have a more cautious approach.

NHS England said helping new clinics overcome challenges around staff recruitment will be a key priority as this will determine the pace at which they will be able to see new patients from the waiting list.

A spokesman for Great Ormond Street Hospital said a consultant pediatrician and consultant psychologist were already leading the centres' multidisciplinary team. We have been actively recruiting since November 2023. Building a workforce takes time as we are recruiting in disciplines where there are known shortages, such as doctors and psychologists, he said.

No staff working at the now-closed Tavistocks gender identity development service had been hired for the new clinics, he said. The Cass review stipulates that when centers are operating at full capacity, they must be staffed by clinicians from mental health services and services for children and young people with autism and other neurodiverse presentations. There should also be support for looked after children and children who have experienced trauma.

Casss' new model aims to move services away from a highly specialized focus; she said that no one in the team should have tunnel vision on gender and that doctors should continue to work in parallel in other parts of the NHS outside of gender centres.

The more we can bring this back into normal adolescent care, the better, she said.

It's about seeing people as whole people; if they have to go on a hormonal route, then that's fine and it should still be available built into services, Cass said this week. Access to endocrinology and fertility services should be available to the minority of patients who Cass expects will continue to seek medical intervention.

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Cass said she had an encouraging chat with the clinical lead for the new London center last weekend, who said a very diverse range of young people had been seen and that patients were very pleased to have access to a wide range services.

A spokesman for Great Ormond Streets said: We are working rapidly to recruit the right skills of people.

He said the group sessions were not specifically designed to reduce waiting lists, adding that group sessions and workshops have the added benefit of reducing isolation and increasing a sense of social support for isolated young people and their families.

The families we spoke with expressed their appreciation for this opportunity. These will not be the only interventions offered and will be part of a personalized care package tailored to the individual needs of young people and their families, he said, adding that there will be some one-to-one options for those children who cannot access group interventions.

The central aim of the new services is to help young people thrive and achieve their life goals, Cass's review said.

Mermaids, a charity supporting transgender young people, said it was pleased that the voices and experiences of trans young people appeared to be heard and respected in the review, but added that the NHS was failing trans young people, with terrifying waiting lists between increased politicization of support provided to children and young people.

A teenage mother who was referred to a waiting list for care at the Tavistock Gender Clinic but never progressed far enough to the top of the list to get an appointment said she thought her daughter would benefit from the new approach .

This looks like normal health care, she said. It has sometimes felt like trans-identifying children have been excluded from all the normal rules in schools and health care. I just want her to get standard NHS healthcare, with a strong mental health element.

Sources

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2/ https://www.theguardian.com/society/2024/apr/11/five-thousand-children-with-gender-related-distress-awaiting-nhs-care-in-england

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