In Scotland, NHS Greater Glasgow and Clyde, as well as Lothian Health Boards, have paused the prescription of puberty blockers to individuals under the age of 18. The decision aligns with similar actions in England where, following the Cass Review, NHS England announced a cessation in the routine prescription of puberty blockers, limiting their future use to clinical research trials starting December. This review raised concerns about the lack of evidence supporting the safety and effectiveness of gender care treatments.

This change affects the whole of the UK differently: in Wales, there are no gender clinics specifically for under-18s, and patients typically need referrals to clinics in England; in Northern Ireland, the prescribing of puberty blockers has been constrained since March 2020 to those accepted into the existing regional gender service.

The UK government is currently considering legislative action to restrict access to puberty blockers from unregulated providers, especially those who deliver services online. Health Secretary Victoria Atkins highlighted the aim to uphold stringent ethical and medical standards.

The Cass Review itself, led by Dr. Hilary Cass, has spurred significant debate regarding the treatment of transgender youth, emphasizing the need for comprehensive understanding and careful communication in discussions about gender incongruence and treatment. Her findings underscored the complexity of gender identity issues and cautioned against any simplistic approach to gender-affirming care without robust evidence.

In response to the pause in Scotland on puberty blocker prescriptions, the Scottish Green LGBT group, Rainbow Greens, voiced concerns, stressing such a move contradicts the commitments in the Bute House Agreement, which pledged to prioritize the wellbeing of transgender individuals. They’ve called for an emergency meeting to discuss this urgent healthcare issue. In the political realm, figures like Scottish Green MSP Gillian Mackay, as well as SNP’s Kate Forbes and Fergus Ewing have engaged in discussions, signaling a potential reevaluation of the Bute House Agreement concerning the inclusivity and protection of trans rights in healthcare policy.