A top Human Rights Council-appointed expert has welcomed the decision by all health authorities in the United Kingdom to halt the routine use of puberty-blockers offered to children as part of gender transition services, amid a sharp increase more widely in the number of teenage girls seeking such treatment and concerns that it might disrupt brain development.

The development is in line with several western European countries that have reportedly reduced access to similar gender identity treatments whose benefits were found to be “remarkably weak”, according to a National Health Service (NHS) England-commissioned review, published on 10 April by consultant paediatrician Dr. Hilary Cass.

UN Special Rapporteur Reem Alsalem also welcomed the commitment by the UK Secretary of State for Health and Social Care to implement the implications of the Cass Review.

It “has…very clearly shown the devastating consequences that policies on gender treatments have had on human rights of children, including girls…its implications go beyond the UK,” said the UN Special Rapporteur on violence against women and girls, Ms. Alsalem.

Referrals spike

The independent rights expert cited the Review’s findings that between 2009 and 2016, the number of adolescent girls referred to NHS-England’s service for gender distress – or dysphoria - increased from just 15 to 1,071.

These referrals “breached fundamental principles, such as the need to uphold the best interest of the child in all decisions that affect their lives”, the Special Rapporteur insisted, while transgender rights groups have maintained that there are long waiting lists for treatment.

Mental anguish

Noting the “extraordinarily high number of teenage girls” impacted by anxiety and depression in recent years, Ms. Alsalem said it was crucially important that health authorities stopped “rapidly initiating permanent gender transition pathways that usually begin with puberty blockers, which could cause temporary or permanent disruption to brain maturation”.

Instead, girls potentially seeking “gender affirming interventions” should be offered more holistic psychological support, protected by legislation that should ensure “transition does not become the only option that is acceptable to discuss with them”.

‘Detransition’ support

The same opportunity for wider therapeutic support should also be available to “detransitioners” - individuals who have discontinued gender transitioning - “most of whom are girls”, Ms. Alsalem maintained, in support of the Review’s findings.

“Far too long, the suffering of this group of children and adults has been ignored or discounted. The report’s findings and recommendation signals that they have been heard, seen, and that their specific needs have been recognised.”

Toxic debate

According to Dr Cass’s report, “many more” young girls are being referred for gender transition treatment today, marking a distinct change from the past, when most requests for medical help came from adolescent boys.

Reiterating an earlier call for tolerance regarding discussions surrounding gender treatments amid a “toxicity of the debate” identified by the Cass Review, Special Rapporteur Alsalem stressed that researchers and academics who expressed their views should not be “silenced, threatened or intimidated”.

Special Rapporteurs are not UN staff and are independent from any government or organization. They serve in their individual capacity and receive no salary for their work.