January 17, 2024 - 4:00pm

A controversial private hormone clinic for young people with gender dysphoria has been given the go-ahead. The Gender Plus Hormone Clinic has been approved by the regulator, the Care Quality Commission, to prescribe hormones for those over the age of 16, just days after the World Health Organization made a startling admission.

The WHO, which is widely regarded as being captured by gender ideology, recently announced new guidelines on healthcare for transgender people — but these do not apply to children and adolescents. “On review, the evidence base […] is limited and variable regarding the longer-term outcomes of gender-affirming care for children and adolescents,” the WHO admits. 

Adolescents, in this context, include individuals up to the age of 19. So is it safe to prescribe cross-sex hormones to patients under that age? The answer, according to the WHO, seems to be that we don’t know. 

The new clinic says that hormones will be prescribed only to over-16s who have been assessed by a team of clinical psychologists after a minimum of six sessions. But the fact remains that it isn’t just the WHO which has reservations about such treatment. The NHS acknowledges that long-term use of cross-sex hormones may cause “irreversible changes” and “temporary or even permanent infertility”. 

There are obvious questions about whether young people who have self-diagnosed with gender dysphoria, and who may have been influenced by material they’ve found on websites or in books promoting transition, are capable of evaluating the risks of medical intervention. You can’t get a tattoo under the age of 18, but the CQC apparently thinks it’s fine for adolescents to go to a private clinic and pay for hormone treatment with unknown outcomes.

This is exactly what critics predicted would happen when the closure of the Gender Identity Development Service (Gids) at the Tavistock Clinic was announced two years ago. It was severely criticised in an interim report by Dr Hilary Cass which highlighted the service’s “affirmative, non-exploratory approach, often driven by child and parent expectations”. The Cass review said that a diagnosis of gender dysphoria meant other health conditions, such as autism and eating disorders, were in danger of being overlooked.

Two years on, replacement NHS services have yet to open and the waiting list for children expressing anxiety about their sex now stands at five years. With Gids due to close in March, there’s an opportunity for the private sector, which is now filling the gap left by the NHS. The newly-approved clinic is part of Gender Plus, a private service whose staff include clinicians who previously worked at Gids. 

The risks of privatising treatment for gender dysphoria, and creating a two-tier system based on family wealth, have been pointed out many times. Families seeking expensive private treatment are likely to have expectations quite at odds with current advice from NHS England, which is that many children who think they’re transgender are going through a “transient phase” and will grow out of it. 

It’s hard to know whether the delay in setting up alternative NHS services to Gids has been caused by a shortage of resources or nervousness about abandoning the “affirmative” approach to kids with gender dysphoria. But when an organisation as in thrall to gender identity as the WHO has admitted it doesn’t know the long-term effects of medical intervention, it is surely time for clinicians and regulators to think again.

Joan Smith is a novelist and columnist. She has been Chair of the Mayor of London’s Violence Against Women and Girls Board since 2013. Her book Homegrown: How Domestic Violence Turns Men Into Terrorists was published in 2019.