Meeting of the Parliament 08 May 2024
Yesterday, I attended the Health, Social Care and Sport Committee’s meeting to hear directly from Dr Hilary Cass following her review of gender care services for children and young people. I had hoped to ask a question but, despite emailing the committee on Friday, I was told that time had run out. Unfortunately, that was just the latest in a series of questions that I have raised on the topic that have been rejected or denied. The fact of the matter is that children, young people, parents and campaign groups deserve answers, which is why my party has brought a debate on the issue to the Parliament.
Talking about gender in Scotland has become toxic, but we need to be clear that the Cass review is not about ideology. It is a scientific evidence-based review of the medical care that we have been giving to vulnerable young children. It is a monumental and fearless piece of work. I say “fearless” because, even amid the toxicity of the gender debate, the crucial report did not shy away from its difficult findings—namely, that we have been letting down a generation of vulnerable and distressed children.
One would think that the publication of a damning report on the medical care of children would jump straight to the top of any Government’s in-tray and that politicians of all stripes would be united in wanting to ensure that mistakes and poor practices were stopped immediately and that the required improvements were put in place. However, the response from the Scottish National Party Government could not have been more lacklustre.
From the moment that the Cass review was commissioned four years ago, the SNP Government sought to dismiss it as being irrelevant to Scotland, even though the medical approaches that were being reviewed were almost identical to those that were being used here. The Government disregarded the interim report, which cast doubt on the safety of puberty blockers for children, and, when the final report was published last month, it dithered, delayed and obfuscated until clinicians took the decision out of its hands by announcing that NHS Scotland would pause the use of puberty blockers for under-18s.
Although the use of puberty blockers is undoubtedly one of the key aspects of the Cass review, the nearly 400-page document makes a total of 32 recommendations to improve gender care for young people in Scotland. The recommendations include offering children fertility counselling before they proceed down a medical pathway; assigning a child a medical practitioner to take charge of their care and ensure that they get the personalised help that they need; support for parents, carers or siblings if needed; and a requirement to keep a national data set on gender services in order to continually update best practices.
The SNP has continued to be deafeningly silent on those and a host of other reasonable, commonsense recommendations. I made a promise to families who have been failed by gender care services in Scotland, and I intend to keep raising the issue until the Scottish Government implements all 32 recommendations of the Cass review without delay.
The Cass report should fundamentally change how we look at gender care in Scotland. It should be approached with caution and care, and it should be given holistically, viewing a child as a rounded individual and tailoring the approach to their unique needs. Yes, the report concludes that there is little evidence to support use of puberty-suppressing hormones, but it also details that children and young people might not be offered the right psychological support and assessments when experiencing gender distress. Medical intervention is not always required, but that has been common practice for many individuals. Meanwhile, children’s mental health has been left to deteriorate.
Although the Sandyford clinic has finally paused its use of puberty blockers and cross-sex hormones for those who are under the age of 18, gender care services need a complete overhaul. The Scottish Government needs to make that a priority because, as things stand, the waiting times for children and young people to see a clinician at a gender clinic can be over four years. Child and adolescent mental health services waiting times are through the roof, and the SNP has remodelled the funding of gender care services, which has resulted in a cut to the budget of those services.
I say to members, regardless of their opinion on the Cass review or on gender care services, that the Scottish Government is failing young people.