‘Trans toddlers' allowed gender treatment on NHS

Telegraph

14-05-2025

The NHS is treating nursery-age children who believe they are transgender after watering down its own guidance, The Telegraph can reveal.
The health service was previously set to introduce a minimum age of seven for children to be seen by its specialist gender clinics, claiming anything less was 'just too young'.
The limit was removed after the proposals were put out to consultation, with new guidance due to be published showing that children of any age are eligible.
However, a source close to the consultation process said NHS England had 'caved to the pressure' of trans activists to remove the limits.
The children are not given powerful drugs such as puberty blockers at the clinics, but are offered counselling and therapy along with their family.
Up to 10 children of nursery age are being treated, according to new data, while as many as 157 children aged nine or younger have been referred to the clinics.
Seven 'just too young'
The NHS previously said that children under seven years old were 'just too young' to be considered to have gender dysphoria, citing an example of a young child taking a liking to toys or clothes typical of the opposite sex as normal.
'We know that showing an interest in clothes or toys of the opposite sex – or displaying behaviours more commonly associated with the opposite sex – is reasonably common behaviour in childhood and is usually not indicative of gender incongruence,' it said.
That draft guidance, published in 2023, added that by seven years old, 'children may have more developed their cognitive, comprehension and communication skills to an extent that they will be able to engage with health professionals'.
The guidance was drawn up after the Cass review into children's transgender services, led by the paediatrician Baroness Cass, found the NHS had been sending children on a one-way path to change gender at the Tavistock clinic.
Doctors routinely prescribed puberty blockers despite a lack of evidence to support their safety and effectiveness, and instead of assessing for other conditions.
The clinic was closed as a result and the NHS began opening more 'holistic' regional gender clinics as part of plans to move away from a 'medical model'.
Last month, The Telegraph revealed that these plans included testing all children for neurodevelopmental conditions such as autism and checking their mental health.
The number of nursery-aged children referred to the new services is said to be 'fewer than 10', according to data released by the NHS under freedom of information laws.
The exact number of under-fives was withheld in order to prevent them from being identified, but with 157 children under 10 waiting to be seen, it raises the prospect that dozens of under-sevens have been referred to the clinics as a result of the about-turn.
NHS insists it is following Cass
The NHS said it was following the Cass review's recommendation not to set an age limit and that any care for children aged under seven would be focused on family support and advice.
The Cass review recommended that children who wanted to socially transition be seen as early as possible by medical professionals in order to identify and address any mental health concerns or neurodevelopmental conditions.
The Government has also thrown its support behind the move, insisting it is following the recommendations of the review.
Labour has been caught in the middle of controversies over transgender ideology.
Wes Streeting, the Health Secretary, has indefinitely banned puberty blockers and pledged to ensure women-only spaces in NHS hospitals do not include trans women after the Supreme Court's ruling on biological sex.
However, other Labour MPs have vocally opposed both of these decisions.
The new guidance has raised fears that the new services could repeat mistakes made at the Tavistock, which was seeing three new children under seven each month until it was shut down.
Helen Joyce, director of advocacy for human-rights charity Sex Matters, said: 'Research shows that pre-adolescent children who feel confused or distressed by the fact of their sex will usually grow out of this stage if they're sensitively supported, but not when they're encouraged to believe the unscientific notion that everyone has a 'gender identity' that may differ from their sex.'
She added: 'The question for the new NHS hubs is whether they perpetuate the failed 'affirmation' model of the now-closed GIDS clinic, in which case parents should keep their children well away, or whether they offer genuinely holistic care based on evidence, not ideology. If the treatment does more harm than good, the length of the waiting list is irrelevant.'
However, others said it was better for parents to talk to doctors rather than, for example, have teachers encourage the child to socially transition, such as by changing their name and dressing as the opposite sex for school.
Stephanie Davies-Arai, director of Transgender Trend, said: 'Although it seems unbelievable that children under five are being referred to the new gender hubs, it was a recommendation of the Cass review that children are seen as early as possible.
'This makes sense because parents have been given such bad advice for so long, and may believe their child is 'transgender',' she said.
'Trans lobbyists have told parents that children know their 'gender identity' from age three and there is no harm in 'affirming' a child's identity. It is important that these parents can get proper information and sensible advice from the gender hubs rather than listening to activists.'
The current child gender services are operated by London's Great Ormond Street Hospital, Alder Hey Children's Hospital in Liverpool, and University Hospitals Bristol, with another service planned for the East of England later this year.
So far, about 250 children have been seen by the new services, which are designed to see 25 patients a month each.
The NHS plans to have seven or eight services operating across the country, which will allow it to see up to 200 new children per month, it is understood.
Waiting list up 12pc in a year
The waiting list stands at 6,225 as of the end of March, up by 12 per cent from 5,560 a year earlier, as demand has continued to rise. The average waiting time to be seen has also risen to more than two years, from 100 weeks to 116.
Professor James Palmer, NHS medical director for specialised services, said children and their families 'can access mental health support if they need it' while on the waiting list.
'The NHS is now almost halfway through its planned expansion of regional services, and we are seeing significantly fewer referrals as children are first assessed by paediatric or mental health experts and provided with care in NHS services that are more appropriate to their needs,' he added.
A Department of Health spokesman said: 'We are working with NHS England to reform children's gender services in line with the recommendations from the Cass review, to provide children with timely, holistic support.
'We've opened three new children and young people's gender services with a fourth anticipated to open later this spring. These new services will increase clinical capacity and reduce waiting times, so patients can be seen sooner and closer to home.'