Gender services for children to move out of Glasgow's Sandyford clinic

Gender services for children and young people in Scotland are to be delivered by paediatricians in a regional network of clinical settings instead of at the existing Sandyford clinic in Glasgow.

The public health minister Jenni Minto also confirmed that a team from Scotland would join a UK-wide study into the use of puberty blockers, after their routine prescription was halted in April.

The changes have been recommended to the Scottish government by its chief medical officer, Prof Sir Gregor Smith.

Prof Smith's findings for Scotland follow the Cass review, which found children in England were let down by a lack of research and there was weak evidence on medical interventions.

Scotland’s only specialist service for under-18s was at the Sandyford clinic in Glasgow.

In his report to Scottish ministers, Prof Smith recommended that gender identity healthcare services for young people are "not provided in an adult sexual health setting (such as the Sandyford clinic) but are provided within paediatric clinical settings, as with other age-appropriate services for children and young people."

They will also be delivered regionally, rather than just at the one site in Glasgow.

Access to the service is now only available following referral from a clinician, which Ms Minto said was in line with other child and adolescent specialist services.

New National Standards for Gender Identity Care include a commitment that young people will be screened for neurodevelopmental conditions and autism during initial assessments for gender dysphoria.

A new training framework is to be introduced too, aimed at improving specialist skills of staff who will work within an "evidence-based" approach.

Detailed care plans will be required for each patient to transfer from children's to adult services.

Improvement needed on waiting times

Ms Minto told the Scottish Parliament: "Since December 2022, the Scottish government has invested over £4.4m to support gender identity healthcare improvement.

"Over £3.6m of this being allocated directly to NHS Boards providing gender identity clinics, to support them to improve service delivery.

"Independent evaluation of the impact of that investment on waiting times and quality of care is underway. A report will be published this winter.

"We all want to see improvement in waiting times to access these services."

Figures released to BBC Scotland News showed that at the end of 2023 there were 1,100 young people on the waiting list for the Sandyford.

The longest wait was about four-and-a-half years.

Like other parts of the UK, Scotland has seen a rapid rise in the number of young people questioning their identity or experiencing gender dysphoria.

Figures obtained by the BBC showed that in total 1,077 young people have been seen at the Young Persons Service at the Sandyford since January 2017.

The number seen each year has fallen from a high of 314 in 2018 to just 90 last year.

Scottish Labour's Jackie Ballie said that staff would need additional support and training, while criticising waiting times - an issue she said was being exacerbated by staffing issues at the Sandyford.

She asked if a national service would "resolve" the waiting times issue.

Ms Minto said additional funding was being invested, and that a further review would take place.

She added that staff recruitment was "challenging" due to the nature of the transgender rights debate.

Scottish Conservative MSP Meghan Gallacher said the Scottish government had "snuck out" its response to the recommendations in the Cass review after July's general election.

She continued: "The SNP minister failed to answer a simple question about the future of puberty blockers in Scotland, leaving open the possibility of them being prescribed in Scotland again.

"If the SNP government are accepting the Cass Review’s recommendations in full, they need to get on with the job and provide clarity to vulnerable young people and families who are still waiting for answers."

The Scottish Liberal Democrats leader Alex Cole-Hamilton said the children "at the heart" of the debate would have been living in "profound anxiety" if their pathways had been paused.

Ms Minto said ongoing research through Glasgow University would help to ensure those directly affected would "have their voices heard."

Scottish Green MSP Gillian Mackay said: "Trans people know their own minds and experiences... There is clearly a lot more to do if we are to build a truly supportive, responsive and caring system and reduce the shocking waiting times that are causing so much misery."