Summary

  • Public Health and Women's Health Minister Jenni Minto delivers a statement after the prescription of puberty blockers to children was paused by NHS Scotland

  • She says "careful consideration" will be given to the recommendations in the Cass review of gender services for under-18s in England

  • Dr Hilary Cass's review said children had been let down by a lack of research and there was "remarkably weak" evidence on medical interventions

  • Jenni Minto says the Scottish government remains committed to providing support and to reforming and improving gender identity healthcare

  • The Sandyford clinic in Glasgow says new patients aged 16 or 17 will no longer receive other hormone treatments until they are 18

  1. Gender identity healthcare for young people: The headlinespublished at 15:39 British Summer Time 23 April

    If you're just joining us, here is a recap of the ministerial statement on gender identity healthcare for young people.

    • SNP ministers have been accused of stalling in their response to a review of gender identity services for young people in order to protect their political partnership with the Greens
    • Public Health Minister Jenni Minto told MSPs that while the Cass review looked at services provided by NHS England, the findings would now be carefully considered in Scotland
    • The Scottish Tories said the government was "kicking the can down the road", adding that it had failed to clarify if any of the review's recommendations would be implemented
    • Scottish Labour said Ms Minto's statement lacked substance, describing it as a "sop to the Greens". The party membership is to vote on the future of its power-sharing agreement, prompted by concerns over gender and climate policies

    That's all from the live page team today. The editor was Catherine Lyst. The writers were Craig Hutchison and Ashleigh Keenan-Bryce.

  2. Background: Vote of no confidencepublished at 15:36 British Summer Time 23 April

    The Alba Party's Holyrood leader Ash Regan is submitting a motion of no confidence in the Scottish Green co-leader and government minister Patrick Harvie which could force a vote he would almost certainly win.

    Regan, who was previously in the SNP, resigned as a government minister in order to vote against gender reform legislation.

    Patrick HarvieImage source, PA
    Image caption,

    Scottish Green co-convener Patrick Harvie

    Her motion comes over Harvie's failure to say if he accepts the findings of the Cass Review into gender care.

    Asked five times if he accepts the report, Harvie refused to say, instead claiming it has been "politicised and weaponised" against trans people.

  3. When will the Scottish government debate the report findings?, asks Reganpublished at 15:32 British Summer Time 23 April

    Ash Regan asks when the government will be scheduling a full debate on the comprehensive findings of the Cass report and its "many implications" for health, education and law in Scotland.

    She adds that, listening to the minister, it appears as though the Scottish government has not read or "has not absorbed" the Cass reports conclusions. She asks the minister if the government is "really saying it does not accept the recommendations in full".

    Jenni Minto says Cass was a report commissioned by NHS England, looking at services in England and as a result, not all recommendations fit pathways in Scotland.

  4. Green MSP stresses importance of 'lived experience'published at 15:31 British Summer Time 23 April

    It's now the turn of Green MSP Gillian Mackay, who says many young people will be concerned about pausing the prescriptions for hormones on their healthcare journey.

    Mackay says: "We need to work as quickly as possible to ensure that the concerns of the clinicians are resolved, so that they can provide this care with confidence."

    The Green MSP adds: "Scottish Trans have suggested that we should consider setting up our own research study".

    She asks how the Scottish government can ensure "lived experience" is at the heart of any action going forward.

    The public health minister points out that NHS Scotland is already engaging with NHS England's research study regarding puberty blockers.

    She says Scotland's chief scientist's office is also involved with the research.

    Hearing from those with lived experience is vital, she adds, highlighting the role of the lived experience co-ordinator.

    "I remain absolutely committed to my own engagement with young people affected," she says.

  5. Young people affected should be at forefront of our minds, says Haugheypublished at 15:24 British Summer Time 23 April

    The SNP's Clare Haughey says the people who should be at the forefront of thoughts are the young people who are affected by this change.

    She asks the minister what steps are being taken to support those patients and their families, both those accessing and those waiting to access services.

    Minto says NHS Greater Glasgow and Clyde has engaged with people on the YPGS waiting list to address any unmet needs.

    The health board is also working with third-sector organisations to support those on waiting lists for the service.

  6. Scottish Lib Dem leader says 'urgent need' to commission more medical researchpublished at 15:21 British Summer Time 23 April

    Alex Cole-Hamilton

    Alex Cole-Hamilton says there are elements of the Cass review that some will find challenging, with the stated lack of an evidential base for care pathways that have now been paused.

    The Scottish Lib Dem leader says there is an "urgent need" to commission more medical research to promote greater understanding.

    The minister agrees it is a "challenging report" and she points to funds going to Glasgow University and co-operation with the chief scientist as well.

  7. Will the SNP ditch the Bute House Agreement?published at 15:19 British Summer Time 23 April

    Rachael Hamilton points out some members of the SNP-Green government have questionied the integrity of the Cass review.

    The Tory MSP calls on the minister to consider "ditching the Bute House Agreement coalition of chaos".

    Jenni Minto hits back, saying she is speaking directly to the young children and their families who have been impacted by this decision.

    The minister reiterates her pledge to work with the clinicians and researchers going forward.

  8. Dr Cass is an eminent physician, says ministerpublished at 15:15 British Summer Time 23 April

    The minister says the Cass report contains 32 recommendations and it will take time to consider them and “make the right decisions” from a clinical perspective.

    “The Scottish government welcomed the report,"she says. "I have been reading it and I recognise that Dr Cass is an eminent paediatric physician. I am listening to my clinicians with regards to this, also the stakeholders.”

  9. Baillie: Does Jenni Minto consider the Cass report a 'valid scientific document'?published at 15:14 British Summer Time 23 April

    Jackie Baillie

    Scottish Labour's Jackie Bailie says the Cass report “deserves to be treated seriously” and today's statement seems to be aimed at keeping the Bute House agreement alive.

    She asks Minto if she agrees with Patrick Harvie when he says the Cass review is not a “valid scientific document”.

    She says that instead of acting, the Scottish government seems to be setting up another working group.

    Baillie adds that there is already a national gender identity healthcare reference group and asks whether the newly proposed group will replace this.

    She concludes by asking the minister to confirm she will suspend the commissioning of the young peoples gender service until the report's recommendations are fully considered.

  10. 'The decision-making has been for clinicians to make, not politicians'published at 15:12 British Summer Time 23 April

    "The Scottish government has clearly welcomed the report from Dr Hilary Cass," Minto tells the chamber.

    "The decision-making has been for clinicians to make, not politicians."

    She says: "I am putting the children and families that are needing this support at the heart of the way that I'm working forward".

    The minister says she is getting the best advice she can fom clinicians.

  11. 'Direction of travel on this vitally important issue is as clear as mud' - Tory MSPpublished at 15:10 British Summer Time 23 April

    Megan Gallacher

    Tory MSP Megan Gallacher tells the chamber she spent last week trying to secure a ministerial statement on the Cass review and puberty-supressing hormones, but every attempt was voted down.

    "Finally, after confirmation from the health board of a pause in puberty-supressing hormones for new patients, we have a statement today," she says.

    However, she says the statement will "offer no comfort whatsoever" to families that have been failed by gender care services in Scotland.

    "The Scottish government's direction of travel on this vitally important issue is as clear as mud," she adds.

    Gallacher says the statement did not make clear whether any of the recommendations in the Cass review will be accepted.

    She says members of the Scottish government have publicly dismissed the findings of an evidence-based expert and she accuses it of stalling for time.

    She asks when will there be a meaningful update and she calls on the minister to "assure parliament that all government ministers will follow the science rather than ideology".

  12. 'Gender care in Scotland will be as person-centred as possible'published at 15:03 British Summer Time 23 April

    Minto says the Scottish government is working with NHS Greater Glasgow and Clyde and NHS National Services Scotland to establish a nationally commissioned young people's gender service to ensure young people's gender care in Scotland is "as person centred and effective as possible".

    "The Cass review recommends that gender identity healthcare must operate to the same clinical standards as other services - we agree," the minister adds.

  13. 'Work already under way will be improved and built upon' says ministerpublished at 14:58 British Summer Time 23 April

    "It's important to note that in Scotland we're already making progress in a number of aspects of gender identity healthcare highlighted in the Cass review." the minister says.

    She says she will remain engaged throughout to continue to engage on improving matters.

    The minister says the Scottish government has already committed to investing £9m to support the improvement of gender identity healthcare, to be delivered over a five-year period.

    "So that national improvement work already under way will be improved and built upon," she adds.

  14. Chief Medical Officer will update parliament before summer recesspublished at 14:54 British Summer Time 23 April

    The minister says the Scottish government already has a strategic action framework for the improvement of NHS gender identity services.

    As part of this, she says, the Chief Medical Officer (CMO) has agreed that the deputy CMO and other senior medical officers will support "careful consideration" of the Cass reviews recommendations and engage with the Scottish Association of Medical Directors and other clinical leaders.

    A multi-disciplinary clinical team with the office of the CMO including paediatric, scientific and pharmacy will assess the recommendations and engage with the relevant health boards on the recommendations.

    The minister says the CMO will provide an update to parliament before the summer recess.

  15. Vitally important the Cass review recommendations are carefully considered, says Mintopublished at 14:46 British Summer Time 23 April

    "The NHS Greater Glasgow and Clyde Young People's Gender Service in Scotland remains absolutely committed to providing the best quality care for patients and referrals," says the minister.

    "The service will continue to provide hollistic care and support."

    "The Cass review is a detailed, wide ranging report," she adds.

    It was commissioned by NHS England and all the recommendations may not be applicable to NHS Scotland.

    She says it is "vitally important" the recommendations are carefully considered and that will take time.

  16. 'These young people and their families must be at the heart of our decisions and thoughts'published at 14:41 British Summer Time 23 April

    Jenni Minto speaks out against clinicians receiving vitriol just for doing their job.

    The minister tells the chamber: "It was absolutley correct that before making a public announcement, NHS Greater Glasgow and Clyde and NHS Lothian took time to speak to all the young people who would be impacted under this pause."

    "These young people and their families must be at the heart of our decisions and thoughts when we discuss this issue."

  17. 'It is not for politicians... to make clinical decisions'published at 14:37 British Summer Time 23 April

    The minister says: "It is not for politicians, nor civil servants, to make clinical decisions about clinical pathways."

    These decisions should be made only by clinicians and minister will not make them, she stresses.

    "I fully support health board autonomy in clinical decision making."

  18. What have others said about the Cass Review and puberty blockers?published at 14:36 British Summer Time 23 April

    Dr Emilia Crighton, NHS Greater Glasgow and Clyde's director of public health said: "The findings informing the Cass review are important, and we have reviewed the impact on our clinical pathways.

    "The next step from here is to work with the Scottish government and academic partners to generate evidence that enables us to deliver safe care for our patients."

    Vic Valentine, of Scottish Trans and the Equality Network, said pausing puberty blockers was the wrong decision and said it would "harm trans children and young people".

    A statement said: "This decision has been taken within the context where the reality of trans people's experiences and lives is questioned almost daily in some of the media and some political circles.

    "This makes us worry that the decision has been influenced by that context rather than solely through consideration of the best interests of trans children and young people."

    The Rainbow Greens published an open letter calling for an emergency general meeting to discuss the future of the power-sharing agreement.

    Speaking at a protest in Glasgow, Rainbow Greens co-convener Jen Bell said: "In the Bute House Agreement the Scottish government promised to dismantle the gatekeeper system and put trans patients at the heart of decisions on their own healthcare.

    "Sandyford's decision breaks that promise."

  19. The Cass review requires thoughtful consideration says the ministerpublished at 14:34 British Summer Time 23 April

    Jenni Minto points out this commitment to support was a key part of the Bute House Agreement.

    The minister tells the chamber the Cass review requires thoughtful consideration.

    She says the pause announced to prescribing puberty blockers to children will provide time to assess the medications.

    The small number of young people affected by these medicines will not be affected by the pause mirroring the position in NHS England.

  20. Minister pledges support to trans and non-binary young peoplepublished at 14:30 British Summer Time 23 April

    Jenni Minto

    Public Health Minister Jenni Minto begins by speaking directly to trans and non-binary young people across Scotland.

    The minister says she knows how difficult recent times will have been with "toxic commentary" online.

    She insists that the Scottish government remains committed to providing support and to reforming and improving gender identity healthcare.