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Scotland has paused all new prescriptions of transgender medications such as puberty blockers and cross-sex hormones for minors, the latest in a string of developments in Britain pumping the brakes on transgender medical services for minors.

Scotland’s only youth gender clinic, the Sandyford clinic in Glasgow, which is operated by Scotland’s National Health Service (NHS) made the announcement on Thursday.

New prescriptions for puberty blockers and cross-sex hormones have been paused, although children already receiving these drugs will be able to remain on them, the clinic said in a statement. Teenagers must now be 18 before being prescribed cross-sex hormones, the clinic said.

“We are committed to providing the best possible clinical care for young people accessing and understand the distress that gender incongruence can cause,” the clinic said. “While this pause is in place, we will continue to give anyone who is referred into the Young People Gender Service the psychological support that they require while we review the pathways in line with the findings.”

Scotland’s decision comes after the release of the Cass Review, a long-awaited review criticizing youth transgender medical services was released last week in England.

The landmark final report from pediatrician Dr. Hilary Cass is the result of a major independent review on children and gender identity commissioned by the NHS in 2020.

“The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” Cass stated in her report. The evidence we do have for gender medicine is built on “shaky foundations,” she wrote in an accompanying editorial published in a medical journal.

Puberty blockers should no longer be prescribed to children except in the context of research due to these powerful drugs’ effects on brain development and bone health, the report says.


Cross-sex hormones — estrogen and testosterone — should be prescribed to trans-identifying 16 and 17-year-olds only with an “extremely cautious” approach, and there should be a “clear clinical rationale” for not waiting until the teen is 18, the report says.

Waiting would preserve fertility and manage any other conditions. The report also warns that children who are referred to gender services present with high rates of abuse and neglect including sexual abuse and parental substance abuse.

In the wake of the report, Britain’s National Health Service (NHS) said all new treatment for 16 and 17-year-olds will be paused immediately, and it will review all transgender medical treatment.

The week before the report was released, the Tavistock clinic, England’s only youth gender identity clinic, officially closed its doors after being dogged by controversy for years.

The clinic, the biggest in the world, referred thousands of children for puberty blockers. In its last years, Tavistock began to see an increasing flood of young girls with gender-related distress asking for drugs despite having other mental issues like depression, anxiety, eating disorders, and histories of abuse.

In the U.S., at least 23 states have already moved to ban medical transgender services for children.