We are reviewing the legislation with experts to understand the implications and will provide factual information for those affected once we have it. We recommend that any child or young person currently accessing gender-related care outside of the NHS speak with their provider before 3rd June 2024 to understand how this may affect them.

From an initial read, there are aspects of this legislation, such as age and identity verification, that may also have consequences for those accessing private care including trans adults and people living with endometriosis, fibroids and testicular cancer, as well as profound impacts on trans young people.

If you or a loved one is affected and need some support, get in touch with our helpline on 0345 3 30 30 30.

This comprehensive report serves as a beacon of guidance for healthcare providers, offering insights into the unique needs of LGBTQ+ migrants. With tailored recommendations and a commitment to understanding, it equips providers to foster a culture of inclusivity within their practices.

From cultural competency gaps to navigating the intricacies of the UK healthcare system, this report sheds light on the challenges faced by LGBTQ+ migrants. By acknowledging these hurdles, we pave the way for proactive change and improved healthcare access.

As we unveil this vital resource, we call on healthcare providers and stakeholders to join us in our mission. Together, let’s break down barriers and champion inclusivity in healthcare for all members of the LGBTQ+ community.

Our commitment to supporting LGBTQ+ youth, particularly trans and non-binary individuals, remains steadfast. In the words of Hilary Cass, “I would urge everybody to remember the children and young people trying to live their lives and the families/carers and clinicians doing their best to support them. All should be treated with compassion and respect.” 

We understand that our communities have been eagerly awaiting this review and will have questions about its implications for them, their friends, family, and loved ones. We are collaborating with various sector peers in advocating for the rights and well-being of LGBTQ+ youth. Together, we will delve further into the findings of the Cass Review and provide our analysis and guidance in due course. 

In the meantime, we urge individuals and organisations working with or for LGBTQ+ and trans and non-binary youth to prioritise their psychological and physical well-being in any discussions concerning their experiences. Long-standing research consistently and clearly demonstrates the harmful effects of unsupportive environments on trans youth. It is paramount to uphold their right to express their identity, as well as to establish safe spaces where LGBTQ+ youth can freely explore their gender identity without fear of stigma or discrimination. 

We acknowledge the concerns and uncertainties many may feel about the future, but we are one of many dedicated charities, service providers and organisations tirelessly working to find a way forward. We welcome conversations with organisations and service providers who want to join us in fostering safe spaces, spreading compassion, collaborating for change, and working towards a more inclusive and supportive environment for LGBTQ+ youth. 

LGBT Foundation cautiously welcomes the announcement of two new regional centres that have the potential to provide an improved provisional service to the many children, young people and their families who have been failed by the existing poor-quality service.

Children and young people exploring their identity have needed urgent action for some time. However, this haste should not come at the expense of not involving people with the knowledge and experience to deliver a service that meets the needs of young people.

Those with lived and professional experience are essential in providing a healthcare service that can meet the needs of those who use it. We urge NHS England to involve LGBTQ+ organisations in developing these services, ensuring they remain inclusive and can meet a diverse range of needs.

We have seen considerable success from services that employ and seek support from trans and non-binary practitioners in providing a safe space, reducing stigma, and combatting confusion around using gender services, and we advocate for this as a way forward.

To safeguard the future of children and young people we ask for:

• Meaningful involvement for trans, non-binary, and questioning children and young people and their families, with services created with and by people with lived experience to guarantee the needs of their service users are met.
  
• Purposeful relationships with LGBTQ+ organisations with a track record of providing vital support to children, young people, and their families in their struggles to get appropriate support from Gender Identity Development Services.
  
• Trans and non-binary people to be involved in the service at all levels, from clinical professionals to patients.

We know this is a worrying time for trans and non-binary young people and their loved ones, with the announced closure of the Tavistock Gender Identity Development Service (GIDS) and the recent statements by Dr Hillary Cass. We are working with a coalition of our peers and inclusive organisations to provide the correct level of information to all people concerned. We are aware that the statement by NHS England on puberty blockers contradicts the details provided by Dr. Hilary Cass in her letter to them. We will continue to seek clarification around the role of puberty blockers and push for this information to be accessible and publicly available.

We are committed to supporting and uplifting trans and non-binary people, their friends and families, and all those who are questioning or who need to explore their identity in a safe and supportive space, whether they are trans or not. Everyone deserves to be able to use services that are safe, supportive, and inclusive, and we will continue to campaign for this.

Our main concerns are that:

• Barriers to accessing the service have been increased, leaving children and young people with less access to a service that has already been failing to meet the demands of service users for a number of years. This leaves children and young people without essential support or treatment to keep them safe.
• For those children and young people who do manage to be seen by the service, additional barriers have been put in place which will prevent them from accessing essential medication.

• Young people will be required to take part in a clinical study in order to access hormone blockers or cross-sex hormones, meaning that they cannot meaningfully consent to take part in this research in a way that is ethical.
  
• The specification actively discourages the exploration of gender, questioning gender stereotypes, and social transition under the grounds that gender incongruence in childhood may be a ‘transient phase’. Families and primary care facilitators are advised not to respect children and young people’s names or pronouns, and not to affirm social transition prior to diagnosis.
  
• Young people experiencing mental health issues or any neurodiversity such as autism or ADHD may be forced to delay their treatment until they have been able to access interventions for these experiences first.

Evidence shows that 94% of young people maintain their gender identity following social transition and that social transition itself is a key protective factor in alleviating dysphoria and distress and suicide prevention (Olson et al., 2022).

We encourage the use of the WPATH-approved DSM-5-TR and ICD-11 diagnostic criteria for ‘gender incongruence’, as this is more up-to-date and aligned with international clinical best practice than the outdated ‘gender dysphoria’ diagnosis.

We are calling on allies to respond to the Public Consultation (open until 4th December) and tell NHS England what trans and non-binary young people and their families need from an inclusive and affirming service: https://www.engage.england.nhs.uk/specialised-comm…

LGBT Foundation will be working on making the consultation more accessible and providing our communities with more information in the coming weeks.

If you have concerns or are affected in any way by the launch of this Service Specification, contact our helpline on 0345 3 30 30 30 or email HELPLINE@lgbt.foundation.