Intended for healthcare professionals


Gender identity services for children and young people in England

BMJ 2022; 377 doi: (Published 01 April 2022) Cite this as: BMJ 2022;377:o825
  1. Ken C Pang, associate professor13,
  2. Jeremy Wiggins, executive officer2,
  3. Michelle M Telfer, associate professor13
  1. 1Royal Children’s Hospital, Parkville, VIC 3052, Australia
  2. 2Transcend Australia, Castlemaine, Australia
  3. 3Murdoch Children’s Research Institute, Parkville, Australia
  1. Correspondence to: K C Pang ken.pang{at}

Landmark review should interrogate existing international evidence and consensus

The long awaited interim report of the Cass review was finally published in March this year.1 Commissioned in September 2020, the independent review led by paediatrician Hillary Cass examined NHS gender identity services for children and young people in England. These services are currently provided by a single specialist clinic known as the Gender Identity Development Service. After consulting people with gender diversity, health professionals, and support and advocacy groups, Cass expressed various concerns within her interim report, such as increasingly long waiting lists, the “unsustainable workload” being carried by the service, and the “considerable risk” this presented to children and young people.1

Recognising that “one service is not going to be able to respond to the growing demand in a timely way,” Cass used her interim report to recommend creation of a “fundamentally different service model.” Under this model, the care of gender diverse children and young people becomes “everyone’s business” by expanding the number of providers to create a series of regional centres that have strong links …

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