By Joshua Arnold
The Washington Stand
The United Kingdom’s National Health Service (NHS) is developing new guidance that will require health care providers to screen trans-identifying minors for autism and trauma, according to draft plans leaked to the media. The NHS guidance applies the findings of the 2024 Cass report, continuing the U.K.’s cautious retreat from providing gender transition procedures to minors. “I’m excited to see this. It’s actually just common sense,” said Dr. Jennifer Bauwens, director of Family Research Council’s Center for Family Studies.
According to the draft guidance reviewed by The Telegraph, British doctors must review eight areas of the child’s life, which includes constructing a “detailed history” of the child’s social, cognitive, and physical development.
“Given the high prevalence of neurodiversity identified within this population, all those attending the NHS Children and Young People’s Gender Service should receive screening for neurodevelopmental conditions,” the guidance directs.
“One thing that’s very clear is that there are co-occurring, mental issues. There are psychological issues that are going alongside those who are identifying as transgender,” Bauwens, a longtime clinician, described. “And to leave those issues unexplored is malpractice because it’s too obvious that there are other things going on.”
“It’s the way that I was trained. It’s the way that we should be training people: to look for known, co-occurring issues,” she continued. “From the time I started at FRC, we’ve just been advocating for a thorough assessment and a thorough understanding.”
If a screening detects such neurodevelopmental conditions, including autism, the child should receive a referral for specialized mental health services. A team of doctors will then determine whether the child’s symptoms are solely caused by autism or whether the child needs separate treatment for gender dysphoria, too.
British data show a corresponding rise in both gender dysphoria and autism, especially among young girls entering adolescence. The rate of gender dysphoria rose from 0.14 children per 10,000 in 2011 to 4.4 per 10,000 in 2021, while the rate of autism rose from a relatively constant one in 2,500 children to one in 34 children by 2018. Professor Michael Craig, a 16-year clinical lead for the NHS National Autism Unit, estimated that about half of the patients seen at Tavistock, the U.K.’s infamous (and now-shuttered) pediatric transgender center, had autism.
Under the draft guidance, the medical team would also have to consider other factors related to the child’s development, including any exposure to “adversity and trauma,” “family context,” and the child’s sexual development, knowledge, and orientation.
“When you’re working with children, the typical approach — unless there’s some obvious reason why you wouldn’t involve the family — the goal is to involve the family. Because, for a good outcome, you need buy-in from all the family members,” explained Bauwens. “It’s been a divergent practice to isolate the child and institute some other intervention without the family’s knowledge.”
“There’s no question therapists — and anyone who’s in the health care setting — should be doing a thorough assessment,” Bauwens responded. “At this point, we’ve seen enough … people who are identifying as transgender, that they often have high rates of autism. We have studies of this. We also have studies that show high rates of trauma or going through childhood traumas. And there’s enough to show that a number of kids who are identifying as trans also have the social contagion feature.”
The guidance seeks to move the U.K.’s public health care system away from Tavistock’s “medical model” and toward a “new holistic assessment framework that was described by Dr. [Hillary] Cass in her report,” according to an NHS spokesman. Dr. Cass reviewed the draft guidelines earlier this year, The Telegraph noted.
“This is good news, but it’s kind of like, ‘Yeah, this is the way practice should be done.’ And not just practice for that matter — research should be done this way as well,” Bauwens added. “Once you sense that there are other variables contributing to the main issue that’s being researched, you should be including those variables, or else you’re going to get a faulty result. … So, this is sadly and yet also excitingly refreshing, to see a return to just good practice.”
The NHS plans to officially release the guidelines “soon,” publishing them for a “full public consultation” before their final implementation, the spokesman said.
Originally published at The Washington Stand!
