PM urges ‘extreme caution’ on gender treatments as NHS plans major review of clinics
The prime minister has said there should be “extreme caution” about gender treatments as a new report said children are being failed by gender services.
NHS England said it would now pause first appointments at adult clinics for teenagers under 18, and intends to carry out a major review of its adult gender services and use of hormones.
The report by Dr Hilary Cass found that there is “remarkably weak evidence” to support gender treatments for children.
The “toxicity of the debate” is also not helping, with people afraid of discussing transgender issues openly, she said.
The paediatrician criticised the current system in her report on gender identity services for children and young people.
Dr Cass makes 32 recommendations, including that gender services operate “to the same standards” as other children’s health services.
She recommends “extreme caution” and “a clear clinical rationale for providing hormones at this stage rather than waiting until an individual reaches 18”.
The current policy on giving children testosterone or oestrogen from age 16 should also be urgently reviewed, according to Dr Cass.
Addressing young people, she writes: “I have been disappointed by the lack of evidence on the long-term impact of taking hormones from an early age; research has let us all down, most importantly you.”
She said it was also important to ensure parents “are not unconsciously influencing the child’s gender expression”.
Dr Cass also recommends “a holistic assessment” including a mental health assessment and screening for conditions such as autism.
Dr Cass says the ‘toxicity’ around gender issues is a serious problem. Pic: PA
‘We have no good long-term evidence’
A review of 50 studies on puberty blockers and 53 on hormone treatments – carried out for the report – found a “lack of high-quality research” into their use in young people.
“The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress,” said Dr Cass.
The publication comes weeks after NHS England confirmed children would no longer be prescribed puberty blockers outside of research trials.
It’s also less than a fortnight since the much-scrutinised Gender Identity Development Service (GIDS) closed in London – with two new hubs to replace it.
The review was commissioned by NHS England four years ago after a steep rise in the numbers seeking help for gender issues.
The controversial Gender Identity Development Service (GIDS) closed last month. Pic: PA
There was particular concern over early medical interventions despite a lack of evidence on their use and long-term impacts.
Prime Minister Rishi Sunak welcomed the review, saying: “It aligns with our approach on this issue”.
“Of course we must treat children who are questioning their gender with compassion and sensitivity, but we have to recognise that we need to move with extreme caution in these areas, because we just simply don’t know the long-term impacts of what this all means,” he said.
Laura Farris, the victims and safeguarding minister, told Sky News there would be a “fundamental change of direction” as a result of the review’s findings and that work had started after an interim version of the report.
She said: “We are going to have regional support centres across the UK so that a child who is questioning their gender will be given a holistic package of support – and not just funnelled down an irreversible pathway where they may find that they reach adulthood and then wonder how on earth they were ever allowed to take those steps.”
Concerns report is ‘open to misinterpretation’
Mermaids, a charity that supports transgender young people, said the report “recognises the current system is failing trans youth”.
The charity criticised “appalling waiting lists of more than six years, virtually no first appointments offered for over a year, and increased politicisation of the support offered to children and young people”.
It added: “Trans youth tell us they want services which are accepting and respectful, which offer supportive spaces to explore their gender, and provide access to medical transition if and when they need it.
“We are pleased the voices and experiences of trans young people appear to have been heard and respected, and we welcome Dr Cass’ calls for trans children and young people, and their families, to be ‘treated with compassion and respect’.”
But Mermaids added it also had concerns some of the language in the report is “open to misinterpretation” and “could be used to justify additional barriers to accessing care for some trans young people in the same way the interim report has been”.
“We call on NHS England, and the NHS across the UK, to resist pressures from those who seek to limit access to healthcare, listen to trans youth directly, and act urgently to provide gender services which are timely, supportive and holistic,” the charity added.
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‘Wrong’ services have ‘terribly let down’ children
Dr David Bell, a psychiatrist who authored a critical report about gender services in 2018, told Sky News that Dr Cass’ review makes clear that the affirmation model – accepting when a child expresses that they are transgender – “has been completely the wrong clinical stance”.
“The right clinical stance is neutrality, exploration, understanding all the other multiple problems these children have that are being expressed through distress about their gender,” he said.
“These children have many complex problems and have been terribly let down, first of all by being put on a medical pathway which was inappropriate and which there has been considerable concern about the damage done to children by puberty blockers.
“But also that the other problems that they had were not properly addressed… by clinical services that act in such a way following the ordinary canons of clinical care.
“Instead what’s happened, they were totally captured by trans ideology so it became an ideological issue rather than a clinical issue and it is that that’s caused the damage.”
‘Falling off a cliff edge’
Other recommendations include a “follow-through service” for 17-25-year-olds, with Dr Cass warning teenagers are “falling off a cliff edge” when it comes to care.
She also urged a “more cautious approach” for children than for adolescents when it comes to social transitioning – where someone might change their pronouns, name, and clothing.
The paediatrician said her review was “not about defining what it means to be trans, nor is it about undermining the validity of trans identities”.
However, she cautioned that strong feelings on trans issues were having a damaging effect.
She said experienced clinicians had at times been “dismissed and invalidated” and that young people had been “caught in the middle of a stormy social discourse”.
“There are few other areas of healthcare where professionals are so afraid to openly discuss their views, where people are vilified on social media, and where name-calling echoes the worst bullying behaviour. This must stop,” she wrote.
She warned that “polarisation and stifling of debate” would also hamper essential research in an area with “remarkably weak evidence”.
In response, NHS England said it had made “significant progress” towards establishing a “fundamentally different gender service for children and young people” based on Dr Cass’s earlier recommendations, as well as “extensive public consultation and engagement”.
A spokesperson said: “We will set out a full implementation plan following careful consideration of this final report and its recommendations, and the NHS is also bringing forward its systemic review of adult gender services and has written to local NHS leaders to ask them to pause offering first appointments at adult gender clinics to young people below their 18th birthday.”
Negotiations to reset the UK’s post-Brexit relationship with the EU are going “to the wire”, a Cabinet Office minister has said.
“There is no final deal as yet. We are in the very final hours,” the UK’s lead negotiator Nick Thomas-Symonds told Sky’s Sunday Morning with Trevor Phillips.
On the possibility of a youth mobility scheme with the EU, he insisted “nothing is agreed until everything is”.
“We would be open to a smart, controlled youth mobility scheme,” he said. “But I should set out, we will not return to freedom of movement.”
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The government is set to host EU leaders in London on Monday.
Put to the minister that the government could not guarantee there will be a deal by tomorrow afternoon, Mr Thomas-Symonds said: “Nobody can guarantee anything when you have two parties in a negotiation.”
But the minister said he remained “confident” a deal could be reached “that makes our borders more secure, is good for jobs and growth, and brings people’s household bills down”.
“That is what is in our national interest and that’s what we will continue to do over these final hours,” he said.
“We have certainly been taking what I have called a ruthlessly pragmatic approach.”
On agricultural products, food and drink, Mr Thomas-Symonds said supermarkets were crying out for a deal because the status quo “isn’t working”, with “lorries stuck for 16 hours and food rotting” and producers and farmers unable to export goods because of the amount of “red tape”.
Asked how much people could expect to save on shopping as a result of the deal the government was hoping to negotiate, the minister was unable to give a figure.
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Starmer’s stance on immigration criticised
On the issue of fishing, asked if a deal would mean allowing French boats into British waters, the minister said the Brexit deal which reduced EU fishing in UK waters by a quarter over five years comes to an end next year.
He said the objectives now included “an overall deal in the interest of our fishers, easier access to markets to sell our fish and looking after our oceans”.
Turning to borders, the minister was asked if people would be able to move through queues at airports faster.
Again, he could not give a definitive answer, but said it was “certainly something we have been pushing with the EU… we want British people who are going on holiday to be able to go and enjoy their holiday, and not be stuck in queues”.
PM opens door to EU youth mobility scheme
A deal granting the UK access to a major EU defence fund could be on the table, according to reports – and Prime Minister Sir Keir Starmer has appeared to signal a youth mobility deal could be possible, telling The Times that while freedom of movement is a “red line”, youth mobility does not come under this.
The European Commission has proposed opening negotiations with the UK on an agreement to facilitate youth mobility between the EU and the UK. The scheme would allow both UK and EU citizens aged between 18 and 30 years old to stay for up to four years in a country of their choosing.
Earlier this month, Home Secretary Yvette Cooper told Phillips a youth mobility scheme was not the approach the government wanted to take to bring net migration down.
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Lack of UK training ‘big driver of net migration’
When this was put to him, Mr Thomas-Symonds insisted any deal on a youth mobility scheme with Europe will have to be “smart” and “controlled” and will be “consistent” with the government’s immigration policy.
Asked what the government had got in return for a youth mobility scheme – now there had been a change in approach – the minister said: “It is about an overall balanced package that works for Britain. The government is 100% behind the objective of getting net migration down.”
Phillips said more than a million young people came to the country between 2004 and 2015. “If there isn’t a cap – that’s what we are talking about,” he said.
The minister insisted such a scheme would be “controlled” – but refused to say whether there would be a cap.
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‘It’s going to be a bad deal’
Shadow cabinet office minister Alex Burghart told Phillips an uncapped youth mobility scheme with the EU would lead to “much higher immigration”, adding: “It sounds very much as though it’s going to be a bad deal.”
Asked if the Conservatives would scrap any EU deal, he said: “It depends what the deal is, Trevor. And we still, even at this late stage, we don’t know.
“The government can’t tell us whether everyone will be able to come. They can’t tell us how old the young person is. They can’t tell us what benefits they would get.
“So I think when people hear about a youth mobility scheme, they think about an 18-year-old coming over working at a bar. But actually we may well be looking at a scheme which allows 30-year-olds to come over and have access to the NHS on day one, to claim benefits on day one, to bring their extended families.”
He added: “So there are obviously very considerable disadvantages to the UK if this deal is done in the wrong way.”
Jose Manuel Barroso, former EU Commission president, told Phillips it “makes sense” for a stronger relationship to exist between the European Union and the UK, adding: “We are stronger together.”
He said he understood fishing and youth mobility are the key sticking points for a UK-EU deal.
“Frankly, what is at stake… is much more important than those specific issues,” he said.
Gary Lineker is to leave the BBC after this season’s final Match Of The Day and will no longer present its coverage of the World Cup, Sky News understands.
It comes after he “apologised unreservedly” for a social media repost featuring a rat – used in propaganda by Nazi Germany to dehumanise Jewish people – and said he would “never knowingly share anything antisemitic”.
Lineker’s last appearance on the BBC will be on 25 May, the final day of the season, with confirmation expected on Monday.
The former England star announced in November he would step down from Match Of The Day this year, but was set to return to front the World Cup in 2026, as well as FA Cup coverage.
Lineker, 64, said he was unaware the post he shared was antisemitic and it went against “everything I believe in”.
In response to the presenter resharing the post, the Campaign Against Antisemitism said his “continued association with the BBC is untenable”.
And when asked about Lineker last week, BBC director general Tim Davie said: “When someone makes a mistake, it costs the BBC reputationally.”
The presenter was temporarily suspended from the BBC in March 2023 after an impartiality row over comments he made criticising the then Conservative government’s asylum policy.
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Lineker has hosted Match Of The Day since 1999 and has been the BBC’s highest-paid on-air talent for seven consecutive years. He also has a successful podcast production company.
Kelly Cates, Mark Chapman and Gabby Logan will share the role of presenting Match of the Day. Pic BBC/PA
Mark Chapman, Kelly Cates and Gabby Logan will take over the highlights show from next season.
When the trio take over as hosts, it will be the first time the role has been shared by three people.
Sky News has contacted the BBC for comment.
A teenager has been arrested after a 16-year-old boy died following reports of a “disturbance” at a beach in Ayrshire.
Kayden Moy was found seriously injured by officers at Irvine Beach at around 6.45pm on Saturday.
The teenager, from East Kilbride, South Lanarkshire, was taken to hospital but died in the early hours.
Police Scotland said on Sunday evening that a 17-year-old boy had been arrested and enquires were continuing.
Officers believe the incident may have been filmed and have urged witnesses and anyone with information to come forward.
Kayden. Pic: Facebook
The incident happened at Irvine Beach in Ayrshire, Scotland. File pic: iStock
Detective Chief Inspector Campbell Jackson said: “An extensive investigation is under way to establish the full circumstances surrounding this death.
“Our officers are supporting the boy’s family at this very difficult and heartbreaking time.
“From our investigation so far, we know there were a number of people on the beach around the time of the disturbance.
“We believe several of them were filming at the time and may have footage of what happened.
“I would urge people to review the footage they have and contact police if they think the footage captured could be of significance to our investigation.”
This can be submitted anonymously, the force said.
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Superintendent Jim McMillan added: “We understand this death will be of great concern for the local community, but please be assured that we are doing everything we can to identify those involved.
“There will be additional patrols in the area as we carry out our enquiries and anyone with any concerns can approach these officers.”
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