In a recent decision, England's National Health Service (NHS) has announced that it will no longer prescribe puberty blockers for children and young people with gender dysphoria or gender incongruence. The NHS claims that there is insufficient evidence to support the safety and clinical effectiveness of puberty-suppressing hormones.

The decision, which has been widely criticized by LGBTQ groups, was made following a careful consideration of an evidence review commissioned by the NHS in 2020. The policy document published on Tuesday also took into account the latest evidence published since then.

Going forward, puberty blockers will only be available to young people participating in clinical research trials and certain private clinics. Currently, fewer than 100 young people receive puberty blockers through the NHS, and they will be allowed to continue their treatment.

The availability of puberty blockers will also be maintained through some private gender identity clinics. However, the emphasis of treatment for young people, according to the NHS clinical policy, will now primarily focus on psychosocial and psychological support. Gender-affirming hormones and surgery may be considered later in adulthood.

The decision by NHS England comes amidst recent legal and political scrutiny surrounding gender-affirming care for young people in England. LGBTQ advocates believe that this scrutiny has coincided with a rise in anti-trans rhetoric within the country.

While some British politicians have welcomed the announcement, including Health and Social Care Secretary Victoria Atkins, LGBTQ campaign group Stonewall has expressed criticism. The group argues that "all trans young people deserve access to high-quality, timely healthcare" and is concerned about the delay in prescribing new treatments until the end of 2024.

Another charity, Mermaids, which supports trans, non-binary, and gender-questioning children and young people, has labeled the NHS announcement as "deeply disappointing" and believes it further restricts the support available to trans youth.

In contrast to the situation in the United Kingdom, major medical associations in the United States, including the American Medical Association (AMA), the American Psychiatric Association, and the American Academy of Child & Adolescent Psychiatry, agree that gender-affirming care is clinically appropriate for children and adults.

Gender-affirming care encompasses a multidisciplinary approach that helps individuals transition from their assigned gender to their affirmed gender. Puberty blockers, a noninvasive therapy that can be reversed, play a role in this care. By mimicking the actions of a puberty-stimulating hormone in the brain, these blockers effectively pause puberty until they are discontinued.

The AMA and LGBTQ advocates stress that gender-affirming care can be a life-saving treatment for trans youth, particularly as transgender and nonbinary youth in the US are twice as likely to have attempted suicide compared to their cisgender peers. These findings were revealed in a 2022 survey conducted by the Trevor Project, an organization dedicated to LGBTQ youth suicide prevention and crisis intervention.

The decision by NHS England to halt the prescription of puberty blockers has sparked a heated debate regarding the importance of timely and evidence-based healthcare for transgender and gender-questioning individuals. As the discussion continues, it remains to be seen how this decision will impact the support and treatment available to young people in the UK.