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April 29, 2025
In the wake of the Cass Review into gender identity services, leaked plans reveal that children in England presenting with gender dysphoria will soon be routinely screened for neurodevelopmental conditions, including autism and ADHD. This move, expected to be formalized in new NHS guidance, marks a significant shift in how young people seeking gender identity care will be assessed.
A Holistic Approach to Gender Identity Care
The Cass Review, published in April 2024, previously led to the banning of puberty blockers for under-18s in England and Scotland. Now, the NHS is set to move away from a strictly medical model, instead adopting a more holistic approach. According to reports, the new guidance will require medical professionals to consider a broad range of factors when a child is referred to gender identity services. These include mental health, family dynamics, sexual development, learning disabilities, and neurodevelopmental conditions such as autism spectrum disorder (ASD).
A leaked document states:
“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.”
If screening indicates the presence of conditions like ASD, children may be referred to specialized paediatric neurodevelopmental services for further assessment.
Reactions from Stakeholders
The proposed changes have sparked debate. The Scottish Greens have criticized the move, calling it “inappropriate” and warning that it could further stigmatize both trans and autistic individuals, as well as increase already lengthy waiting times for both trans healthcare and autism assessments.
Gillian Mackay, Scottish Greens MSP, commented:
“This assertion is totally inappropriate and is part of an attempt to further stigmatise and delegitimise trans people and their identities and shows a lack of understanding about people with autism.”
Meanwhile, NHS England has emphasized its commitment to implementing the Cass Review’s recommendations. A spokesperson said the new assessment framework is out for stakeholder testing and will soon undergo a full public consultation.
UK health minister Stephen Kinnock, speaking to BBC Radio 4, stressed the need for individualized care:
“The best way to do that now is to really look at how we get our gender services working for our young people in a way that reflects the complexity of each individual.”
Implications for Scotland
While the Scottish Government accepted the Cass Review’s findings and implemented the ban on puberty blockers, it remains unclear whether the new screening guidance will apply in Scotland. A government spokesperson confirmed that a new model for gender identity healthcare for young people is being developed, which will be based in paediatric clinical settings and informed by best available evidence.
Broader Context
The announcement comes amid wider debates on the rights and treatment of transgender individuals in the UK, including recent guidance from the Equality and Human Rights Commission (EHRC) regarding single-sex spaces.
Disclaimer:
This article is based on information reported by The National and other publicly available sources. The proposed NHS guidance has not yet been formally published and may be subject to change following public consultation. The topic of gender identity and neurodevelopmental screening is complex and evolving; readers are encouraged to consult official NHS and government resources for the most current information.
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