Official Scottish Transgender Guide Says 12 Year Olds Can Be Referred to Medical Services

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An official handbook has issued guidance for child and youth care services, suggesting that children as young as twelve could be referred for medical advice about transitioning.

A report published by the Care Inspectorate (pdf), a regulatory body set up by the Scottish government in 2011, suggested that care home staff can “support young people to explore appropriate options and provide access to a range of different supports.”

To seek medical assistance to transition, according to the guide, young people can seek a referral can be made to Sandyford Gender Service, an NHS gender identity clinic in Glasgow.

The report referred to the legal provisions to suggest that children as young as 12 can “make decisions about medical treatment, although we recognise this will not always be the case.”

The issue of gender dysphoria in children has been studied by an independent review commissioned by the NHS that was led by pediatrician and former president of the Royal College of Paediatrics and Child Health, Dr. Hilary Cass.

The review published an interim report in February 2022, citing safety issues over the long-term effects of puberty blockers and cross-sex hormones.

It also linked the “lack of safeguards for children” at the Tavistock gender clinic London to the “affirmative model” of care which “originated in the USA.” The report prompted Britain’s National Health Service (NHS) to announce last July that it would close the now infamous clinic this spring.

Consultant David Bell, one of the whistleblowers at Tavistock, spoke of gender dysphoria in an interview with Channel 4 news in January 2021. He argued that there needs to be a “thoughtful engagement” with young people “as opposed to motoring them through to treatment pathways, which have irreversible consequences for their bodies.”

Inclusive Environment

Care Inspectorate’s guide makes a list of recommendations for care workers to create “an inclusive environment” for all young people, including transgender young people.

Transgender young people should be able to share a room with other children who share their identity, the guide said.

“If any young person, including a transgender young person, is concerned about sharing a room with others, consider making alternative arrangements including giving them their own bedroom where appropriate and feasible.”

In communal bathrooms, single-cubicle or private washing facilities would be preferable to communal showers. The guide said that the provision of gendered facilities such as toilets is a social convention. The staff is advised to ask the young person about the facilities they wish to use and their concerns.

In its recommendations on creating an inclusive environment for young people, Care Inspectorate referred to the Equality and Human Rights Commission’s (EHRC) Technical Guidance for Schools in Scotland, which however, as of Nov. 3, 2022, has been marked as outdated and under review.

Another recommendation was to use gender-inclusive language, such as “come on everybody” instead of “come on boys and girls.”

“Provide opportunities for young people to say their pronouns, for example by staff introducing themselves with their own pronouns. Respect and use young people’s pronouns and preferred names–remember these might change over time,” said part of the guidance.

The report by Care Inspectorate has been criticised for inaccuracies and suggestions that care staff can signpost children and young people “to seek medical assistance to transition.”

“Since when did staff caring for children have the expertise to do this? This new guidance ignores the consistent research studies carried out for over 20 years that highlights that the majority of gender-questioning children stop being gender dysphoric once they’ve gone through puberty,” child psychologist Carolyn Brown a retired deputy principal psychologist at Fife Council said.

Care Inspectorate, however, suggested that it “can be helpful for staff to be aware of sources of additional support for young people.”

The regulator’s pamphlet was developed together with LGBT Youth Scotland, a charity largely financed by the public sector and Scottish government funds, which in 2020–2021 added up to £325,000.