Transgender Updates: February 2025

Cass review fallout

The impact of the Cass review continues to be felt, with the British Medical Association (BMA) voting on 17 July to reject the findings of the report. The BMA is the only medical organisation in the UK not to accept the report, calling on its members to publicly critique the findings and for the ban on prescribing puberty blockers to under 18s to be lifted. The BMA’s position has led to around 1,500 doctors signing a letter of protest, with some longstanding members resigning.

Meanwhile, NHS officials have announced that as a response to the concerns raised by the author of the Cass report, a review into the services offered to adults with gender dysphoria will be expedited, with clinic inspections commencing in September 2024. The review, to be led by Dr David Levy, will assess the quality and stability of the services offered, and also determine if the existing service model is still appropriate. NHS England also intends to expand services for young people and provide support for patients wishing to detransition.

Transgender issues in the law

The Supreme Court heard an appeal from Scottish campaigners on how women are defined in law. The campaign group ‘For Women Scotland’ challenged a prior ruling by the Court of Session which found that guidance expanding the definition of "woman" to transgender women with a gender recognition certificate (GRC) was lawful. For Women Scotland argued that "certified sex is a legal fiction", whereas the Scottish Government argued that a GRC changes sex "for all purposes". The hearing took place over 26 and 27 November, but a verdict is not due until Spring next year.

The emergency legislation introduced on 29 May which temporarily outlawed the supply of puberty blockers pursuant to an overseas or private prescription and limiting NHS provision to within clinical trials has been deemed lawful by the high court. The NHS ceased prescribing puberty blockers at gender identity clinics from March 2024. On 29 July, Mrs Justice Lang handed down a judgment in which she stated “In my view, it was rational for the [health secretary] to decide that it was essential to adopt the emergency procedure to avoid serious danger to the health of children and young people”.

Wes Streeting, the current health secretary, commented that he was working with NHS England to set up a clinical trial to establish the evidence on puberty blockers. On 11 December, Streeting stated in the Commons that the ban on the sale and supply of puberty blockers to transgender individuals and those with gender dysphoria was to become permanent, with the Scottish Government following this ban. The ban on the sale or supply of puberty blockers to under 18s is also to became permanent in Northern Ireland.

Medical treatment of transgender individuals

With the prescribing of puberty blockers through the NHS to young people with gender dysphoria being restricted to clinical trials, many individuals who are questioning their gender identity anxiously awaited the announcement of a clinical trial to examine the effects of puberty blockers. After some delay, it has been announced that the trial will begin early in 2025. In future, when a young person is referred to one of the new regional gender services, they will be asked if they wish to join the trial.

Wes Streeting also commented that more than 6,200 children and young people were on waiting lists in England for gender services. He referenced a plan for eight new regional centres offering gender services for children and young people and stated that he wanted these up and running by 2026. Research by the University of York revealed that although the number of children and young people diagnosed with gender dysphoria by a GP has risen fiftyfold over 10 years, the prevalence of the condition is still low.

Elsewhere, experts from the Royal Infirmary of Edinburgh and the University of Cambridge set out guidelines for ensuring the "safety and dignity" of transgender people before and after general surgery. The guidance was created independently of the NHS and was published in Anaesthesia - the journal of the Association of Anaesthetists.

Inquiry into Mermaids by the Charity Commission

Following a two-year inquiry by the Charity Commission, the investigation has concluded that, although there were issues with the way Mermaids was run, there was no other evidence of misconduct.

Mermaids is a transgender youth charity that was set up in 1995 to provide advice and support to trans-identifying young people and their families. It grew rapidly between 2016 and 2023, and the Commission found that it struggled to cope with this growth, leading to mismanagement within the organisation. However, despite many public complaints and a series of negative news stories, the regulator found no evidence that Mermaids provided medical advice, made medical referrals without the approval of a parent or failed to have appropriate safeguarding policies in place.

The chair of the Charity Commission said that both Mermaids and other charities working with young people who are affected by issues of gender identity must “have regard to the findings, conclusions and recommendations of the Cass review”. This led to Mermaids being told to update its position on puberty blockers and to follow the advice of the Cass review in relation to involving parents in social transitioning and the provision of chest binders to children.

Overestimation of transgender individuals in the UK

Following the 2021 census, it was revealed that around one in 200 people aged over 16 in England and Wales identified as a different gender to their sex at birth. However, following doubts raised over bias in the statistics, a review was carried out that concluded the number of transgender people in the UK was overestimated.

The review found that those who did not speak fluent English or Welsh may have misunderstood the question asking if the gender they identify with is the same as their sex registered at birth. This misunderstanding may have led to more people inaccurately answering "no" to this question. Although the number of people answering this question incorrectly is thought to be relatively small, the potential error resulted in a figure of 29% for the total number of transgender people who do not speak English as their first language, despite that fact only 10% of people overall stated they do not speak English or Welsh as their first language.

The Office for Statistics Regulation has therefore downgraded the data from "accredited official statistics" to "official statistics in development" to reflect the possible flaws.

Transgender sportspersons

Controversy over transgender sportspeople continues, with the Ladies Professional Golf Association (LPGA) updating its gender policy for competition eligibility to prohibit women who transitioned after going through male puberty to compete on leading women’s golf tours from the 2025 season onwards.

The England and Wales Cricket Board (ECB) has also announced that any female player who transitioned after male puberty will be ineligible to play in the top two tiers of the sport. This follows the International Cricket Council’s (ICC) decision to ban transgender women who have gone through male puberty from playing in international women’s matches.

Both organisations stated that their decisions were based upon thorough consultations with medical experts and a range of stakeholders.

‍

If anyone is affected by the above or needs guidance on family law, please get in touch with our family team for support and assistance.