Scotland’s only gender clinic for minors is formally pausing the prescription of puberty blockers and hormone medications that are designed to facilitate gender transitions for children after a review commissioned by the English government questioned the efficacy of those practices.

This announcement effectively ends the practice of providing sex-change drugs and hormone medications to children in Scotland — just one month after England instituted the same ban.

Per the new policy formalized on April 18, new patients in Scotland must wait until they are 18 years old to access those drugs or hormone medications. However, patients who are under the age of 18 and have already begun such remedies to facilitate a gender transition will not be forced to stop.

“We are committed to providing the best possible clinical care for young people … and [we] understand the distress that gender incongruence can cause,” the announcement from the Glasgow-based Sandyford Sexual Health Service read.

“While this pause is in place, we will continue to give anyone who is referred into the Young People Gender Service the psychological support that they require while we review the pathways in line with the findings,” the announcement added.

The National Health Services of Greater Glasgow and Clyde (NHSGGC), which is the publicly funded health care system that runs the gender clinic, formally notified its patients of the pause on Thursday.

According to a statement from NHSGGC, these remedies were paused because of the findings in the Cass Review: a comprehensive report on gender transition treatments for minors that was commissioned by the English government. The report, led by Dr. Hilary Cass, found that the rationale used to justify sex-change drugs and hormone alterations to facilitate sex changes in children is based on weak evidence and that the health risks it poses to children are unclear. 

“The findings informing the Cass Review are important, and we have reviewed the impact on our clinical pathways,” NHSGGC Director of Public Health Emilia Crighton said in a statement.

“The next step from here is to work with the Scottish government and academic partners to generate evidence that enables us to deliver safe care for our patients,” she added.

Crighton also said the “toxicity around public debate” about treatments for children with gender dysphoria “is impacting the lives of young people seeking the care of our service and does not serve the teams working hard to care and support them.”

Tracey Gillies, the executive medical director of NHS Lothian, emphasized the importance of putting patient safety above all else.

“The Cass Review is a significant piece of work into how the NHS can better support children and young people who present with gender dysphoria,” Gillies said in a statement. “Patient safety must always be our priority, and it is right that we pause this treatment to allow more research to be carried out.”

Researchers in the United States have also been studying the potential that puberty blockers could cause irreversible negative effects on children. A study published by the Mayo Clinic in March found that boys who take puberty blockers could suffer “irreversible” harm based on the effects the drugs have on testicular cells.

The study was conducted by researchers at the Cold Spring Harbor Laboratory in Minnesota, which is a leading research institution in the field of genetics that has produced five Nobel Prize-winning scientists.

Although some Republican-led states in the United States have begun to prohibit doctors from prescribing these drugs and hormone medications to children, the practice is still legal in more than half of the country. Access to these drugs, and access to sex-change surgeries for minors, has become a leading cause of division between Republicans and Democrats in the country.