THE NHS in Scotland is set to follow England in moving to a "regional model" of providing gender identity healthcare for under-18s.
In a statement in the Scottish Parliament on Tuesday, Minister for Public Health and Women's Health Jenni Minto said the Scottish Government would be accepting the recommendations of a report by the Office of the Chief Medical Officer into the Cass Review.
The review spearheaded by Dr Hilary Cass looked into the provision of gender identity healthcare for under-18s by the NHS in England.
It made a series of recommendations and claimed that there was "weak evidence" surrounding the use of medical interventions such as puberty blockers and cross-sex hormones on children.
It led the UK Government to ban new prescriptions of puberty blockers for young people, with the NHS in Scotland following soon after.
The Scottish Government also commissioned its own multi-disciplinary report in the recommendations of the Cass Review and whether it had implications for Scotland, which was received by ministers just before the Holyrood recess. Minto said: "The Scottish Government has accepted the findings of the report in full and work has started to implement its recommendations.
"One such recommendation is that gender identity healthcare services for young people are, and I quote: 'not provided in an adult sexual health setting (such as the Sandyford Clinic) but are provided within paediatric clinical settings, as with other age-appropriate services for children and young people.'
"The report also found that to ensure sustainable services a distributed network, or regional model, would be the appropriate delivery model instead of one site.
"We are actioning this at pace to address the immediate fragility of gender identity healthcare for young people and to develop a sustainable longer-term model."
Currently, there are four NHS-run specialist gender identity clinics in Scotland.
However, only one — the Sandyford clinic in Glasgow — deals with young people.
Tory MSP Rachael Hamilton asked Minto whether the Sandyford, which also provides gender identity and other sexual health services to adults, would be closed.
Minto confirmed that it would remain open for adult users "as it offers a wide range of sexual health services" but repeated that moving forward under-18s would no longer be seen at the clinic but in a "paediatric setting" instead.
It comes after NHS Scotland's Gender Identity Service said it would no longer be accepting self-referrals, with people now only able to receive an appointment following a recommendation from a clinician.
Minto stated that this was also a recommendation of the Scottish Government's report into the findings of the Cass Review.
Research into the long-term outcomes of people in Scotland accessing gender identity healthcare is currently being conducted by the University of Glasgow with the help of grant funding from the Scottish Government.
Minto said that the first outcomes of this research were expected towards the end of the year.
The Cass Review has been subject to criticism from members of the British Medical Association (BMA), who have called implementation of its findings to be "paused" while it conducts a critique.
Members of the BMA's council recently voted in favour of a motion which asked the association to “publicly critique the Cass Review”, due to what it called “unsubstantiated recommendations driven by unexplained study protocol deviations, ambiguous eligibility criteria, and exclusion of trans-affirming evidence”.
A group of academics at Yale Law School also criticised the Cass Review, claiming it “obscures key findings, misrepresents its own data, and is rife with misapplications of the scientific method”.
However, both the UK and Scottish Governments have stood by Cass's findings, with John Swinney stating that a "multidisciplinary clinical approach" is being taken towards the reform of transgender healthcare in Scotland.
