Puberty blockers for transgender and gender-diverse young people: a case for compassionate treatment

Healthcare provision for transgender and gender-diverse young people (TGDY) remains emotive, controversial and ethically challenging.1 The indefinite ban on the prescription of puberty blockers (PBs) implemented by NHS England2 in response to the Cass review3 poses ethical questions for those treating TGDY and the proposed clinical trials. The review’s recommendation to screen for ‘neurodevelopmental conditions including autism, or autistic spectrum disorder’ (ASD) as part of the assessment process raises further questions, as posed in this journal by Simona Giordano.4

Background

The review was commissioned in response to the growing numbers of TGDYP, concerns about treatment protocols, recent English legal cases regarding consent, changing patient demographics and the association with ASD.3 It did not specifically address ethical issues but instead reviewed available evidence to guide and inform its recommendations. Nevertheless, its rapid practical implementation required the application of moral principles; hence, Giordano’s…

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