BY: DM
Published 1 week ago
Across some clinics and policy circles, there’s a growing trend of requiring transgender and nonbinary youth to undergo testing for ADHD and autism before they can access gender-affirming care. This practice, which has been quietly adopted in parts of Europe and is now creeping into policy discussions in the U.S., is being sold as a protective measure. The National Health Service (NHS) is spearheading the practice, despite push back from the transgender community.
While officials describe this as a “holistic” approach to care, critics argue it pathologizes trans identities and creates additional barriers to essential medical services. Here is a breakdown of the policy that has gone into effect in parts of the UK, and how it will impact trans people across the pond.
Trans people in the UK will now face unnecessary testing.
This new policy requires young trans people to be evaluated for neurodevelopmental disorders like attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) before being considered for medical transition.
“Children/young people referred to NHS gender services must receive a holistic assessment of their needs to inform an individualized care plan,” the NHS states. “Standard evidence-based psychological and psychopharmacological treatment approaches should be used to support the management of the associated distress from gender incongruence and co-occurring conditions, including support for parents/carers and siblings as appropriate.”
The NHS plans to roll out the program later this year, following a consultation period. Clinicians will conduct mental state examinations, evaluating mood, anxiety, and emotional regulation. If screenings indicate the presence of neurodevelopmental conditions like autism, referrals to specialized pediatric services will be considered. Doctors will then determine whether the child’s gender dysphoria symptoms are influenced by these conditions.
Critics are pushing back against the Cass Review.
The policy follows recommendations from the Cass Review, an NHS-commissioned examination of youth gender care that has faced criticism for flawed and selective evidence use. LGBTQIA+ advocacy groups and medical professionals argue that the policy stigmatizes trans and autistic youth and undermines their autonomy. The Yale Law Review slammed the findings in the Cass Review, suggesting that the data was misused.
“Unfortunately, the Review repeatedly misuses data and violates its own evidentiary standards by resting many conclusions on speculation. Many of its statements and the conduct of the York SRs reveal profound misunderstandings of the evidence base and the clinical issues at hand,” per the Yale Law Review.
Concerns have also been raised about the already extensive wait times for autism diagnoses within the NHS. According to the BBC, children are waiting up to two years for ADHD diagnosis, and the NHS does not seem to have an answer to the problem. Over 3,000 kids are still stuck on waitlists for ADHD, autism, or both. In 2023, they even hit pause on new referrals for months just to play catch-up with the backlog.
In summary, it seems as if the UK – especially the NHS – has bigger fish and chips to fry. The backlash is loud for a reason. Trans youth deserve affirming care, not suspicion. And while the NHS claims this approach is about “comprehensive care,” folks on the ground know it’s just another delay tactic wrapped in medical jargon.
Should youth be evaluated for ADHD and autism before receiving gender-affirming medical care? Comment below!
