Scottish GPs advised to refer gender-questioning teens to activist groups, critics warn

Scottish GPs have been advised to refer children questioning their gender to LGBT activist groups for 'affirmative' counselling, despite recommendations from the Cass Review.

Guidance from NHS Lothian – Scotland’s second largest health board – urges family doctors to direct 16-year-olds to LGBT Health and Wellbeing, a group that supports transitioning, even for young children.

Critics argue this approach contradicts the Cass Review, which advised a cautious and thorough assessment of gender distress rather than an ‘affirmative-only’ model.

The Cass Review called for 'holistic' evaluations, raising concerns that social transition might lead to unnecessary medical interventions. Despite this, NHS Lothian suggests that if a young person still wishes to transition after ‘affirmative counselling’, GPs can refer them to the Chalmers Gender Identity Clinic for hormone treatment consideration when they turn 18.

Concerns have also been raised about GPs being asked to prescribe hormone treatments, which many believe they lack the expertise for. Some of these treatments are unlicensed for gender dysphoria, with limited evidence on their long-term safety.

“Telling GPs to send confused 16-year-olds to activist groups for ‘affirmative’ counselling flies in the face of the Cass review findings and the assurances the health board had given at Holyrood as recently as last month,” Trina Budge, a director at the For Women Scotland campaign group, said.

“For the NHS to be sending vulnerable patients to partisan lobbyists which promote the transition of five-year-olds and have described puberty blockers as ‘wonderful’ is utterly reckless.”

Meanwhile, NHS Lothian insists it supports the Cass Review and does not directly refer patients to these third-party organisations but provides information on various LGBT resources for signposting.