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Help us hold the NHS to account for providing unsafe treatment for young people with gender dysphoria

Help us hold the NHS (3)
I Anna Castle and Ms C are planning to bring a judicial review against the NHS for providing unsafe treatment advice for young people from 17 years old and vulnerable adults. Hundreds of 17 year olds are referred to the adult service each year – more than any other age group.

We are two mothers whose stories are remarkably similar (although we have never met)

  • We are the mothers of teenage daughters (16 and 17 years old) who felt they were lesbians.
  • Our daughters are neurodiverse – autism and ADHD
  • Our daughters have both self-harmed
  • During lockdown our daughters accessed trans activist websites
  • During lockdown our daughters felt they were born in the wrong body and sought medical transition
  • We were shut out of the medical process as we had concerns about medical transition and our daughter’s vulnerabilities
  • Our daughters are on the waiting list for medical treatment
  • Our daughters no longer live with us but with their affirming fathers.


We want to protect our daughters from taking experimental medication that has lifelong irreversible consequences. They need therapeutic help and not powerful drugs. They need unbiased evidence based advice and not controversial gender ideology. We know our concerns echo those of many mothers round the country. If the Adult Service Specifications are changed this will offer much better protection and treatment to young people and vulnerable adults - not just our daughters.

The Case

Increasingly in families across the UK young people are identifying as something other than their birth sex. This is often driven by unregulated groups promoting controversial gender ideology in schools. Young people struggling with their identity and relationships are easily drawn in to believing they were born in the wrong body through online chatrooms.

Young people are then affirmed in their beliefs by teachers, social workers and doctors. Some young people then seek medical help to transition with the use of powerful experimental unlicensed drugs. A significant number of these young people are vulnerable through poor mental health and neurodiverse disability such as autism and ADHD.

We had been very encouraged that the NHS had adopted a much safer practice for young people with gender dysphoria when it published the Interim Service Specification for Specialised Services for Children and Young People with Gender Dysphoria on 9th June 2023. This document and the Consultation Report and Equalities Impact Assessment that accompanied it required a much more cautious approach to treatment.

The significant uncertainties around hormonal treatment were acknowledged (with puberty blockers only being prescribed in a research protocol) and therapeutic intervention being the primary approach. This approach applies to young people up to the age of 18 years old.

BUT – the specification allows for young people to be referred to an adult clinic from 16 years old and treated there from 17 years old. This is justified as a helpful approach to reduce the waiting list. Adult Clinics however operate under a different service specification where the majority of people are referred for medical treatment after only 2 meetings. There is no acknowledgement of the serious concerns about hormonal treatment and psychological services are not required or routinely offered.

Psychological services that are offered have to be ‘gender affirming’ and conform to the controversial WPATH Guidance. Unlike the Children and Young People’s Service Specification there is a strong warning to psychologists not to engage in conversion therapy.

The new Children and Young People’s Service Specification creates the bizarre situation that if a young person is 17 years old they could be treated under it with a cautious therapeutic approach at one of the paediatric clinics OR if they are treated in an adult clinic could be on hormonal treatment after 2 meetings.

A patient’s co-morbidities do not magically disappear at age 17. Why should there be less protection for an adult with poor mental health and co-morbid disabilities ?

The Cass interim report recommendations adopted by NHS England were for the purpose of bringing the service into line with normal standards of paediatric care. The adult service has not similarly been reviewed to align with normal standards of adult healthcare.

We have been advised by our lawyers that the effect of the new service specification is not only bizarre for 17 year olds. It is unlawful because it discriminates against those who need the protection most – young people and vulnerable adults with neurodiverse disability and/or poor mental health.

Next Steps

We have sought advice from Jeremy Hyam KC and our solicitor, Paul Conrathe, will be writing next week to NHS England to threatening Judicial Review unless the Adult Service Specifications are withdrawn and updated in line with the NHS interim service specification for children and adolescents, to provide adequate safeguards for young people and vulnerable adults.

We Need Your Help

We need to send a pre-action letter threatening judicial review this week and then prepare to urgently launch proceedings in the High Court.

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Comments section

Helen Thank you Anna Castle and Ms C for bringing this vital legal challenge to ensure no child under 18 can be put on a course of experimental medical intervention, with known risks of physical and psychological harm.

Marc I believe in medicalised treatment when all other options have failed and this is necessary. I expect all options to be tried before this significant step.
I don't buy young people know their best interests. They certainly can't imagine their adult selves. My view is keep your body safe, keep your mind hopeful, be gay and be loved

Deirdre Wonderful women 👏👏👏

Gillian Proponents of gender ideology are trying to influence vulnerable minors into life-changing drug therapy and mutilating surgery. This needs to be stopped - it's totally scandalous.

Judi Wishing you both the best of luck with this case. Stay strong. What you are going through is so painful and gut wrenching.

Elaine You are doing an amazing job exposing the scandalous creep of gender ideology.It's so important to prevent this mutilation of girls, which is what being referred to Adult Gender Services will lead to. They are ignoring the Cass Review and lessons learned from Tavistock debacle!

Carol I really hope you win

Madeleine Thank you for doing what you're doing.

Stephen Good luck. they need to be held to account.

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Gary, Orpington

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