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The Scottish Government has commissioned NHS National Services Scotland to work with a wide range of clinical and other stakeholders to consider how best to meet the needs of the population in terms of young people’s gender healthcare services for NHS Scotland. This work is ongoing, and aims to define the scope of a specialist service in Scotland.

The Scottish Government anticipates that an outline service specification based on this work will be presented to NHS Strategic Planning Board for Scotland for consideration later this year.

The Scottish Government has commissioned Public Health Scotland (PHS) to collect, collate and publish waiting times for all gender identity clinics within the NHS in Scotland. This work will standardise and make routine reporting of waiting time information for these specialist clinical services. This commission also includes collation of patient cohort data, to help inform future service delivery. This work is ongoing.

The Scottish Government also provided funding in 2021 to NHS Greater Glasgow and Clyde to support the publication of a trans/non-binary specific report as part of a wider Health Needs Assessment it published in May 2022, in partnership with NHS Lothian and PHS. The main report can be accessed here: stor.scot.nhs.uk/bitstream/handle/11289/580332/Final Report %2831 May 2022%29.pdf?sequence=1 and the trans/non-binary specific supplementary report accessed here: Health needs assessment LGBT+ people: Transgender and non-binary supplementary report (scot.nhs.uk) .

Furthermore, the Scottish Government has provided grant funding to the University of Glasgow for a programme of research on long-term health outcomes for those accessing gender identity healthcare in Scotland, to help expand the collective evidence base for this healthcare. This work is in progress, and funding has been awarded to a number of research projects and a PhD post as part of this programme.

The Scottish Government understands that Public Health Scotland intends to publish, as official statistics in development, gender identity clinic waiting times information provided by NHS Grampian, NHS Greater Glasgow and Clyde, NHS Highland and NHS Lothian in late summer 2024. This will be subject to the necessary data quality and completeness standards being met.

I refer the member to the answer to S6W-26400 on 19 April 2024. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .

The National Gender Identity Healthcare Reference Group continues to meet and make progress against all the commitments set out within the referenced December 2021 Strategic Action Framework. This includes:

• Healthcare Improvement Scotland developing standards for gender identity healthcare for NHS Scotland;
• NHS Education Scotland developing a Transgender Health Knowledge and Skills framework for NHS staff;
• Public Health Scotland working with Health Boards to deliver publication of waiting times data by them; and
• Grant funding to the University of Glasgow to administer a programme of research on gender identity healthcare.

Decisions on clinical pathways are not for the Scottish Government. These decisions are for clinicians, based on the best evidence available, through the appropriate clinical governance structures.

The Scottish Government is unaware of any discussions between NHS Scotland Health Boards and the UK Government regarding the prescription of puberty-suppressing hormones as a treatment option for gender dysphoria.

The term “puberty-suppressing hormones” is non-specific, and could be applied to a range of medicines used for a variety of conditions.

The Scottish Government and NHS Scotland are proactively engaged with NHS England and its commissioned research study on puberty-suppressing hormones as a treatment option for gender dysphoria. This is being delivered by the National Institute for Health Research (NIHR). The Scottish Government and the NHS in Scotland are currently observers to that ongoing study development process, however consideration by NHS partners of what further engagement with this study may be appropriate is ongoing, as the scope of the research continues to be developed and defined by NIHR.

The final report from the NHS England-commissioned Independent Review of Gender Identity Services for Children and Young People (the ‘Cass Review’), chaired by Dr Hiliary Cass, was published on 10 April. The Cass Review did not review or consider clinical services as offered by Health Boards in Scotland.

However, both the Scottish Government and Scottish Health Boards had continued to proactively engage with the Cass Review as it progressed, to share information on improvement work in Scotland; shared learning; best practice; and to understand outputs of the review in England.

The Scottish Government welcomes the final report of the Cass Review, and we are now closely considering its findings at pace. Health Boards will also be considering the content of the report in the context of how this type of healthcare is delivered within Scotland.

On 18 April, in a joint statement, NHS Greater Glasgow and Clyde and NHS Lothian confirmed that both Boards have paused any new prescription of puberty-supressing hormones and cross-sex hormones for young people as a treatment option for gender dysphoria.

The small number of patients directly impacted by this change, and their families, were notified in advance of this statement. It is right that they were the first to hear about it, sensitively and from the services caring for them, before a public statement was made.

I refer the member to the answer to question S6W-26406 on 19 April 2024. All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers .

The Scottish Government welcomes the publication, on 10 April, of the final report and recommendations of the NHS England-commissioned Independent Review of Gender Identity Services for Children and Young People, chaired by Dr Hiliary Cass (‘the Cass Review’).

The findings of the review, and the associated systematic review papers, are being closely considered by both the Scottish Government and Health Boards in Scotland in the context of how such healthcare is best delivered here.

On 18 April, in a joint statement, NHS Greater Glasgow and Clyde and NHS Lothian confirmed that both Boards have paused any new prescription of puberty-supressing hormones and cross-sex hormones for young people as a treatment option for gender dysphoria.

The small number of patients directly impacted by this change, and their families, were notified in advance of this statement. It is right that they were the first to hear about it, sensitively and from the services caring for them, before a public statement was made.