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Ethics briefing
  1. Rebecca Mussell1,
  2. Sophie Brannan1,
  3. Caroline Ann Harrison2,
  4. Julian C Sheather1,
  5. Veronica English1
  1. 1 Medical Ethics, British Medical Association, London, UK
  2. 2 Ethics, BMA, London, UK
  1. Correspondence to Rebecca Mussell, Medical Ethics, British Medical Association, London WC1H 9JP, UK; rmussell{at}

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The Tavistock and Portman NHS Foundation Trust - Cass Review and potential further legal action

In previous Ethics briefings 1 we have highlighted the developments in the case of Bell & Another v the Tavistock and Portman NHS Foundation Trust. The case concerned a judicial review of the practice of prescribing puberty blocking treatment to children and young people at the Gender Identity Development Service (GIDS) managed by the Tavistock and Portman NHS Foundation Trust (the Trust). The Court of Appeal in its judgement2 found the Trust’s practices to be lawful, and overturned previous guidance given by the High Court which had contradicted the 'Gillick principle' regarding whether a child or young person could consent to medical treatment, without the consent of its parent.

Despite this legal success, concerns over the GIDS continued. In September, NHS England commissioned an independent and wide-ranging review of gender identity services for children and young people led by Dr Hilary Cass, past president of the Royal College of Paediatrics and Child Health.

Dr Cass’s Interim review, published in March,3 has resulted in a decision by NHS England to close the GIDS at the Trust by Spring 2023, and replace it with regional centres at existing children’s hospitals offering more 'holistic care' with ’strong links to mental health services’. It is proposed that regional centres will be established at Great Ormond Street Hospital, and Alder Hey Children’s NHS Foundation Trust.

Dr Cass was critical of the clinic’s failure to collect sufficient data on the impact of puberty blockers in under-16s. …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.