GENDER identity services in NHS England have been found by an expert report to have failed children and young people.

Retired consultant paediatrician Dr Hilary Cass’s major report details how children have been let down by a lack of research and evidence on medical interventions in gender care in a debate which she says has become toxic.

Healthcare professionals have been afraid to openly discuss their views in a conversation which has seen people bullied and vilified on social media, Dr Cass said.

Her review was commissioned by NHS England in 2020 after a steep rise over 10 years in the number of children and young people presenting for gender dysphoria, when people feel a mismatch between their gender and their biological sex.

The final report comes less than a fortnight after the Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust closed, a decision ordered following Dr Cass’s interim report in 2022, and weeks after the NHS said it would no longer prescribe puberty blockers to children because of fears over their long-term effects.

Two new regional hubs opened in London and the north of England as NHS England moves away from a single-service model.

There are 32 recommendations in the report, including a call for gender services to operate “to the same standards” as other health services for children and young people.

Dr Cass’s report says there should be “a holistic assessment” of people referred, including screening for neurodevelopmental conditions such as autism and a mental health assessment.

The report also expressed concern about earlier medical interventions despite a lack of evidence on their use and the long-term impacts on young people.

The health service is urged to review its policy on giving children masculinising or feminising hormones from the age of 16, urging “extreme caution.”