Gender Identity

Gender incongruence and gender services for children and young people

There have been recent national changes to the way NHS services for children and young people with gender incongruence are delivered. Following the Cass Review and the introduction of new service standards, referrals to the national CYP Gender Service can no longer be made directly from primary care. Instead, referrals must now come through secondary care – either Paediatrics or Child and Adolescent Mental Health Services (CAMHS).

This change has been introduced to ensure that young people receive a holistic assessment of their health and wellbeing needs, with coordinated support before any onward referral to a specialist gender service.

The Somerset pathway

In Somerset, we are implementing a joined-up approach. If a young person requests a referral to the national CYP Gender Service:

• GP practices should refer to the CAMHS Single Point of Access (SPA).
• CAMHS and Paediatrics will then undertake a joint assessment, in line with the wishes of the young person, to identify their needs and agree the most appropriate next steps.

Local support

Alongside the national pathway, Somerset ICB commissions 2BU Somerset, a local youth work charity supporting LGBTQ+ young people aged 11-18 with their mental health and emotional wellbeing. 2BU works closely with CAMHS and other local services. GPs may wish to signpost young people and their families to 2BU while the referral process is underway.

15. You must provide a good standard of practice and care. If you assess, diagnose or treat patients, you must: 

-promptly provide or arrange suitable advice, investigations or treatment where necessary

-refer a patient to another practitioner when this serves the patient’s needs.

(Good medical practice, paragraph 15)