Why I wanted puberty blockers as a child: Trans woman, 24, who feels she was born in the wrong body will spend £35,000 to ‘correct’ her broad shoulders, a deep voice and facial hair

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Written By Rivera Claudia

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A trans woman spending £35,000 to ‘correct’ her masculinity says getting puberty blockers as a child could have ‘saved’ her. 

Jocelyn Claire Reed, from Liverpool, made the decision to transition to female at 18.

Puberty left the now 24-year-old with broad shoulders, a deep voice and facial hair.

She says the changes would have been prevented had she been given the powerful body-altering medicines as a pre-teen. 

The social media make-up influencer now takes hormone replacement therapy for ‘the rest of my life to reverse my male puberty’.

Jocelyn Claire Reed, from Liverpool, made the decision to transition to female at 18. Puberty left the now 24-year-old with broad shoulders, a deep voice and facial hair

The social media make-up influencer now takes hormone replacement therapy for 'the rest of my life to reverse my male puberty'. Ms Reed will also seek gender-affirming treatment privately

The social media make-up influencer now takes hormone replacement therapy for ‘the rest of my life to reverse my male puberty’. Ms Reed will also seek gender-affirming treatment privately

Puberty blockers, known medically as gonadotrophin-releasing hormone analogues, stop the physical changes of puberty in teens questioning their gender. Pictured one example of these drugs, called Triptorelin

Puberty blockers, known medically as gonadotrophin-releasing hormone analogues, stop the physical changes of puberty in teens questioning their gender. Pictured one example of these drugs, called Triptorelin

Ms Reed will also seek gender-affirming treatment privately.

It comes as the highly-anticipated Cass Review, penned by leading paediatrician Dr Hilary Cass, today ruled children given NHS trans treatment have been set on a path of irreversible change despite scant medical evidence.

She called for GPs to resist attempts by private providers to prescribe puberty blockers or hormones, ‘particularly if that private provider is acting outside NHS guidance’.

The hormones, which can permanently weaken bones, were banned last month on the NHS for children.

Some kids as young as nine have been given them.

They are, however, still available, prescribed privately ‘off-label’ by some medics at non-NHS-based gender clinics. 

Ms Reed said: ‘I completely support puberty blockers because if I’d had that when I was younger, it would’ve saved me from having to correct my male puberty.

‘I’ve had to go through laser hair removal. I’ll need my vocal cords shaven — and will potentially need my broad shoulders shaven, too.

‘I’m on estrogen pills for the rest of my life to reverse my male puberty.

‘All-in-all, it’s going to cost about £36,000, especially as some of it is cosmetic.’

She added: ‘I’m paying £1,500 in mortgage every month — I just don’t see how I’m going to save up.’ 

Dr Cass’ report, commissioned four years ago, made 32 recommendations to overhaul NHS trans services to improve the care children receive. 

Among them were calls for NHS England to put a ‘full programme of research’ in place to analyse the characteristics and outcomes of every young person who uses gender services.

Others implored the Government to introduce clearer guidelines on so-called ‘social transitioning’ in schools.

Social transitioning refers to when someone changes how they present or express themselves, such as through using different bathrooms. 

It found there was no clear evidence it had a positive or negative on a child’s mental health.

Ms Reed said: 'I completely support puberty blockers because if I'd had that when I was younger, it would've saved me from having to correct my male puberty. 'I've had to go through laser hair removal. I'll need my vocal cords shaven — and will potentially need my broad shoulders shaven, too'

Ms Reed said: ‘I completely support puberty blockers because if I’d had that when I was younger, it would’ve saved me from having to correct my male puberty. ‘I’ve had to go through laser hair removal. I’ll need my vocal cords shaven — and will potentially need my broad shoulders shaven, too’

She added: 'All-in-all, it's going to cost about £36,000, especially as some of it is cosmetic. I'm paying £1,500 in mortgage every month — I just don't see how I'm going to save up'

She added: ‘All-in-all, it’s going to cost about £36,000, especially as some of it is cosmetic. I’m paying £1,500 in mortgage every month — I just don’t see how I’m going to save up’

It comes as the highly-anticipated Cass Review, penned by leading paediatrician Dr Hilary Cass (pictured), today ruled children given NHS trans treatment have been set on a path of irreversible change despite scant medical evidence. She called for GPs to resist attempts by private providers to prescribe puberty blockers or hormones, 'particularly if that private provider is acting outside NHS guidance'

It comes as the highly-anticipated Cass Review, penned by leading paediatrician Dr Hilary Cass (pictured), today ruled children given NHS trans treatment have been set on a path of irreversible change despite scant medical evidence. She called for GPs to resist attempts by private providers to prescribe puberty blockers or hormones, ‘particularly if that private provider is acting outside NHS guidance’ 

But those who socially transitioned ‘at an earlier age’ or before seeing a medical professional ‘were more likely to proceed to a medical pathway’, it added. 

Ms Reed, however, argued being able to wear dresses from the age of four helped her feel more secure and called for greater mental health support among trans children. 

‘When I was younger, my family let me dress up as a princess. To be able to express myself like that made me more comfortable,’ she said. 

‘And other kids just got on with it — no-one ever pointed it out or tried to make me feel bad.

‘I might’ve been quite lucky, in that sense.’

She added: ‘There currently isn’t enough support at all for trans children.

‘I didn’t have any holistic mental health support, which would’ve made things 10-times easier.

‘Trans children already have so much going on in their head, with feeling like we were born in the wrong body, that more mental health resources are needed.’ 

What has the Cass report recommended? 

Dr Hilary Cass made 32 recommendations in total on multiple aspects of gender care for child. Here is the summary of what they are…

Research

The NHS should put in place a ‘full programme of research’ looking at the characteristics, interventions and outcomes of every young person presenting to the NHS gender services, with consent routinely sought for enrolment in a research study which follows them into adulthood.

Gender care is ‘an area of remarkably weak evidence’, the review stated, but results of studies have been ‘exaggerated or misrepresented by people on all sides of the debate to support their viewpoint’.

Dr Cass said there is currently ‘no good evidence on the long-term outcomes of interventions to manage gender-related distress’.

Alongside a puberty blocker trial, which is expected could be in place by December, there should be research into psychosocial (therapeutic) interventions and the use of the masculinising and feminising hormones testosterone and oestrogen.

On the latter, the review warned giving such hormones to 16-year-olds should be an approach taken with ‘extreme caution’.

Care must be holistic

The care of children and young people questioning their gender identity or experiencing gender dysphoria ‘needs to be holistic and personal’.

Services ‘must operate to the same standards as other services seeing children and young people with complex presentations and/or additional risk factors’.

The review says assessments of needs with a view to informing ‘an individualised care plan’ should include screening for neurodevelopmental conditions, including autism, as well as a mental health assessment.

Age

The approach to care for the youngest children should be different to that for teenagers.

There should be no lower age limit to accessing help and support and parents and families should be helped to ensure options ‘remain open and flexible for the child’.

For those yet to hit puberty, there should be a ‘separate pathway’ of care within each regional network of services, and young children and their parents should be prioritised for ‘early discussion with a professional with relevant experience’.

There should be ‘follow-through services’ for 17 to 25-year-olds, rather than being transferred straight into adult services, with regional centres either extending the age range of their patients or through ‘linked services, to ensure continuity of care and support at a potentially vulnerable stage in their journey’.

The review said all children should be offered ‘fertility counselling and preservation’ before going down the route of medical intervention.

Approach to referrals

Referrals into the now-closed Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust were ‘unusual’ in that they were accepted directly from GPs and from non-healthcare professionals including teachers and youth workers.

Dr Cass said she supports the NHS England proposal for all referrals to come via secondary care.

Social transitioning

There was ‘no clear evidence’ that social transition in childhood has any positive or negative mental health outcomes and ‘relatively weak’ evidence for effects in adolescence.

But children who socially transitioned – changing names, pronouns – at an earlier age or before being seen in clinic ‘were more likely to proceed to a medical pathway’.

Partial transition ‘may be a way of ensuring flexibility’, the review said, adding that appropriately-trained clinical staff should advise on the risks and benefits of social transition ‘referencing best available evidence’.

It warns parents must be careful not to unconsciously influence the child’s gender expression.

Workforce

Professionals have been reluctant to engage in the clinical care of gender-questioning children and young people due to the weak evidence in the area, a lack of consistent professional guidance and support, and long-term implications of making the wrong judgment about treatment options, the review said.

There is a need for the ‘appropriate skill mix to support both individuals who require medical intervention and those who do not’ as work continues to increase the available workforce.

The workforce should include a wide range of specialists including paediatricians, psychiatrists, clinical nurse specialists, social workers, specialists in neurodiversity, speech and language therapists and occupational health specialists.

Endocrinologists and fertility specialists should also feature ‘for the subgroup for whom medical treatment may be considered appropriate’.

The review said NHS England must identify gaps in professional training programmes and develop training materials ‘to supplement professional competencies, appropriate to their clinical field and level’. 

Detransition

NHS England should consider whether a separately commissioned service is needed for people who wish to detransition – where someone discontinues or reverses a medical gender transition – given that people who regret going through this process might be hesitant to return to the same service they had previously used.

The review states that ‘better services and pathways’ are needed for a group of whom many are ‘living with the irreversible effects of transition and no clear way to access services’.

The percentage of people treated with hormones who then detransition remains unknown because of the lack of long-term follow-up studies, but the review stated there is suggestion numbers are increasing.

Anyone detransitioning should be carefully monitored in a supportive setting, especially when coming off hormone treatments.

Private healthcare

With puberty blockers no longer being prescribed to children on the NHS, the review stated that no GP should be expected to ‘enter into a shared care arrangement with a private provider’ if a young person has been given access to them via that route.

The review said GPs had ‘expressed concern about being pressurised to prescribe hormones after these have been initiated by private providers and that there is a lack of clarity around their responsibilities in relation to monitoring’.

Dr Cass said the Department of Health and Social Care and NHS England must ‘consider the implications of private healthcare on any future requests to the NHS for treatment, monitoring and/or involvement in research’, noting that a young person’s eligibility to take part in the NHS study into puberty blockers could be affected if they took puberty blockers outside the study.

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