Children referred to NHS gender identity clinics could be screened for neurodevelopmental conditions such as autism and ADHD.
New services are being set up in the wake of the Cass Review of gender-related treatment for young people.
The review led to a UK ban on puberty blockers for under-18s experiencing gender dysphoria and found patients’ mental health was not being fully assessed.
A draft specification for the new services, seen by The Telegraph, said: ‘Given the high prevalence of neurodiversity identified within this population, all those attending the NHS Children and Young People’s Gender Service should receive screening for neurodevelopmental conditions.’
The conditions will include ADHD, autism, learning disabilities and other mental health issues.
Doctors will reportedly be asked to build a ‘detailed history’ of the patient’s cognitive, social and physical growth to account for ‘substantial’ changes that happen during puberty.
Patients will be treated by a ‘multidisciplinary team’ of experts who will create individual plans for each individual depending on their diagnosis.
Those with a suspected neurodevelopmental condition could be referred to separate specialists who will help determine whether the child’s symptoms are caused by the condition.
They would then be treated for the condition while kept under review by a gender clinic to see if they also need separate treatment for gender dysphoria.
The guidance, which could be changed after public consultation, was drawn up in the wake of the Cass Review, whose final report was published last year.
The review was led by Dr Hilary Cass, a retired consultant paediatrician and former president of the Royal College of Paediatrics and Child Health.
It carried out seven new reviews of existing scientific literature and more than a thousand interviews with trans youths, clinicians and others.
The report concluded current medical practice for gender issues are built on ‘shaky foundations’ and ‘weak evidence’.
A £10 million NHS-funded clinical trial looking into the effectiveness and risks of pubity blockers is set to start this year and run until 2031.
Dr Cass pointed to a link between the rise in teenage girls ‘struggling with gender identity, suicidal ideation and self-harm’ and ‘undiagnosed autism, which is often missed in adolescent girls’.
One study found transgender people were three to six times more likely than others to be on the autistic spectrum.
The draft specification also referred to ‘evidence of an increased frequency of family parental physical and/or mental ill health and other family stressors in this group’.
The Cass Review’s recommendations have been supported by the Royal College of GPs, the Royal College of Psychiatrists, the Academy of Medical Royal Colleges and the Association of Clinical Psychologists.
The British Medical Association (BMA), the trade union which represents 190,000 doctors, initially called for a pause in implementing the recommendations but changed to a ‘neutral’ stance late last year.
The NHS said: ‘We will soon be going to full public consultation on this draft specification, which sets out the new holistic assessment framework that was described by Dr Cass in her report.
‘NHS England has recently changed the referral pathway so child patients can only access gender services that we commission if they’re referred by a paediatrician or a child and adolescent mental health worker.’
Get in touch with our news team by emailing us at webnews@metro.co.uk.
For more stories like this, check our news page.