Children referred to gender identity clinics in the UK will now be required to undergo screening for autism, ADHD, learning disabilities, and other mental health conditions, under new guidance from the National Health Service (NHS), UK newspaper The Telegraph has reported.

“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 new specification cited by the newspaper states.

The decision follows a sharp rise in both gender dysphoria and autism diagnoses among young people over the past decade. 

Between 2011 and 2021, recorded cases of gender distress among minors jumped from 0.14 to 4.4 per 10,000, with adolescent girls driving much of the increase. 

Under the new NHS protocols shared with the Telegraph, a multidisciplinary team including doctors and psychologists will evaluate eight key areas of each child’s life, including medical history and family relationships.

The aim is to ensure that underlying conditions contributing to gender distress are properly identified and treated.

Historically, there was a “reluctance to explore or address” mental health conditions among young people presenting with gender dysphoria, the NHS guidance notes. 

Moving forward, the assessment of mental health and neurodevelopmental disorders will be an integrated part of gender-related care.

Previously, gender clinics in the UK, could recommend or prescribe treatments like puberty blockers, hormone therapy, or refer patients for surgeries such as mastectomy which involves the removal of breast tissue as well as genital surgery, interventions which can have irreversible and lifelong consequences.

Independent review warning

Until recently, children in the UK as young as 10 or 12 could be prescribed puberty blockers through the Tavistock Gender Identity Development Service after psychological assessment. 

However, growing concerns over the lack of evidence on long-term outcomes — highlighted by a major independent review by paediatrician Dr. Hilary Cass — prompted sweeping reforms. 

In her four-year review which was concluded in April 2024, Cass warned against treating gender identity issues in isolation. 

She stressed the need to see children as “whole people” and to address common conditions like depression and undiagnosed autism, particularly in teenage girls.

Teenage girls “struggling with gender identity, suicidal ideation and self-harm” often experienced “undiagnosed autism, which is often missed in adolescent girls,” according to her review.

Cass described autism as the “common denominator” with one study finding transgender people were three to six times more likely to be autistic than those who are not.

Under the 2024 guidance, puberty blockers are no longer routinely prescribed to minors and can only be accessed through participation in formal clinical research trials. 

The latest move to screen children for mental health conditions also comes against a broader backdrop of shifts in the UK’s approach to gender identity. 

On April 16, 2025, a landmark ruling by the UK Supreme Court established that transgender women would not be considered women legally under the Equality Act 2010. 

The court unanimously ruled that the terms "woman" and "sex" in the Equality Act refer to biological sex, meaning a person born biologically female. 

The ruling means that the legal definition of “woman” would be based on biological sex rather than gender identity.