All the cool kids are trans. OK, nobody is actually saying that. But young people — children — sometimes have questions of sex identity, especially at puberty and apparently as a result of not-so-subtle cultural messages. That’s probably why a U.K. clinic involved in “sex changes” for children reports increasing numbers of referrals: 5,000 in 2021 compared to 250 about 10 years ago, according to The Times of London. All the cool kids are trans. To make sex changes on individuals too young to vote, drive, work full-time or enter into contracts is crazy. And since the opposite condition, or at least good reasoning on the part of the staff of the clinic — the Tavistock and Portman National Health Service Foundation Trust — seems to be lacking, the British National Health Service is stepping in. And, as of next spring, shutting it down. Which means the clinic will no longer be rushing children into radically changing or perhaps destroying their lives by taking puberty blockers. While not addressing the judgment of Tavistock and Portman clinicians, the NHS is concerned about the mental state of gender-confused children. So the NHS says children will be treated in a decentralized fashion at children’s hospitals in methods described as more holistic and involving the services of mental health professionals. The change is the result of an interim report by The Cass Review led by Dr. Hilary Cass, former president of the Royal College of Paediatrics and Child Health. Following the interim report, released in February, are a final report and recommendations to come out next year. In a letter in the report addressed to children and young people, Cass said some are concerned that she will recommend that hormone treatments be stopped. Cass replied, “We know quite a bit about hormone treatments, but there is still a lot we don’t know about the long-term effects. “Whenever doctors prescribe a treatment, they want to be as certain as possible that the benefits will outweigh any adverse effects so that when you are older you don’t end up saying ‘Why did no one tell me that that might happen?’ This includes understanding both the risks and benefits of having treatment and not having treatment.” Among the problems with Tavistock and Portman’s sex change efforts are, according to The Cass Review, that they “developed organically” and were not “subjected to some of the usual control measures that are typically applied when new or innovative treatments are introduced.” The treatments were developed despite “significant gaps in the research and evidence base.” And The Cass Review indicated that unlike other children in distress, kids in states of gender confusion are, under current practices, being denied “psychological and social support.” Which brings up another problem — that of “diagnostic overshadowing.” “Many of the children and young people presenting have complex needs, but once they are identified as having gender-related distress, other important healthcare issues that would normally be managed by local services can sometimes be overlooked,” the review said. The Cass Review recommends that “any child or young person being considered for hormone treatment should have a formal diagnosis and formulation, which addresses the full range of factors affecting their physical, mental, developmental and psychosocial wellbeing. “This formulation should then inform what options for support and intervention might be helpful for that child or young person.” While following The Cass Review, the NHS will presumably still be involved in child sex changes, not acknowledging the reality of XY and XX chromosomes. But at least the NHS is recognizing some of the psychological issues surrounding what it refers to as confused “birth-registered males” and “birth-registered females.” And there are the haunting possibilities Cass raised in her letter to young people who may later regret allowing sex change procedures to be enacted upon them: “Why did no one tell me that that might happen?” Sad that the overall outlook of the NHS prohibits it from examining the spiritual aspects of some truly hurting children and young people. This article appeared originally on The Western Journal.