What has happened since the Cass Review was launched nearly four years ago?

The Cass Review was commissioned by NHS England to look into gender services for children (Alamy/PA)

A major review into gender services for children and young people has been published.

Here is a timeline of events since it was launched almost four years ago.

GIDS at the Tavistock trust was the only service available in England for children and young people with gender dysphoria (Aaron Chown/PA) — Gids at the Tavistock Centre was the only service available in England (Aaron Chown/PA)

– 2020

September: The Independent Review of Gender Identity Services for Children and Young People is commissioned by NHS England and NHS Improvement to make recommendations about NHS services for gender-questioning children and young people.

Led by Dr Hilary Cass, former president of the Royal College of Paediatrics and Child Health, it is known as the Cass Review.

NHS England says it has been established “in response to a complex and diverse range of issues” including the significant rise in referrals to the Gender Identity Development Service (Gids) at the Tavistock and Portman NHS Foundation Trust from just under 250 in 2011/12 to more than 5,000 in 2021/22.

October and November: The Care Quality Commission (CQC) inspects Gids, which is the only service available in England for children and young people with gender dysphoria, also treating children and young people from Wales.

– 2021

The Care Quality Commission rated Gids inadequate in a 2020 inspection (Alamy/PA)

January: The CQC publishes its inspection report which rates the service inadequate overall.

The watchdog says the service is difficult to access, with young people waiting more than two years for their first appointment, and that staff do not develop holistic care plans for patients, with “significant variations in the clinical approach of professionals” and no clarity in records on why decisions had been made.

– 2022

March: Dr Cass publishes her interim report, saying a “fundamentally different service model is needed which is more in line with other paediatric provision”, and concluding that a sole provider of such services is “not a safe or viable long-term option”.

July: The NHS announces Gids will close and be replaced with a regional network, aimed to be up and running by spring 2023.

– 2023

The deadline for the regional clinics to be operating is pushed back amid what NHS England describes as the “complex” set-up of the “completely new service”. The new aim is spring 2024.

– 2024

NHSE said it hopes two new regional hubs will be the first of up to eight specialist centres (Alamy/PA) — NHS England said it hopes two new regional hubs will be the first of up to eight specialist centres (Alamy/PA)

March: NHS England confirms children will no longer be prescribed puberty blockers at gender identity clinics, saying there is not enough evidence to support their “safety or clinical effectiveness” and that they would only be available to children as part of clinical research trials.

April: New regional hubs open as the Gids at Tavistock officially closes.

Led by London’s Great Ormond Street Hospital and Alder Hey Children’s Hospital in Liverpool, NHS England hopes they will be the first of up to eight specialist centres as part of the north and south hubs over the next two years.

The Cass Review’s final report is published.