Advice for NAHT members in maintained schools, academy trusts and academies in England that explores schools’ duties towards their transgender pupils.

May 2024

In 2020, NHS England and NHS Improvement commissioned an Independent Review of Gender Identity Services for Children and Young People (the 'Cass Review') to make recommendations about the services provided by the NHS to children and young people who are questioning their gender identity or experiencing gender incongruence. 

As part of this guidance development, we referenced aspects of the Cass Review’s interim report, which were felt to be helpful considerations for schools. Aspects of the interim report from the Cass Review were also referenced in the government’s draft guidance on gender-questioning children. 

While the analysis of the interim report remains correct, in April 2024 the Cass Review’s final report was released. Although its remit remained focused on NHS services, the final report also included aspects that school leaders may find helpful in considering as part of any approach.

Social transition

• The Cass Review advised that a more cautious approach around social transition should be taken for children than for adolescents. 
• In additional FAQs, the Cass Review also advised that it is important to try and ensure that those already actively involved in the young person’s welfare provide support in decision making and that plans are in place to ensure that the young person is protected from bullying and has a trusted source of support.

Parental Engagement

For both children and adolescents’, outcomes are best if they are in a supportive relationship with their family. For this reason, parents should be actively involved in decision making unless there are strong grounds to believe that this may put the child or young person at risk. 

Clinical support

• The Cass Review suggested that 'when families/carers are making decisions about social transition of pre-pubertal children, services should ensure that they can be seen as early as possible by a clinical professional with relevant experience', and 'clinical involvement in the decision-making process should include advising on the risks and benefits of social transition as a planned intervention, referencing best available evidence. This is not a role that can be taken by staff without appropriate clinical training'. The Cass Review also notes it is important that flexibility is maintained, and options remain open
• Helping parents and families to ensure that options remain open and flexible for the child, whilst ensuring that the child is able to function well in school and socially is an important aspect of care provision and there should be no lower age limit for accessing such help and support
• The holistic assessment framework (developed by the Clinical Expert Group alongside the Cass Review) is split into eight non-sequential domains centred around the individual child/young person and their parents/carers. One of these is 'education setting and social context':

- Consideration of the child/young person’s functioning in relation to education, their broader well-being and the nature of their peer relationships is important in assessing their overall functioning and supports a holistic understanding of their strengths and vulnerabilities

- It is important to obtain information about school attendance and any difficulties in educational achievement, as well as a recent Education, Health and Care plan for any young person with special educational needs

• 'School reports, when thoughtfully completed were extremely useful in confirming whether the child had capacity and ability to consent' - as such, members may wish to facilitate and fulfil, insofar as is possible, any requests for information made to the school as part of a clinical process relating to a gender questioning or gender incongruence student. 

March 2024

This briefing was provided to aid members pending the anticipated publication of guidance by the Department for Education (DfE). On 19 December 2023, the DfE released a consultation on draft non-statutory guidance on gender-questioning children, which NAHT has responded to. You can read a summary of the draft guidance for school leaders and find out more about our response to the consultation here. 

While leaders, governors and trustees may wish to review the DfE’s draft guidance when considering any approaches, it is important to underline that you do not need to change your current policies at this stage.

Once the DfE's guidance has been finalised, we will review this joint guidance accordingly. Until then we have retained this as an additional reference for members who are considering their approaches.