Letter to Care Inspectorate (Scotland): Formal complaint regarding the “Guidance for children and young people’s services on the inclusion of transgender including non-binary young people”

Jackie Irvine  

Chief Executive Officer 

Care Inspectorate

Compass House

11 Riverside Drive

Dundee

DD1 4NY 

cc Doug Moodie, Chair, Care Inspectorate 

    Joanna MacDonald CSWO, NSWA 

    Siobhan Brown MSP, Minister for Children, Young People and The Promise  

8 September 2026 

Formal complaint regarding the “Guidance for children and young people’s services on the inclusion of transgender including non-binary young people” (updated 2026) is contrary to Health and Social Care Standards which the Care Inspectorate must uphold, in particular standared:4. 11 I experience high-quality care and support, based on relevant evidence, guidance and best practice. The Guidance does not have an evidence base and compromises the safeguarding and welfare of children in care of the state.  

Dear Jackie Irvine, 

We are writing to register a formal complaint about the recently re-issued “Guidance on the Inclusion of Transgender and Non-binary Young People in Children and Young People’s Care Services”.  The Guidance is not evidence-based and contains recommendations which have not been established as being in the best interests of children and as such is in breach of the Health and Social Care Standards which you are committed to uphold.   

Despite growing evidence of harm of affirmative practices, the Care Inspectorate Guidance continues to promote the notion of the “trans child” and the practice of affirmation of a child’s belief that he or she is in the “wrong” sex and “wrong” body. This ideological stand undermines the safety, welfare and best interests of some of the most vulnerable children in Scotland – those who are looked after by the state. By adopting the extreme positions and practices that it does, the Guidance undermines the protection of children in care from harm.  

The latest guidance acknowledges, as it must, the Cass Review’s findings on the rapid rise in gender dysphoria, the high rates of looked-after status, adverse childhood experiences, neurodiversity and mental health problems among this cohort, and also the Supreme Court ruling of April 2025 that “sex” in the Equality Act 2010 means biological sex. Yet it fails to recognise the import of these, and does not translate them into an evidence based, cautious, exploratory, safeguarding-first approach. Instead, it continues to centre organisations and practices rooted in an affirmation model that treats self-declared gender identity as settled fact to be validated and facilitated by services.  

Key examples of activist influence and breach of Standards notably 4.11 include: 

• Explicit thanks to LGBT Youth Scotland for support in developing the earlier version, repeated reliance on that organisation’s materials, surveys and recommendations, and promotion of its posters, information and events (including Pride, Trans Awareness Week and Purple Friday). Similar prominence is given to Stonewall resources. These are advocacy groups with a clear ideological position, not neutral clinical or safeguarding authorities. Their involvement shapes the tone, language and recommended practice far more than the cautionary evidence from Cass or the legal clarity on biological sex. 

  
  

• Encouragement of “LGBT visibility” measures such as displaying trans flags, rainbow lanyards, and affirming memorabilia as markers of good practice. One case example celebrates staff unexpectedly decorating a care home with trans flags. For traumatised children who may be seeking belonging, attention or escape from distress, such signals can function as social incentives rather than neutral support.  Demanding that staff should support ideological claims about gender, undermines their ability to safeguard these vulnerable children from making decisions that they cannot know or understand the consequences of.   

• Language and practice that prioritise preferred names, pronouns and identity affirmation while warning against suggesting a young person may be “confused” or that feelings could be “just a phase.” While the text notes that identity can change, the overall framing discourages exploratory curiosity about underlying causes (trauma, autism, same-sex attraction, social contagion, peer influence) that Cass and subsequent evidence have highlighted as common.  

  
  

Looked-after children are among the most vulnerable children in Scotland. They frequently present with histories of abuse, loss, neglect, attachment difficulties, autism/ADHD and mental illness – exactly the comorbidities Cass identified as elevated in gender-distressed cohorts. Affirmation-first approaches that socially transition or facilitate medical pathways without a holistic and sensitive exploration of the causes of distress and alternative explanations place these children at heightened risk of irreversible harm through being put on a medical pathway to medicalisation, infertility, sexual dysfunction.  

Services should not be "guided” to adopt activist-derived materials as “current good practice” while ignoring the growing body of evidence of harm. The failure to refer to advice offered by Genspect, Transgender Trend, Hannah Barnes’ book Time to Think, or to any alternative to activists’ one-dimensional advice to “affirm” points to a refusal to consider the range of evidence that is readily and widely available.  The lack of any attention to well-accepted understanding of child-development, and to principles of holistic mental-health care is a dereliction of the regulator’s safeguarding responsibility. 

The protected characteristic of gender reassignment does not require that a child’s belief about their gender identity must be affirmed.  It means that that child should not be treated less favourably than children who do not have that protected characteristic. Having their sex denied, their identity changed, and their body parts surgically removed without evidence of any benefit is clearly a detriment.   Care services should not be encouraged to treat sex as mutable, to suppress biological reality in language and provision, or to outsource policy and best practice development to campaigning organisations. Single-sex spaces, accurate record-keeping by biological sex, and a default of exploratory psychological support remain both lawful and essential for the safety of all children, especially girls and those with complex trauma. 

We request that you: 

1. Withdraw and substantially revise the guidance to remove activist framing and centre evidence-informed, safeguarding-first principles. 

2. Commission an independent review involving clinicians, safeguarding experts and gender-critical or sex realist perspectives rather than primarily the claims and recommendations of reckless advocacy groups. 

3. Ensure future materials prioritise biological sex for risk assessment, accommodation and privacy, treat social transition as a significant psychosocial intervention requiring careful multi-disciplinary consideration, and avoid incentives that may encourage identity-based claims among distressed children. 

4. Confirm what steps will be taken to audit current practice in regulated services for any evidence of ideologically driven rather than clinically driven support. 

   
   

Vulnerable children in care deserve protection from contested ideology as much as from every other form of harm. The current guidance fails that test. We look forward to your substantive response and to evidence that the Care Inspectorate will prioritise children’s welfare over activist pressure. 

Carolyn Brown, Retired Depute Principal Educational Psychologist, Chair of Scot PAG 

Maggie Mellon, independent social worker, Chair of EBSWA 

Brigid Daniel Professor Emerita Queen Margaret University 

Jane Fenton Professor Emerita University of Dundee 

Mary Howden, retired social worker, Director Women’s Rights Network 

Jane McClenachan,