NICE: National Institute for Health and Care Excellence Technology appraisal guidance, 26 May 2010
"Treatment with somatropin should always be initiated and monitored by a paediatrician with specialist expertise in managing growth hormone disorders in children. The choice of product should be made on an individual basis after informed discussion between the responsible clinician and the patient and/or their carer about the advantages and disadvantages of the products available, taking into consideration therapeutic need and the likelihood of adherence to treatment. If, after that discussion, more than one product is suitable, the least costly product should be chosen."
The BSPED wishes to highlight that the management of children with Gender Identity Dysphoria is a highly specialised area. All children and young people with this condition should only be managed by a specialized team of clinicians with expertise in this area.
In England and Wales these services are provided by the Gender Identity Development Service (GIDS) based in London and Leeds.
In Scotland the service is provided by Sandyford Clinic Glasgow, together with clinicians at the Glasgow Royal Children's Hospital.
In Northern Ireland the service is provided by the Royal Belfast Hospital for Sick Children.
All referrals should be directed to these institutions alone