The National Gender Identity Healthcare Reference Group continues to meet and make progress against all the commitments set out within the referenced December 2021 Strategic Action Framework. This includes:

• Healthcare Improvement Scotland developing standards for gender identity healthcare for NHS Scotland;
• NHS Education Scotland developing a Transgender Health Knowledge and Skills framework for NHS staff;
• Public Health Scotland working with Health Boards to deliver publication of waiting times data by them; and
• Grant funding to the University of Glasgow to administer a programme of research on gender identity healthcare.

Decisions on clinical pathways are not for the Scottish Government. These decisions are for clinicians, based on the best evidence available, through the appropriate clinical governance structures.

The Scottish Government is unaware of any discussions between NHS Scotland Health Boards and the UK Government regarding the prescription of puberty-suppressing hormones as a treatment option for gender dysphoria.

The Scottish Government’s Aviation Statement, which will be published shortly, will set out actions that the Scottish Government will take to help achieve our aviation emissions reduction targets.

Additionally, we have already set out 45 recommendations for future investment in Scotland’s strategic transport network in the second Strategic Transport Projects Review, published on 8 December 2022. Within these recommendations we have considered airport access in our strategic transport planning considerations. These have been considered in the recommendations for mass or rapid transit systems for the Glasgow, Edinburgh and Aberdeen City Regions, in the form of Clyde Metro, Edinburgh and South East Scotland Mass Transit and Aberdeen Rapid Transit. These recommendations can provide a transformational change in the service provision, focusing on strategic routes and / or corridors where bus and rail provide the most effective service. This will improve access to an affordable and reliable public transport system within these City Regions.

National Planning Framework 4 is also now in effect. Policy 13, ‘Sustainable Transport’, has a clear intent ‘to encourage, promote and facilitate developments that prioritise walking, wheeling, cycling and public transport for everyday travel and reduce the need to travel unsustainably.’ It promotes the National Transport Strategy 2 and places the climate emergency at the forefront of decision making.

The Scottish Government will consider whether to buy low emission aircraft for use on the Glasgow to Campbeltown, Tiree and Barra air services, to replace the current Highlands and Islands Airports Limited owned aircraft, when such aircraft become commercially available. Our consideration will take into account such factors as the Scottish Government’s budgetary position and the reduction in emissions that available aircraft could likely deliver.

The Scottish Government is grateful for the latest advice from the Climate Change Committee. We have always been clear that meeting the legislated 2030 target – agreed by Parliament on a cross party basis - will be extremely challenging, and may not be feasible. Scotland is already half way to net zero and continues to decarbonise faster than the UK average.

On the 18th of April, Cabinet Secretary for Wellbeing Economy, Net Zero and Energy, outlined plans for a package to accelerate our actions to achieve net zero by 2045, which include a timeline for implementing demand management, to help us achieve our much needed target to reduce car usage.

We will carefully consider the report’s recommendations and provide a Scottish Government response in due course.

The Scottish Government does not hold the detail of this funding. Local decisions on how to allocate funding is the responsibility of NHS Boards.

Public Health Scotland (PHS) collects data and provides analysis on NHS spending and the cost of running services across the 14 territorial health boards, the Golden Jubilee, and the State Hospital. This information is published annually in the Scottish Health Service Costs release (‘Costs Book’).

The data has a breakdown of Hospital, Community, Family Health Services, and subsequent breakdown into sub-categories, however it does not specifically provide funding in preventative and early interventions (also note the difference between expenditure per Cost Book and funding per the question).

The Scottish Government understands that Public Health Scotland intends to publish, as official statistics in development, gender identity clinic waiting times information provided by NHS Grampian, NHS Greater Glasgow and Clyde, NHS Highland and NHS Lothian in late summer 2024. This will be subject to the necessary data quality and completeness standards being met.

The term “puberty-suppressing hormones” is non-specific, and could be applied to a range of medicines used for a variety of conditions.

In the context of the provision of gender identity healthcare to children and young people, I refer the member to question S6O-03286 on 28 March 2024. which is available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/official-report/search-what-was-said-in-parliament .

The Scottish Government does not routinely hold or collate this information. This information should be requested from the relevant Health Boards.

The Scottish Government welcomes the publication, on 10 April, of the final report and recommendations of the NHS England-commissioned Independent Review of Gender Identity Services for Children and Young People, chaired by Dr Hiliary Cass (‘the Cass Review’).

The findings of the review, and the associated systematic review papers, are being closely considered by both the Scottish Government and Health Boards in Scotland in the context of how such healthcare is best delivered here.

On 18 April, in a joint statement, NHS Greater Glasgow and Clyde and NHS Lothian confirmed that both Boards have paused any new prescription of puberty-supressing hormones and cross-sex hormones for young people as a treatment option for gender dysphoria.

The small number of patients directly impacted by this change, and their families, were notified in advance of this statement. It is right that they were the first to hear about it, sensitively and from the services caring for them, before a public statement was made.

The adaptive framework under the new Bill will enable tailored provisions and support to be implemented to support our food producers and we continue to co-develop effective policies to deliver the Vision for Agriculture. As a framework Bill it will not set thresholds which could restrict future flexibility.

How these powers will be used are set out in the Bills associated Policy Memorandum and Explanatory notes .

Future eligibility criteria will be co-developed with partners through the Ag Reform Programme.