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Despite the self-harm and his mental state, the ambulance staff tell the on-duty nurse that the outside mental health assessment service CASS, had refused to intervene, saying the patient wasn't in crisis.

A spokesman pointed out that the landmark Cass Review into gender care published last year did not call for a ban of cross-sex hormones for those aged 16 to 18.

But the Cass Review found that there was a lack of research and "weak evidence" for medical interventions.

Last year a review by paediatrician Dr Hilary Cass found a lack of evidence around treatment for under-18s with the drugs.

She said the Cass review "included a significant programme of engagement, including with young people".