Scotland’s national health service for young people has paused prescribing puberty blockers for new patients under 18 years old following guidance issued last month by the national health service in England prohibiting the gender-affirming treatment.

Puberty blockers pause puberty changes by stopping the body from producing sex hormones including testosterone and estrogen. They can be prescribed to alleviate psychological distress resulting from a mismatch between one’s sex assigned at birth and one’s gender identity.

The Sandyford Clinic, located in Glasgow, announced that new patients aged 16 and 17 “will no longer be prescribed gender affirming hormone treatment until they are 18 years old,” wrote the clinic. Existing patients currently receiving treatment will not be affected.

NHS Greater Glasgow and Clyde (NHSGGC), the national health branch overseeing the clinic, said Thursday that it had contacted patients this week to advise that the prescription of puberty hormone suppressants and gender affirming hormones to young people was paused following research findings published in March by NHS England.

The independent review, led by Dr. Hilary Cass, a consultant pediatrician and former President of the Royal College of Paediatrics and Child Health, found insufficient long-term evidence of outcomes for youth prescribed puberty blockers. As a result, NHS England banned children from receiving puberty blockers except as part of clinical research trials.

NHSGGC and NHS Lothian, another area in Scotland, said that “on clinical advice,” they had deferred starting new patients on these treatments in mid-March in response to the position taken by NHS England and while awaiting publication of the Cass Review. After the review was published and with support from the Chief Medical Officer for Scotland, the health boards formally paused treatment.

Existing patients “will continue on treatment with close monitoring and support, as they wish to and as guided by individual clinical assessments within each service,” the local health agencies confirmed.

Dr. Emilia Crighton, NHSGGC Director of Public Health, said in a statement that the Cass Review findings are important, and the next step is to “work with the Scottish Government and academic partners to generate evidence that enables us to deliver safe care for our patients.”

“We echo the views of Dr. Hilary Cass that toxicity around public debate is impacting the lives of young people seeking the care of our service and does not serve the teams working hard to care and support them,” Crighton said.

Both the health agencies and the Sandyford Clinic said in statements that they were committed to supporting young people seeking gender treatment.

“We are committed to providing the best possible clinical care for young people accessing and understanding the distress that gender incongruence can cause,” said the Sandyford Clinic. “While this pause is in place, we will continue to give anyone who is referred into the Young People Gender Service the psychological support that they require while we review the pathways in line with the findings.”

TIME has reached out to NHSGGC and the Sandyford Clinic for comment and further information.