Transgender children will be tested for autism under new plans to identify any underlying "neurodevelopmental conditions".
The NHS is understood to have revised their guidance so that every child referred to a gender clinic is "holistically assessed for neurodevelopmental conditions" such as ADHD.
After Baroness Cass conducted her review into gender identity services for children across the UK last year, it was revealed that young people who experience gender dysphoria are more likely to suffer from such conditions.
As a result, children's mental health, familial relationships and sexual development will be assessed and evaluated by medical professionals.
Children's mental health, familial relationships and sexual development will be assessed and evaluated by medical professionals (Stock)
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Another aspect of the assessment will address whether the child experiences attraction to the same sex, The Telegraph reports.
Patients will be asked about their "mood, anxiety, emotional regulation, beliefs around weight, potential somatic symptoms, concentration, sleep and appetite, self-harm, and suicidal thoughts and behaviour".
After a public consultation, the new rules will be enforced later in the year.
An NHS spokesman said: "As part of NHS England's commitment to implement advice from the Cass Review, we have recently gone out to stakeholder testing on a proposed revised specification planned to replace the interim service specification for the Children and Young People's Gender Service.
"We will soon be going to full public consultation on this draft specification which sets out the new holistic assessment framework that was described by Cass in her report.
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"NHS England has recently changed the referral pathway so child patients can only access gender services that we commission if they're referred by a paediatrician or a child and adolescent mental health worker."
Medics working at gender clinics across London and Manchester will be the first to use the guidance after Cass approved the plans earlier this year.
Previously, she identified a connection between young girls "struggling with gender identity, suicidal ideation and self-harm" and those with "undiagnosed autism, which is often missed in adolescent girls".
She found it to be the "common denominator" after research revealed that the chances of being autistic were three to six times more likely for transgender people.
The Tavistock Centre in London is the largest and oldest gender clinic in the UK
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A spokesman for Bayswater Support Group welcomed the NHS' "more careful and holistic assessment" but criticised its "scant recognition of the environmental factors influencing children's understanding of gender issues".
The advocacy group which provides a space for parents with transgender children warned that schools still teach gender identity as "fact" and accused the establishments of allowing children to "socially transition without parental consent".
Similarly, the co-chairman of the Clinical Advisory Network on Sex and Gender praised the "proposed holistic approach" and "prioritisation of psychological interventions".
However, GP Dr Louise Irvine highlighted a flaw in the guidance, pointing out that the new rules would "leave the door open for referral of children and young people under 18 for cross-sex hormones".
