England’s health service says it won’t give puberty blockers to children at gender clinics

The publicly funded healthcare system in England has recently made a decision not to routinely provide puberty-blocking medications to children attending gender identity clinics. The NHS asserts that additional evidence is necessary to fully understand the potential benefits and risks associated with such treatment.

The NHS announced on Friday that “outside of a research environment, hormones that suppress puberty should not be routinely prescribed for children and adolescents.” However, individuals under the age of 18 may still receive puberty blockers in exceptional circumstances, while a clinical study examining their effects on children is set to commence by next year.

Scheduled to open later this year, four new regional clinics will replace London’s Gender Identity Development Service, which was the sole facility of its kind in England. A review concluded that the service was overwhelmed by increasing demand and lacked sufficient evidence regarding treatment outcomes, leading to its scheduled closure.

Hormone blockers, capable of temporarily halting puberty, are sometimes prescribed to children experiencing gender dysphoria. In the United States, transgender medical care for minors has been available for over a decade and is endorsed by prominent medical associations.

While the issue of gender-affirming care for children is not as contentious in Britain as it is in the United States, where several Republican-led states have prohibited puberty blockers and other treatments for transgender minors, it has still been the subject of political and legal disputes.

The NHS describes the new guidelines as an “interim policy” that will undergo further review, taking into account the findings of a research study on the impact of puberty-suppressing hormones on gender dysphoria in children and young people.

Last year, a review led by pediatrician Dr. Hilary Cass highlighted “evidence gaps” concerning the use of blockers in gender services for children.

Under the NHS’s new regulations, doctors at the new clinics will still have the discretion to prescribe these medications outside of a research context “on a case-by-case basis” subject to approval from a national panel of medical experts.

It is important to note that the NHS’s decision does not prohibit children and their families from seeking puberty blockers elsewhere; however, doing so will be strongly discouraged by the NHS.

Additionally, once this policy is implemented, the requirement for young people to undergo a specific duration of puberty-blocking treatment before receiving hormone therapy will no longer be necessary, as acknowledged by the NHS.

In 2020, England’s High Court ruled that children under 16 were unlikely to provide informed consent for medical treatment involving puberty-delaying drugs. However, this decision was overturned in 2021 by the Court of Appeal, allowing doctors to prescribe puberty blockers to children under 16 without parental consent.

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Frequently Asked Questions (FAQs) about puberty blockers

More about puberty blockers

• NHS England: Official website of NHS England.
• Gender Identity Development Service: Information about the Gender Identity Development Service in the UK.
• Gender Dysphoria: Overview of gender dysphoria from the American Psychiatric Association.
• Transgender Healthcare: LGBTQIA Provider Guide that includes information on transgender healthcare.
• Puberty Blockers: Information about puberty blockers and their use in the treatment of gender dysphoria from the NHS.
• Children and Consent: NHS’s response to the Supreme Court decision regarding children’s consent to medical treatment.