England’s National Health Service (NHS) will no longer offer puberty-blocking medications to youths under 18 in its clinics, unless they are enrolled in clinical trials planned for the end of the year.
“Puberty suppressing hormones (PSH) are not available as a routine commissioning treatment option for treatment of children and young people who have gender incongruence/gender dysphoria,” according to the NHS final policy.
“We have concluded that there is not enough evidence to support the safety or clinical effectiveness of PSH to make the treatment routinely available at this time,” the policy report noted.
According to The Guardian, the health service plans to replace its Gender Identity Development Service with two clinics — one at the Great Ormond Street Hospital in London, which confirmed it was partnering with the NHS for the new national service, and Alder Hey Children’s Hospital in Liverpool.
Patients already being prescribed the medications will continue to have access to them. The Guardian reported that there are fewer than 100 patients currently being prescribed puberty blockers. However, the interim report commissioned by the NHS said that as of 2021, there were 4,600 young people on the waiting list for gender care and 2,500 more being referred for care per year.
An NHS spokesperson told ABC News that a study on the use of these medications in youth is planned to begin in December of this year, with eligibility criteria not yet defined.
The change comes after a public consultation period, and reports commissioned by the NHS that concluded that existing literature concerning gonadotropin-releasing hormone (GnRH) agonists was “of very low certainty” and that “gaps in the evidence base” prevented them from giving definitive guidance.
GnRH agonists are used in other medical treatments, including for precocious puberty, endometriosis, and prostate cancer, as well as inducing ovulation. Medical organizations backing access to gender-affirming care for youth, including medications when indicated, include the American Medical Association, the American Psychiatric Association, the Endocrine Society, and the American Academy of Pediatrics.
Mermaids, a British advocacy group for trans youth, told MedPage Today in an email that “this announcement is deeply disappointing, and a further restriction of support offered to trans children and young people through the NHS, which is failing trans youth. There were virtually no first appointments offered in 2023, with ever-growing waiting lists of over five years.”
However, they characterized the change as a pause.
“Those currently prescribed puberty blockers won’t see any changes to their treatment, and this is a pause on prescribing — not a ban,” the group said. “It’s also important to note that puberty blockers can be just one possible part of a young person’s gender journey. However, this news still comes as a blow and will deeply affect our communities.”
The change in policy comes as 23 states in the U.S. have banned or restricted gender-affirming care for youth, often citing U.K. and European clinical reviews and policy changes.
In an email to MedPage Today, Joshua Safer, MD, executive director of the Mount Sinai Center for Transgender Medicine and Surgery in New York City, wrote, “We have many decades of experience with the puberty pausing medications referred to as ‘puberty blockers’ and we have not found harm in adults who were treated with these medications when they were adolescents.”
In a Time story, Jack Turban, MD, director of the Gender Psychiatry Program at the University of California San Francisco, said, “Research consistently links gender-affirming medical care (including pubertal suppression) for adolescent gender dysphoria to improved mental health outcomes.”
“It is sad to see this medical care, which many adolescents dramatically benefit from, be so woefully politicized,” he added.
The NHS did not respond to a request for comment.
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