Health Secretary Wes Streeting insisted he is “determined” to improve healthcare for trans people as he announced an indefinite ban on puberty blockers for children.
The decision was announced after the Government took advice from independent experts who warned prescribing such medication to under-18s for gender dysphoria “presents an unacceptable safety risk for children and young people”.
While puberty blockers had been banned on the NHS – outside clinical trials – since March, an order preventing the prescription of the medication from European or private prescribers since May had only been temporary.
The Department of Health and Social Care (DHSC) said legislation was being updated on Wednesday to make that order indefinite, and that the ban will be reviewed in 2027.
While health is a devolved matter, the ban applies across the UK, the department said, adding that the decision had been taken in consultation with the Scottish and Welsh governments, and in agreement with the Northern Ireland government.
Mr Streeting, making a statement in the House of Commons, acknowledged the decision will not be welcomed by everyone but sought to reassure young trans people.
He said he had met many of them since taking up his post in July, and listened to their concerns, fears and anxieties.
In a message directly to them and referencing having come out as gay, he said: “I know it’s not easy being a trans kid in our country today, the trans community is at the wrong end of all of the statistics for mental ill health, self-harm and suicide.
“I can’t pretend to know what that’s like, but I do know what it’s like to feel you have to bury a secret about yourself, to be afraid of who you are, to be bullied for it, and then to experience the liberating experience of coming out.
“I know it won’t feel like it based on the decisions I’m taking today, but I really do care about this and so does this Government. I am determined to improve the quality of care and access to healthcare for all trans people.”
He said decisions were being taken “based on the evidence and advice of clinicians, not politics or political pressure”.
The decision came after the Commission on Human Medicines (CHM) concluded puberty blockers for people with gender dysphoria presented “an unacceptable safety risk for children and young people under 18 years without significant additional safeguards”.
NHS England said the decision “closes a loophole that posed a risk to the safety of children and young people” through private provision.
The ban applies to new patients only, with NHS and private patients already receiving these medicines for gender dysphoria continuing to have access.
The Cass Review into children’s gender care had concluded the quality of studies claiming to show beneficial effects of puberty blockers for children and young people with gender dysphoria was “poor”.
Its author Dr Hilary Cass, now Baroness Cass, welcomed the Government’s announcement, describing puberty blockers as “powerful drugs with unproven benefits and significant risks”.
She said: “That is why I recommended that they should only be prescribed following a multi-disciplinary assessment and within a research protocol.
“I support the Government’s decision to continue restrictions on the dispensing of puberty blockers for gender dysphoria outside the NHS where these essential safeguards are not being provided.”
Despite opposition from some, plans remain in place to set up a clinical trial into the use of puberty blockers next year, with an aim to recruit the first patients by spring.
Mr Streeting said the trial will help to “establish a clear evidence base for the use of this medicine”.
Recognising division on the subject, he told the Commons: “There are some who have called on the Government not to go ahead with the clinical trial recommended by Dr Cass.
“Others on the opposite side of this debate want the Government to ignore the recommendations of the independent expert Commission on Human Medicines.
“We are taking a different approach. The decisions we take will always be based on the evidence and advice of clinicians, not politics or political pressure.”
James Palmer, NHS medical director for specialised services, welcomed the ban but recognised it “will be a difficult time for young people and their families who are affected”, adding that targeted support through local mental health services was on offer.
A third NHS children’s gender clinic for patients in England and Wales opened in Bristol in November, following in the footsteps of two hubs, led by London’s Great Ormond Street Hospital (Gosh) and Alder Hey Children’s Hospital in Liverpool, which opened in April.
In total, up to eight new NHS children’s gender clinics – for children of any age – are due to open by 2026.
These clinics have been set up following the closure of the Gender Identity Development Service, which had been run by the Tavistock and Portman NHS Foundation Trust, at the end of March.
– Anyone affected by the announcement can contact agem.cyp-gnrss@nhs.net or call 0300 131 6775 and select option 3.