The British National Health Service on Tuesday issued new guidance permanently prohibiting the prescription of puberty blockers for children for the purposes of gender transition.
“We have concluded that there is not enough evidence to support the safety or clinical effectiveness of puberty suppressing hormones to make the treatment routinely available at this time,” an NHS spokesperson said in a statement obtained by the Washington Examiner.
Puberty blockers, which are often included in treatment plans for gender transitions for children with gender dysphoria, will now only be available to minors who are participating in clinical trial research.
“Puberty suppressing hormones are not available as a routine commissioning treatment option for treatment of children and young people who have gender incongruence / gender dysphoria,” the NHS spokesperson said.
Fewer than 100 minors are on puberty blockers in the United Kingdom, being seen by endocrinologists at Leeds and University College London Hospital. They will be able to continue their treatment under the new regulations.
The change comes following an NHS-sanctioned independent review of gender transition surgeries and hormone therapy for minors written in 2020, examining nine peer-reviewed studies.
Report author and pediatrician Hilary Cass said the basis of the support for puberty blockers consisted of “small, uncontrolled observational studies, which are subject to bias and confounding, and all the results are of very low certainty.”
The investigation was initially launched following a swell of referrals to the Gender Identity Development Service, run by Tavistock and Portman NHS Foundation Trust. In April 2022, there were over 5,000 referrals to the GIDS, compared to the 250 referrals in 2012.
The GIDS clinic will be closing at the end of March, to be replaced by two new NHS locations in London and Liverpool.
For certain rare medical diagnoses, such as precocious puberty, puberty blockers may be medically necessary to slow a child’s developmental process that is advancing rapidly due to brain or hormone disorders.
Although advocates of gender transition medicine argue that puberty blockers only pause the physical maturation process, certain evidence finds the negative health consequences of prolonged use of puberty blockers to include decreased bone density and cognitive function or development.
Last June, the NHS issued a preliminary policy preventing the use of puberty blockers in minors, noting that there is a high rate of co-diagnosis between gender dysphoria and neurodevelopmental conditions.
“A significant proportion of children and young people who are concerned about, or distressed by, issues of gender incongruence experience coexisting mental health, neuro-developmental and/or personal, family or social complexities in their lives,” according to the June policy guidance. “The relationship between these presentations and gender incongruence may not be readily apparent and will often require careful exploration.”
England’s High Court in 2020 ruled that it is “highly unlikely” children younger than 14 would be competent to give consent to administer puberty blockers.
“We recognise that clinicians may well regard these as cases where the authorisation of the court should be sought prior to commencing the clinical treatment,” the court said at the time.
Last October, Secretary of State for Health and Social Care Steve Barclay made an announcement at the annual Conservative Party conference that the NHS would be reverting back to sex-specific language amid challenges with transgender-inclusive policies.
“As conservatives, we know what a woman is, and the vast majority of NHS staff and patients do, too,” Barclay said at the time.
