NHS England has confirmed that children will no longer be prescribed puberty blockers, in a “landmark decision” announced this afternoon.
Parliamentary Under Secretary of State at the Department of Health and Social Care, Maria Caulfield MP, welcomed the ban, saying it will help ensure care is based on evidence and is in the “best interests of the child.”
The move, announced on Tuesday, will mean that gender identity clinics will no longer be permitted to prescribe the drugs to children, which halt the physical changes of puberty. It follows an independent review of the controversial practice.
A public consultation, interim policy, and an independent review of gender identity services for those under 18 had been commissioned by NHS England in 2020. The public consultation ran from 90 days, closing in November last year, gathering views on the policy proposition that puberty suppressing hormones should not be recommended to be available as a routine commissioning option for the treatment of children and adolescents who have gender incongruence or dysphoria.
It received more than 4,00 responses, roughly a quarter of which were from members of the public, 22% from patients, 21% from parents, 10% from adults identifying as transgender, and 5% from clinicians.
National director of specialised commissioning at NHS England, John Steward, told the Press Association news agency:
“Given that the debate is often very polarised, so too were the responses to the consultation.
“Many people said the policy didn’t go far enough in terms of still allowing potential access (to puberty blockers) through research, and others saying clearly they disagreed fundamentally and that these should be routinely available to everyone who believes they need it.”
The review, led by Dr Hilary Cass, was sparked by a sharp rise in referrals to the Gender Identity Development Service (GIDS) in London, operated by Tavistock and Portman NHS Foundation Trust, which will close its doors later this month.
An interim review, published by Dr Cass in 2022, highlighted a range of concerns around the use of puberty blockers. The review questioned whether puberty blockers “do indeed provide valuable time for children and young people to consider their options,” or whether they effectively ‘lock in’ children and young people to “a treatment pathway which culminates in progression to feminising/ masculinising hormones by impeding the usual process of sexual orientation and gender identity development.”
The review pointed to data from both the Netherlands38 and the study conducted by GID, which demonstrated that almost all children and young people who are put on puberty blockers go on to sex hormone treatment (96.5% and 98% respectively).
The review also said that the “unknown impacts” of puberty blockers on development, maturation and cognition “if a child or young person is not exposed to the physical, psychological, physiological, neurochemical and sexual changes that accompany adolescent hormone surges” was also a key concern.
“It is known that adolescence is a period of significant changes in brain structure, function and connectivity.40 During this period, the brain strengthens some connections (myelination) and cuts back on others (synaptic pruning). There is maturation and development of frontal lobe functions which control decision making, emotional regulation, judgement and planning ability. Animal research suggests that this development is partially driven by the pubertal sex hormones,” Dr Hilary Cass penned.
She said it raised a secondary question as to whether there is “a critical time window for the processes to take place,” or whether catch up is possible when oestrogen or testosterone is introduced later.
In the review, Dr Cass also noted a lack of long-term evidence and data collection on what happens to those prescribed the medication.
It is understood that NHS England hopes to have a study into the use pf puberty blockers prepared by December.
Conservative MP and health Minister Maria Caulfield today welcomed the development, saying: “We have always been clear that children’s safety and welling is paramount, so we welcome this landmark decision by the NHS.
“Ending the routine prescription of puberty blockers will help ensure that care is based on evidence, expert clinical opinion, and is in the best interests of the child,” she said.
Former Prime Minister Liz Truss, meanwhile, whose Health and Equality Acts (Amendment) Bill includes a ban on the prescription of body-altering hormones to children, both privately and on the NHS, said she welcomed NHS England’s decision to end the routine prescription of puberty blockers to children for gender dysphoria.
“I urge the Government to back my Bill on Friday which will reinforce this in law and also prevent these drugs being supplied privately,” Ms Truss said.
Fine Gael TD for Laois Offaly, Charlie Flanagan, said today that the development across the water was “good news,” however came “too late” for many.
“I repeat my call to @HSELive & @DonnellyStephen to establish an independent inquiry into the care and attention of over 200 Irish children who were treated at the discredited Tavistock clinic,” he wrote.
This is good news. Sadly, however for many it’s too late. I repeat my call to @HSELive & @DonnellyStephen to establish an independent inquiry into the care & attention of over 200 Irish children who were treated at the discredited Tavistock clinic. https://t.co/G9VexDs2Wo
— Charlie Flanagan (@CharlieFlanagan) March 12, 2024
Independent Senator Sharon Keogan was also among Irish politicians to welcome the news from Britain, sharing to X: “This day will go down in history as the day sanity came back into the room to save our children and early teens.”
This day will go down in history as the day sanity came back into the room to save our children and early teens. #PubertyBlockers#SaveOurChildren #ChildrenCannotConsent
@DonnellyStephen@rodericogorman @BernardGloster @KateDuggan8
Children to no longer be prescribed puberty…
— Senator Sharon Keogan (@SenatorKeogan) March 12, 2024