NHS pauses gender-affirming hormone prescriptions for 16 and 17-year-olds
NHS England has paused the prescribing of gender affirming hormones for gender incongruence or dysphoria in 16 and 17-year-olds after a review found there was not enough evidence to support their use.
Young people already being prescribed the hormones will be able to continue if they and their parent or guardian and their lead clinician in the NHS Children and Young People’s Gender Service ‘agree in writing that continuation is in their best interests’.
It follows existing guidance which states the hormones should not be prescribed to under-16s for gender treatment.
The pause is being put in place alongside a 90-day public consultation on halting use of the treatments on the NHS for those under 18 years.
All feedback will be considered before the clinical policy is finalised, NHS England said.
A review of the evidence on masculinising and feminising (MAF) hormones for children and adolescents who have gender incongruence or dysphoria was set up following a recommendation in the Cass Report published in 2024.
NHS England commissioned a third party to carry out the independent evidence review including research published since NICE’s previous review of the evidence in 2021.
The review considered evidence on a range of outcomes including mental health and quality of life.
It reported there was ‘very limited and weak evidence’ to support the continued access to MAF hormones by children and young people under the age of 18 years.
NICE had also found limited evidence about the safety, risks, benefits and outcomes related to prescribing of the hormones in young people under 18 years of age.
Under the updated policy, young people who cannot access the treatment will be offered other forms of care at one of the three NHS gender clinics for children currently operating in England.
Professor James Palmer, NHS England’s national medical director for specialised services, said the review had been thorough and complex.
‘The NHS has exercised extreme caution when considering starting young people on this treatment – in accordance with the advice from Dr Cass – and as part of this action will now be pausing any new referrals for this treatment for 16-17 year-olds.
‘The NHS continues to offer specialist support for under 18s managing gender incongruence, including mental health support and referral to specialist children and young people’s gender services where appropriate.’
Some advocacy groups reacted to the news with dismay and said it would discriminate against transgender young people.
TransLucent called the move was ‘yet another blatant act of discrimination against transgender youths’ healthcare, which has been systematically eroded since the Cass review.
‘We will critically assess the NHS’s evidence before responding, but given the gravity of these human rights concerns, we will consider legal action.’
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READERS' COMMENTS [2]
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Given that detransitioners are suing (due a lack of informed consent), then it makes medicolegal sense to only issue to 18 plus patients, but never to under 16s.
The 16-17 grey area has always been a challenge, as consent is usually considered informed if over 15, but given the real risk of detransitioning in adulthood it’s probably safer for doctor and patient to ask them to delay until 18, when nobody can retrospectively claim they could not adaquately consent.
@David
“…18, when nobody can retrospectively claim they could not adequately consent.”
Well, not on age grounds. But I suspect that there may eventually be legal claims against gender clinics even for adults, on the grounds that consent was not valid.
I’m not an expert in gender medicine but my understanding is that the whole rationale has been to allow patients to “live as the opposite sex”. Now the high court, EHRC and supreme court have established that ever since 2010 the Equality Act has meant that people have not had a legal right to access single sex services (EG changing rooms, sports teams, rape crisis services) that do not match their biological sex. And this is regardless of what hormones or surgery they have had, and regardless of the possession of a gender recognition certificate.
It raises the question of whether gender identity clinics have been offering an endpoint (“living as the opposite sex”) which was not legally available. If so that would raise knotty questions about informed consent.