Ban on puberty blockers for trans under-18s ‘is unconscionable’, campaigners say
Puberty blockers for those under 18 with gender dysphoria will be banned indefinitely, the government has announced.
Puberty blockers, which pause the physical changes of puberty such as breast development or facial hair, are a form of gender-affirming healthcare for trans young people.
The Department of Health and Social Care said today that because of an ‘unacceptable safety risk’, private prescriptions of puberty blockers will be banned.
The ban does not apply to the fewer than 100 young people already actively using puberty blockers, to their use in clinical studies or for precocious puberty, when puberty starts at an unusually early age.
Health and Social Care Secretary Wes Streeting said the government intends to set up a clinical trial to establish evidence on puberty blockers.
He added: ‘We need to act with caution and care when it comes to this vulnerable group of young people, and follow the expert advice.’
In March, the NHS stopped offering puberty-suppressing medication to teenagers experiencing gender dysphoria – distress over the mismatch of their sex assigned at birth and gender identity.
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The announcement, which will be revisited in 2027, follows the publication of the NHS-commissioned Cass Report, a review of youth gender care.
Dr Hilary Cass, a paediatrician, described puberty blockers in the April report as ‘powerful drugs with unproven benefits and significant risks’.
The Conservative government placed a temporary emergency ban on puberty blocker treatments shortly after the Cass Report, one extended now by Labour.
Dr Cass said today: ‘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.’
Trans healthcare providers and advocates decried today’s announcement.
Susie Green, the co-founder of the gender health clinic Anne, told Metro: ‘To all the trans young people and their families who are watching the government target them right now, please be assured that we will continue to support you.
‘This is an attack on your autonomy, on your right to be yourself without shame and censure, and we are committed to protecting your right to access gender-affirming healthcare as needed.’
Keyne Walker is the strategy director of TransActual, a trans-led organisation that led a failed legal challenge against the ban earlier this year.
‘Banning medicines with no evidence of serious harm, only for trans people, using powers designed for contaminated and life-threatening drugs, is discrimination plain and simple,’ Walker said, adding it is an ‘an unconscionable act that will have severe ramifications for a generation of trans people’.
‘Evidence of the harm of the temporary ban continues to emerge, and will grow now that it has been made permanent.’
Walker other nations such as France or Germany are moving to make trans healthcare more accessible.
‘When the UK is an outlier used to try to restrict people’s access to healthcare elsewhere,’ they added, ‘then questions ought to be asked how can we be so different.’
What are puberty blockers?
If puberty was a TV show, puberty blockers would be the ‘pause’ button.
They’re medications that halt the production of estrogen or testosterone. These hormones press ‘play’ on puberty, essentially.
Medically speaking, the treatments are called gonadotropin-releasing hormone agonists, or GnRH agonists.
How do puberty blockers work?
Generally, these drugs work by disrupting the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).
These chemicals in people assigned as female at birth nudge the ovaries into making estrogen. In people assigned male at birth, they prompt testes to make testosterone.
Some puberty blockers come as shots given every one, three or six months by a medical professional. Another form is an implant.
Who can get puberty blockers?
Historically, puberty blockers have been used to treat precocious puberty. Sometimes, they are given for prostate cancer and endometriosis, when cells similar to the ones lining the womb grow elsewhere in the body.
They’ve also been used as a form of gender-affirming healthcare for trans young people who suffer from gender dysphoria.
When they’re prescribed in this way, it’s considered ‘off-label’, meaning it’s different to that described in the licence.
The thinking is stopping puberty helps trans youngsters avoid the mental stress of growing into a body that feels wrong and buys time to weigh up surgery when they’re adults.
But health officials have now banned the use of puberty blockers being prescribed to under-18s.
Now, they can’t be sold or supplied to new patients under 18 to treat gender dysphoria other than in ‘clinical trials’.
The decision was made following the Cass Report, which saw paediatrician Dr Hilary Cass review NHS treatment guidelines for youth gender care.
Her report published earlier this year described puberty-blocking medication as ‘powerful drugs with unproven benefits and significant risks’.
Following today’s announcement, the NHS webpage on gender dysphoria now says: ‘Puberty blockers are not available to children and young people for gender incongruence or gender dysphoria because there is not enough evidence of safety and clinical effectiveness.’
What do LGBTQ+ healthcare experts say?
Anne, a trans healthcare clinic, is against the ban. Describing puberty-blocking medication as ‘internationally recognised’, the provider says the drugs help trans youth ‘thrive’.
Another transgender healthcare provider, Trans Care BC, says withholding the treatment ‘can cause additional distress’.
Studies have suggested that trans teenagers on puberty blockers have better mental health, fewer ‘behavioural problems’ and lower odds of suicidal ideation.
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