New restrictions applied for the prescription of puberty blockers

NHS England have announced new restrictions when prescribing puberty blockers to children who are wanting to change to the opposite sex.

Last week, the publicly-funded health service, NHS England stated they will no longer give the hormone-blocking medicines, known as goserelin and leuprolide, to trans youth attending gender clinics.

Commenting on the new restriction, the NHS said: ‘Outside of a research setting, puberty-suppressing hormones should not be routinely commissioned for children and adolescents who have gender incongruence or dysphoria.’

Instead, the hormones will now only be made available to children who take part in clinical trials or under specific circumstances – including those who had a history of treatment ‘outside NHS protocols’.

Updated guidance on the NHS website now says: ‘We are now going out to targeted stakeholder testing on an interim clinical commissioning policy proposing that, outside of a research setting, puberty-suppressing hormones should not be routinely commissioned for children and adolescents who have gender incongruence/dysphoria.’

This change will come into effect when new clinic replacing the Gender Identity and Development Service (Gids) begin to open later this year. No patients being treated by the current Gids service, however, will be affected.

More than 5,000 people responded to a consultation on the new service specification last year. The current service, run by the Tavistock and Portman Trust, is to close in March 2024 following an independent review carried out by Dr Cass – the paediatrician found the service is ‘unsuitable’ and said new model of care is needed.

Dr Cass said many children referred to Gids have complex needs that can be sometimes overlooked and around a third have autism or other types of neurodiversity.

In addition to this, the news has been announced during Pride Month which completely contrasts the meaning of the annual awareness month for individuals who identify as LBGTQ+. Following this, figures from the 2021 census show people aged between 16 to 24 are more than twice as likely to identify as being a part of the LGBTQ+ society and although this is huge progress, more work can be done, but now concerns have been cast since this announcement that authorities in England may not be as expecting as originally hoped.

Children who are looking to begin taking hormone replacements after the new rules come into force, and their families will also be ‘strongly discouraged’ from obtaining gender-affirming drugs such as hormones, from ‘unregulated sources’ or online providers.

A clinical study, run by the new Children and Young People’s Gender Dysphoria Research and Oversight Board, will look at the impact of drugs which delay puberty.

Further details on how the study will run will be released in the coming weeks, but only those signed up to take part in the research will be prescribed puberty blockers, except in exceptional circumstances on a case-by-case basis.

It is expected that the study will mostly involve looking at patient data and records.

Image: Ehimetalor Akhere Unuabona