England’s National Health Service (NHS) has announced significant restrictions on the use of puberty-suppressing drugs for children seeking gender-related treatments. It says that there is insufficient evidence to support the safety and clinical effectiveness of these drugs as a routine treatment option.
On Friday, NHS England said that: “outside of a research setting, puberty-suppressing hormones should not be routinely commissioned for children and adolescents who have gender incongruence/dysphoria.”
This policy change was foreshadowed in October and has now been formally implemented after a period of public comment. The new restrictions will take effect later this year.
The decision by the NHS to restrict the use of puberty blockers follows the closure of the Tavistock Gender Identity Development Service in London, the only youth gender clinic in the country. The clinic faced an overwhelming surge in referrals, from 250 young people in 2011 to 5,000 in 2021.
The effectiveness of puberty blockers has been a subject of bitter debate. While a Dutch study in the 1990s showed positive effects, a British study conducted at the Tavistock clinic in 2021 found no impact on psychological tests. This raised concerns about whether the drugs truly serve their intended purpose of giving adolescents time to consider their options.
James Esses, co-founder of Thoughtful Therapists, told the Daily Telegraph: “The fact that the NHS is holding firm on their intention to prevent the use of puberty blockers outside of the context of clinical trials is seismic. This will hopefully bring an end to vulnerable children being placed down a pathway to irreversible harm.”
And David Bell, a former governor of Tavistock, said: “All the evidence shows that puberty blockers don’t help, and there is clear evidence of physical and psychological harm caused by them, so this change is in line with the evidence we have. A very large percentage of children being treated for gender dysphoria have other problems such as autism and depression, and many are upset or confused about their sexuality.”
Other countries have also taken steps to limit gender-related medical treatments for young people. Finland has started restricting access to these treatments based on evidence reviews, while Sweden has limited the use of puberty blockers and hormones to clinical trials. Health bodies in Norway and the French National Academy of Medicine have also advised caution.