England’s National Health Service (NHS) has announced a landmark decision to end the prescription of puberty blockers at gender identity clinics. The move came in response to a review of gender identity services in England, which found that evidence of their safety and efficacy was lacking.
The review, revolving around data from 2022, included an interim report from Dr. Hilary Cass, who determined that there were “gaps in evidence” of the drugs being helpful to those with gender dysphoria. The BBC reports that she called for a remodeling of policies related to caring for children in gender-related distress.
The year 2022 saw a spike in referrals to Gender Identity Development Services (GIDS), from 250 to over 5,000 annually.
The move was welcomed by Health Minister Maria Caulfield, who promoted the idea of evidence-based care with regard to the controversial hormone therapy:
"We have always been clear that children's safety and wellbeing is paramount, so we welcome this landmark decision by the NHS,” Health Minister Maria Caulfield commented. "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."
Puberty blockers – clinically called puberty suppressing hormones – work to prevent the body from taking on the physical changes that pubescent hormones bring, such as the development of breasts for girls or facial hair for boys. While they do not reverse any changes that have already occurred, they can prevent more from taking place once administered.
The review noted that more studies must be conducted to identify long-term ramifications of such a treatment.
Not an outright ban
The new policy would prevent the “routine” prescription of puberty blockers to minors, but it has not banned them outright. The Guardian points out that children who are part of clinical trials may still receive prescriptions. There is at least one such trial scheduled to begin in 2024, but there has yet to be any word on who would be eligible to participate. It is estimated that fewer than 100 children remain on puberty blockers through the NHS.
A spokesperson for NHS commented on the decision, noting that it is not necessarily the end of the conversation on puberty blockers, but that more data is needed to reach a consensus:
“NHS England has carefully considered the evidence review conducted by NICE and further published evidence available to date. We have concluded that there is not enough evidence to support the safety or clinical effectiveness of puberty suppressing hormones to make the treatment routinely available at this time.”
