NHS halts cross-sex hormone drugs for under-18s

The NHS in England has stopped new prescriptions for cross-sex hormones for 16 and 17-year-olds after a review found that there was “really weak” research into the effectiveness of such drugs.

Cross-sex hormone drugs are used by those who consider themselves to be transgender. They enable a person to develop characteristics associated with their preferred gender rather than their biological sex. Some changes, such as a breast growth or a deeper voice are not reversible.

The NHS has announced they will be pausing any new prescriptions of these drugs to 16 and 17-year-olds. Current guidelines do not allow for hormone treatments to be prescribed for under-16s. Young people who are already taking the hormones will still continue to receive them, but will need to review their treatment with medical professionals.

In 2024 Dr Hilary Cass published her report into children’s gender care, which concluded that children were being let down by “remarkably weak evidence” on medical treatments being used. The report also called for “clear clinical rationale for providing hormones at this stage rather than waiting until an individual reaches 18”.

NHS England commissioned ten independent reviews into various aspects of cross-sex hormone treatment. The reviews found that there was “really weak” evidence to make a conclusion about the effectiveness of these drugs.

Professor James Palmer, National Medical Director for Specialised Services at NHS England, said: “This review has established that the available evidence does not support the continued use of masculinising or feminising hormones to treat gender incongruence or dysphoria for young people under 18” meaning that “we cannot say if they are harmful or effective”.

He added: “We are now launching a public consultation on a revised policy which would see the NHS remove this treatment as a routine intervention for young people under 18.” This consultation will last 90 days and will start on Monday.

A separate planned trial into puberty blocking treatments was also put on hold last month due to worries about the “long-term biological harms” of such drugs.

The trans advocacy group, TransLucent, said the news was “yet another blatant act of discrimination against transgender youths' healthcare” and added: “We will critically assess the NHS's evidence before responding, but given the gravity of these human rights concerns, we will consider legal action.”

Dr Alice Hodkinson, from the campaign group Biology in Medicine, said: “We have known for years that cross-sex hormones are harmful for all children through to age 18 so we welcome this announcement. However, cross-sex hormones do not become any less harmful on a patient’s 18th birthday. There is mounting evidence of the long-term adverse effects which include heart disease, stroke and early mortality.”