Streeting considers banning cross-sex hormones for trans teenagers
Cross-sex hormones could be banned for transgender teenagers under proposals being considered by Wes Streeting, the Health Secretary.
The Government has launched a review into the use of the hormones in under-18s to treat teenagers who want to change gender.
Experts will analyse the available evidence and recommend a decision in July, officials said, raising the prospect that they could be outlawed in the UK in the same way as puberty blockers.
The cross-sex drugs, also known as gender-affirming hormones, involve giving testosterone to someone born female to help change their physical appearance, and estrogen to those born male.
They differ from puberty blockers, which have been banned indefinitely in the UK for treating gender dysphoria outside a clinical trial. Puberty blockers stop the onset of puberty by suppressing the release of hormones which are vital for physical and psychological development.
The puberty blocker ban came as a result of the Cass Review, led by Baroness Hilary Cass, who found that treatment for gender dysphoria had 'been built on shaky foundations'.
But campaigners have criticised the Government's failure to intervene on cross-sex hormones in children.
NHS England responded to the review by Lady Cass, noting her recommendation that 'the new providers should be 'extremely cautious' when considering whether to refer young people under 18 years for consideration of hormone intervention'.
The NHS's inaction on cross-sex hormones has led to at least two legal challenges, including a pretrial hearing on Wednesday led by Keira Bell, a former patient of the Tavistock clinic who received drugs and surgery to become a trans man but has since 'detransitioned'.
In a High Court ruling delivered by Lady Justice Whipple, she said it would be 'premature' to take the case to court given that the Government was now considering a ban.
She also rejected the Ms Bell's argument that it had been 'irrational' for Mr Streeting to look at puberty blockers first rather than both groups of drugs together, but noted 'the very serious issues which underpin this case ... and the claimant's motivation to prevent harm'.
Ms Bell said she was 'relieved that the Secretary of State is now actively considering a ban on cross-sex hormones outside of the NHS' despite this being 'long overdue'.
'These powerful drugs should not be given to children and young people. Not only are the drugs life-changing at a time when so much is uncertain and changing, but so many children and young people are struggling with trauma and are experiencing confusion during their development,' she said.
'The safety of vulnerable children and young people should be a first priority. It now looks like that is beginning to happen.'
A spokesman for Bayswater Support Group, one of the claimants, which supports families with transgender children, said they welcomed the commitment to scrutinise private providers prescribing the hormones, but added 'we must not forget the many children who have already been harmed by the failure to halt this practice as soon as the harms became evident'.
They said it had been 'clear that banning puberty blockers alone would not be enough to protect children ', and they were 'supporting hundreds of families who have to live with the distress and trauma of being unable to protect their child from harm' because of the negligence of those who should be protecting patients against malpractice.
'We hope the Government, regulators and the Royal Colleges reflect on why it took vulnerable parents and victims of medical abuse to get the DHSC to act,' they added.
Dr Alice Hodkinson, one of the founders of Biology in Medicine, a doctors' campaign group, said cross-sex drugs should not be prescribed to any young people 'given the negative effects on fertility as well as the developing body and brain'.
'Distressed young people should instead be directed to supportive, holistic talking therapies that help them to become comfortable with their body and sexuality, so they can grow up into healthy adults.'
It comes after The Telegraph revealed last week that nursery-aged children could be allowed gender treatment after the NHS watered down its guidance.
Gender clinics for children with gender dysphoria were set to be limited to those aged seven and over, but the age limit was removed following a consultation.
New data revealed as many as nine children under five have been referred to a gender identity clinic, which require a referral from a paediatrician or mental health service with sufficient concern about the child questioning their gender.
The NHS said it was complying with the Cass review's recommendation not to set an age limit, and that any care for children aged under seven would focus on family support and advice.
The Labour Party is divided on both children's gender treatment and the Supreme Court's ruling on biological sex.
While Mr Streeting has banned puberty blockers and pledged to ensure women-only spaces in NHS hospitals would not include trans women. Other Labour MPs have vocally opposed both of these decisions.
A Department for Health spokesman said: 'Children's healthcare must always be led by evidence. That is why this Government is implementing the recommendations from the Cass review and acted immediately to extend the puberty blockers ban and make it permanent.
'We are continuing our work with the NHS to reform gender services to ensure young people receive timely, holistic care and support, while reviewing the use of cross-sex hormones in line with recommendation eight of the Cass review.'
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