Health secretary Wes Streeting is considering extending the ban on puberty blockers for transgender youngsters to include private prescription of hormone replacement therapy (HRT), the High Court has heard.
Lawyers representing the government said an expert panel would report in July on the use of HRT, a revelation which came after the court rejected a call for a full judicial review from detranisioner Keira Bell and two others.
The call for a full judicial review came after the UK government announced in December that puberty blockers for under-18s with gender dysphoria would be banned indefinitely because of an apparent “unacceptable safety risk”. Campaigners said not doing the same for cross-sex hormones was “irrational”.
Puberty blockers, which delay unwanted elements of physical puberty, were temporarily banned by the Conservative government in May 2024 following the publication of a report which urged “extreme caution” when prescribing the medication to trans youngsters.
Hilary Cass’ 400-page report made upwards of 32 recommendations to restructure the way in which young trans people received care.
After Labour’s victory in the general election in July, Keir Starmer’s government extended the ban.
Last month, Streeting said he was “genuinely sorry” that the ban had caused “fear and anxiety” for transgender youngsters. Meanwhile, new figures showed waiting lists for gender-affirming healthcare in England increased by 12 per cent in the past year.
HRT is different to puberty blockers because it includes hormones such as oestrogen, progesterone or testosterone, whcih can be used to feminise or masculinise a person’s body.
Feminising HRT is known to increase the size of breast tissue, make body hair lighter and soften facial features. Taking testosterone can stop periods, deepen the voice and increase facial hair.
A lawyer for the Department of Health, Iain Steele, told the High Court that Streeting was “currently seeking clinical and expert advice from NHS England” in regard to HRT, and the legal bid brought by Bell and others was “premature and academic”.
Steele went on to say: “The defendant [Streeting] has instead rationally chosen to keep that possibility under review, and, at his request, NHS England has established an expert working group to advise him, which is occurring in parallel with further work being undertaken by officials with a view to assisting his decision making.”
Responding to the news, Bell said: “I am relieved that the secretary of state is now actively considering a ban on cross-sex hormones outside the NHS. These powerful drugs should not be given to children and young people.
“Although the decision to actively review making a ban on these drugs is long overdue, it is welcome that he is now taking a lead. The safety of vulnerable children and young people should be a first priority. It now looks like that is beginning to happen.”
Speaking to the Daily Mail, Paul Conrathe, who represented Bell and others in court, said that, despite the ruling regarding a judicial review, “they are delighted” Streeting had set up a working group to “urgently review the possibility of a ban on cross-sex hormones being prescribed to children”,
Conrathe went on to claim: “This is long overdue as vulnerable children have been accessing powerful, life-changing, irreversible drugs from activist clinicians in the private sector.”
By contrast, Dr Aidan Kelly, the director of Gender Plus and a consultant clinical psychologist, said there was no reason to prevent trans youngsters having access to gender-affirming care.
“The decision to treat is always a sensitive and complex one, so it should remain one made between the young person, their family and their clinical team,” he added. “There is no basis for the government to be involved in that decision.”
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