NHS England has handed no new prescriptions for gender-affirming medication to any trans person under the age of 18 in at least a year, according to officials.
No new patients have been “identified” as requiring gender-affirming care, including physically reversible puberty blockers, following the closure of the gender clinic at the Tavistock, in London, in March 2024, an NHS statement revealed.
That same month, NHS England announced that it would no longer prescribe puberty blockers to trans under-18s, and that the medication would only be available to young people as part of clinical research trials.
In the wake of an interim report from the Cass Review, the NHS announced in 2022 that it intended to close what was England’s only youth gender clinic, in favour of various regional hubs. The closure was delayed until 2024 because of “complexities“.
Reports into clinics at Great Ormond Street Hospital (GOSH), in London, and Liverpool’s Alder Hey Children’s Hospital, which both opened last April, included concerns about a lack of “safe handover” which, former staff alleged, resulted in a “shoddy, disorganised [and] messy” restructure.
Now, The Times has reported that no new prescriptions for puberty blockers, which have been described as “life-saving” by medical experts, have been given since the Tavistock clinic’s closure.
The claim was confirmed to PinkNews by NHS England, despite medical director for specialised services James Palmer’s comments that “there may be a circumstance where it is important for care” to prescribe puberty blockers.
“The services need the option of taking someone into masculinising or feminising hormones, if that really is the most important thing to be done. But the services have not identified an individual yet for whom it would be a really important bit of their care pathway,” Palmer said.
Private prescriptions for puberty blockers have been banned in all regions of the UK since health secretary Wes Streeting extended a restriction put in place by the previous Conservative government. His decision was met with an outcry, prompting the Ilford North MP to tell a member of the public to “get a grip“.
One of the few ways for trans under-18s to be given puberty blockers via the NHS in England is through a clinical trial, which was commissioned in March by the National Institute for Health and Care Research (NIHR).
NIHR said that more than £10 million ($12.8 million) would be put into an trial, led by a team of researchers at King’s College London, to analyse several areas of gender care for under-18s, but until then, trans youth remain stuck in limbo.
NHS England to set up ‘detransition pathway’
NHS England has also committed to setting up a “detransition pathway” for adults who had medically transitioned and later decided to stop.
LGBTQ+ not-for-profit group TransActual reported that NHS England had set up a programme of work to develop the pathway after reports in August suggested plans had been drawn up to create a model of care for detransitioners.
A spokesperson for TransActual said that, while the NHS should support “all transition journeys,” they were “deeply concerned” about the “potential motivations” of creating the pathway, especially at a time when resources for gender identity clinics were strained.
“The vast majority of trans people do not detransition at all,” the spokesperson said. “For those that do, multiple reasons and circumstances influence them in making a decision to stop, pause or reverse some or all aspects of medical transition.”
Research published last May showed that just 0.47 per cent of trans people medically detransition. By comparison, surgeries such as breast augmentation can have regret rates of up to 47 per cent.
NHS England’s review of adult gender services “must recognise that each person’s transition goals are different”, the TransActual spokesperson added.
“Transition does not have to follow a pre-specified linear pathway. Different people need different levels of support at different times,” and it was “absolutely essential” for the detransition pathway, as well as other NHS gender-related services, to clarify that so-called conversion practices “simply do not work”, they went on to say.
“Any specification must make it clear that discussions about detransition should be initiated by the service user themselves and that nobody should be coerced or compelled to have discussions, or access therapies, they don’t want.”
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