The NHS has announced it will no longer prescribe testosterone or oestrogen to transgender patients under the age of 18, following an extensive clinical review that determined the evidence base was insufficient to justify continued use.
Prof James Palmer, a national medical director for NHS England, confirmed the health service had undertaken a comprehensive examination of available research on hormone treatments for gender incongruence and dysphoria.
“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,” he stated.
A public consultation will now commence on removing these treatments as routine interventions for minors.
The prohibition on new NHS referrals takes effect with immediate force
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Cross-sex hormones are administered to individuals who identify as transgender, with oestrogen given to those born male and testosterone to those born female, enabling physical changes such as breast development or facial hair growth.
The prescription of such treatments to young people first gained significant attention through the Tavistock Gender Identity Development Service in north-west London, which ceased operations in 2024.
Dr Hilary Cass, whose landmark review into children’s gender services prompted restrictions on puberty blockers, had previously called for “extreme caution” regarding cross-sex drugs.
Her findings revealed nearly all young people prescribed puberty blockers subsequently progressed to hormone treatments.
The prohibition on new NHS referrals takes effect with immediate force, though patients already receiving hormone treatment will be permitted to continue their prescriptions.
Private healthcare providers remain unaffected by the policy change, creating a potential avenue for those seeking such treatments outside the national health service.
Health Secretary Wes Streeting had signalled in May that such restrictions were under consideration.
Meanwhile, a separate clinical trial examining puberty blockers has been suspended due to concerns regarding potential long-term biological damage.
The Medicines and Healthcare products Regulatory Agency intervened last month, requesting additional safeguards and proposing a minimum participant age of 14.
Dr Alice Hodkinson, founder of the campaign group Biology in Medicine, welcomed the announcement whilst cautioning that the dangers do not diminish once a patient reaches adulthood.
Wes Streeting had signalled that the policy change was under consideration in May
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“Cross-sex hormones do not become any less harmful on a patient’s 18th birthday,” she warned.
“There is mounting evidence of the long-term adverse effects, which include heart disease, stroke and early mortality.”
She raised particular concerns about vulnerable individuals obtaining prescription hormones through private channels and EU regulatory gaps, specifically citing access from Spain and Ireland.
Dr Hodkinson urged ministers to address these alternative supply routes, including illegal anabolic steroids purchased directly from websites, to safeguard young people from exploitation.
