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The NHS will prescribe gender-changing hormones to teenagers as young as 16 at its youth gender clinics, new guidance states.
It comes a week after the NHS announced an immediate ban on prescribing puberty blockers to under-18s, unless they are part of a clinical trial that is due to start later this year.
But NHS England’s new guidance around “cross-sex hormones” means the drugs can be given to teenagers as part of its Children and Young People Gender Service.
The treatment, known as gender-affirming hormones (GAH), would be available for “young people with continuing gender incongruence [or] gender dysphoria from around their 16th birthday”, as long as they met certain eligibility criteria, it said.
The guidance about the use of masculinising or feminising hormones, issued on Thursday, was criticised by Jackie Doyle-Price, the former health minister, who said administering the cross-sex hormones – testosterone or oestrogen – should not be given to children.
She tweeted: “This kind of hormone treatment causes permanent loss of sexual function. It should never be administered to children for the purposes of gender reassignment.”
She added: “There are brave voices who have spoken openly about the permanent effects of cross-sex hormones.
“Their experience is enough to ban these treatments for anyone before the age of majority. No child can give informed consent to this treatment.”
The announcement comes just weeks before the publication of the independent Cass review, which is expected to crack down on gender-affirming care in the NHS.
The NHS announced last year that it would be closing the Tavistock transgender clinic after a review by Dr Hilary Cass found it was “not safe”.
It was the only NHS transgender clinic treating children and concerns were raised that young people were being rushed down a medical pathway.
The clinic is being replaced by a set of regional centres that will be led by medical doctors, rather than therapists, and consider the impact of other conditions such as autism and mental health issues.
The new guidance regarding the prescribing of GAH as part of the Children and Young People’s Gender Service states that staff must “ensure that the individual understands that there is limited clinical evidence on the effects and harms of prescribing GAH treatment below their 16th birthday; and also that GAH treatment is a significant decision with long term indications”.
It later states that “NHS England will also consider the recommendations of the independent Cass Review in April 2024 in so far as those recommendations relate to this policy document”.
But one government source said: “This is an attempt to strangle the Cass review at birth.”
‘Disturbing development’
Last week, MPs talked out a bill from Liz Truss, the former prime minister, that would have banned puberty blockers altogether.
She tweeted: “The only way we will stop children being supplied with puberty blockers and cross-sex hormones is through primary legislation. Sadly, activist groups have too much influence on public bodies. Write to your MP to back my Bill.”
Helen Joyce, from the women’s right group Sex Matters, said: “This disturbing development demonstrates that winning back evidence-based medicine is going to be a fight.
“One of the most worrying aspects is that children who are self-harming or experiencing psychotic episodes or drug addiction will still be eligible for hormone treatment.
“The NHS must urgently rethink before any more children are harmed by medical practices that are driven by ideology rather than evidence of clinical benefit.”
A spokesman for NHS England said: “This update of the national clinical policy for gender-affirming hormones as an option for young people around 16 with continuing gender incongruence or gender dysphoria continues to be subject to strict eligibility and readiness, and now includes assessment by a national specialist multi-disciplinary team to ensure clinical consensus is reached before life-changing medical treatment is initiated.”