Cross-sex hormones for under 18s could be restricted or banned

Health Secretary Wes Streeting, is "actively reviewing" banning or restricting the private prescription of cross-sex hormones to young people, according to evidence given to the High Court.

Government lawyers say an expert panel will report in July on the use of this type of medication by under 18s wishing to change their gender.

An application by campaigners for a full judicial review of the secretary of state's handling of the issue was rejected on Wednesday afternoon.

Dismissing the application, Lady Justice Whipple said "the case had moved on substantially" as a result of the government setting up a review in April.

The case calling for a full judicial review was brought after the NHS announced in December last year that under-18s would no longer be prescribed puberty blockers at gender identity clinics.

Campaigners argued that the prescription of cross-sex hormones should also be addressed and criticised the government's failure to intervene.

But Lady Justice Whipple said it was not "unreasonable or irrational" for the government to address the question of puberty blockers first and later come to cross-sex hormones.

The court in London was also told health officials are looking at "alternative legal mechanisms" to tackle issues around private and overseas providers who prescribe such drugs.

Cross-sex hormones are given to people who identify as a gender that is different to their biological sex. The medication helps someone who is transitioning to develop characteristics associated with their preferred gender.

For instance, it would help a trans man, a biological female who identifies as a man, develop a deeper voice and facial hair. Existing NHS guidance allows the hormones to be prescribed people aged 16 and over.

They differ from puberty blockers, which stop the onset of puberty by suppressing the release of hormones.

Existing NHS guidance allows the hormones to be prescribed to people aged 16 and over.

The case calling for a full judicial review was brought by Keira Bell and two others, who are remaining anonymous.

They wanted a ban on the prescription of cross-sex hormones by non-NHS organisations, such as private clinics and overseas providers.

As a teenager, Ms Bell was given cross-sex hormones after attending the now closed NHS Gender Identity Development Service (GIDS) run by the Tavistock clinic.

At the time she identified as male, but says she deeply regrets the decision to take medication that altered her body permanently.

Responding to this afternoon's judgment she said: "I am relieved that the secretary of state is now actively considering a ban on cross-sex hormones outside of the NHS.

"These powerful drugs should not be given to children and young people."

Her barrister, Zoe Gannon, had argued that while the health secretary banned the private prescription of puberty suppressing drugs in gender cases involving under-18s, he had "failed or refused" to take the same action in relation to cross-sex hormones, and this was "irrational".

Iain Steele, barrister for the Department of Health and Social Care (DHSC), told the court Mr Streeting "is currently seeking clinical and expert advice from NHS England".

He also said there were a wide range of medical uses for hormones, such as testosterone and oestrogen, which made decisions on whether to restrict or ban their use in different situations complex.

Delivering the judgment rejecting the application for a judicial review, Lady Justice Whipple, sitting with Mr Justice Johnson, said the secretary of state had acted rationally.

She said, "This is an immensely difficult and sensitive area of policy formation where there are strong and genuinely held views on each side of the debate and where there is no consensus."

She added Mr Streeting was taking practical steps and was therefore entitled to more time to consider the issues.

She continued that it was appropriate that there was an active review and that was to be welcomed.

A Department for Health and Social Care spokesperson 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."

The government continues to work with the NHS to reform gender services to young people, the spokesperson added.