NHS England has paused new referrals for masculinising or feminising hormone treatment for 16- and 17-year-olds, following a review that found insufficient evidence to support its continued use. The decision applies to young people with a diagnosis of gender incongruence or dysphoria.
The review, commissioned after the Cass review of children's gender care, concluded that the available evidence does not demonstrate whether such treatment is beneficial or harmful for this age group. NHS England is now consulting on plans to remove the treatment as a routine procedure for under-18s, with a 90-day public consultation launched on Monday.
Existing patients under 18 currently receiving cross-sex hormones may continue treatment, but each case must be reviewed individually with clinicians. New referrals are paused during the consultation period.
Prof James Palmer, NHS England's national medical director for specialised services, said the NHS has exercised extreme caution in line with Dr Hilary Cass's recommendations. He emphasised that specialist support, including mental health services, remains available for young people managing gender incongruence.
The move follows a separate pause in a clinical trial on puberty blockers for children as young as 10, due to concerns about long-term biological harms. Use of puberty blockers for under-18s was banned in 2024.
Advocacy groups reacted differently: TransActual called it a 'profound attack on young people's bodily autonomy', while Sex Matters said the pause 'comes too late' for many children and should be made permanent.
