UK bans puberty blockers for minors

Earlier this year, an independent study commissioned by England's National Health Service (NHS) concluded that gender medicine was operating on "shaky foundations" when it came to evidence for certain medical treatments, including prescriptions for hormones to pause puberty or to change physical characteristics.

Following the study, puberty blockers for treating gender dysphoria in minors were temporarily banned. Although the ruling was challenged, Britain's High Court upheld the temporary ban in July, saying that it was lawful.

In early December, the U.K. announced an indefinite ban on new prescriptions of puberty blockers for minors experiencing gender dysphoria. The decision will apply across England, Scotland, Wales, and Northern Ireland.

According to British Health and Social Care Secretary Wes Streeting, he decided to make the temporary ban on puberty blockers permanent in consultation with medical experts, including the country's Commission on Human Medicines.

According to NBC News, transgender children who are already taking puberty blockers can continue doing so under the ban. Cisgender children who experience puberty at an abnormally early age will also be able to receive new prescriptions for puberty blockers. The U.K. government will review the ban again in 2027.

Reactions to the ban

Responses to the decision have varied, with some supporting the ban and others opposing it.

Lara Brown, a senior research fellow at the Policy Exchange thinktank, called the ban a "victory" for child safeguarding and evidence-based medicine.

However, Lauren Stoner, CEO of the trans rights charity Mermaids, said she was "deeply disappointed" by the ban and that "[t]he government is entirely disregarding the voices of trans youth, who made clear their deep opposition to the restriction of private prescriptions for puberty blockers during consultation."

Sian Berry, a lawmaker for the U.K.'s Green Party, also called the ban a "worrying decision," saying that since puberty blockers could still be used safely by young people for other reasons, banning it for trans children could amount to discrimination.

Hilary Cass, the pediatrician who led the NHS report, said she supported the indefinite ban on puberty blockers. "Puberty blockers are powerful drugs with unproven benefits and significant risks, and that is why I recommended that they should only be prescribed following a multidisciplinary assessment and within a research protocol," she said.

However, a recent report from the Council of Europe noted that there were "ethical implications of only offering treatment to a small group of patients" through clinical trials, since "for many young people the only way to receive treatment is to participate in the trial, therefore calling into question whether consent can be constituted as free and informed in these situations."

Could a similar ban happen in the United States?

Currently, gender-affirming care for children is regulated at the state level rather than the federal level. Since 2021, 26 states have banned gender-affirming care for children, including puberty blockers, hormones, and surgeries.

However, there could soon be changes at the federal level. According to STAT, President-elect Donald Trump has pledged to stop any federal support of gender-affirming care.

The U.S. Supreme Court also recently heard oral arguments in a case challenging Tennessee's ban on gender-affirming care for minors, which was enacted in March 2023. It is the first ban on gender-affirming care to come before the Supreme Court.

In the case, three families and a healthcare provider challenged Tennessee's ban, arguing that it violates the Equal Protection Clause of the 14th Amendment. The American Academy of Pediatrics, the American Medical Association, and almost two dozen other professional medical organizations have filed an amicus brief in support of the challenge, outlining the benefits of gender-affirming care.

According to Axios, the Supreme Court seems likely to uphold Tennessee's ban, with conservative justices suggesting through their questioning that they don't want to overrule the state law. A decision on the case is expected next spring.

According to health policy experts, if the ban on gender-affirming care for children is upheld, there could be future restrictions on adult access to the care, both at the state and federal level.

"We've already started to see some of that, so I'm not sure that is a trend that will reverse," said Caroline Medina, director of policy at the Whitman-Walker Institute, an LGBTQ-focused research and advocacy organization. Currently, Idaho, South Carolina, and Florida have banned Medicaid funding for adults seeking gender-affirming care.