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NHS England has launched a consultation on removing masculinising and feminising hormones as routine treatment for children and adolescents with gender incongruence or dysphoria.
In consultation documents published on 9 March 2026, NHS England said it had reviewed evidence and concluded that “there is not enough evidence to support the safety or clinical effectiveness of feminising and masculinising medicines to make the treatment routinely available to children and young people at this time”.
NHS England has paused new referrals for the hormones while the consultation is live, but said patients aged 16 and 17 years who have already been initiated on treatment may continue “if they and their parent or guardian and their lead clinician in the NHS Children and Young People’s Gender Service agree in writing that continuation is in their best interests”.
In the consultation documents, NHS England added it would like to hear from interested parties on whether they think that all relevant evidence has been taken into account for the proposed clinical policy.
It has also requested comments on whether its draft equality and health inequalities impact assessment reflects potential impacts and if there are any other issues it should consider when deciding whether to adopt the policy.
In 2024, Hilary Cass, former president of the Royal College of Paediatrics and Child Health, led a review of children’s gender care, in which she warned that “extreme caution” should be taken in providing masculinising and feminising hormones to patients aged under 18 years.
The current NHS England clinical policy for masculinising and feminising hormones was first published in 2016 and updated in 2024 in immediate response to the final report of the Cass Review. It allows for their restricted use in the NHS Children and Young People’s Gender Service by those who are aged 16 or 17 years old, and who display persistent signs of gender dysphoria.
Later in 2024, gonadotrophin-releasing hormone analogues — also known as puberty blockers — were banned indefinitely in the UK for patients aged under 18 years or the treatment of gender incongruence and/or gender dysphoria, following an evidence review by the National Institute for Health and Care Excellence and the Cass review.
A spokesperson for the Royal Pharmaceutical Society said the Society would be responding to the consultation and did not want to comment at this time.
NHS England’s consultation on masculinising and feminising hormones is open until 7 June 2026.
