Pharmacists risk being criminalised in puberty blockers ban, warns RPS

Pharmacists must not be criminalised over the supply of puberty blocking hormones, the Royal Pharmaceutical Society (RPS) has said.

The Society published its statement on 31 July 2024, following a High Court ruling on 29 July 2024, which ruled that an emergency prohibition order for gonadotrophin-releasing hormone (GnRH) analogues used to suppress puberty remains valid.

The order came into force on 3 June 2024, making it a criminal offence to supply puberty blockers to patients aged under 18 years, outside the terms of the order.

“The RPS is concerned this may inadvertently result in pharmacists declining to supply these medicines at all for fear of prosecution, which will negatively affect patient care,” its statement said.

“For example, these medicines can still be legitimately supplied to [patients aged] under 18 [years] for very early onset of puberty (usually caused by another condition), to people [aged] under 18 [years] with gender dysphoria already in treatment, and to people aged 18 years and over.”

In a full position statement on the GnRH prohibition order and the ‘Cass Review‘ into gender identity services for children and young people, which was published in April 2024, the RPS said: “The order may criminalise pharmacists who inadvertently supply GnRH analogues believing it is not for puberty suppression. Therefore, they may be at risk of unwittingly breaking the law.”

The NHS announced in March 2024 that puberty blockers would no longer be routinely prescribed to children and young people who have gender incongruence/gender dysphoria.

Then, in April 2024, the Young People Gender Service in Scotland paused new prescriptions of puberty hormone suppressants and gender affirming hormones while new evidence was generated.

“The recent policy changes … may force young people and their families to seek healthcare from the independent healthcare setting, including overseas providers which operate outside of UK regulation,” the RPS position statement added.

In its latest statement, the Society said it has “raised concerns about the potential criminalisation of pharmacists with the Department of Health and Social Care on behalf of the profession and civil servants recognise this risk”.

“We urge the government to consider a solution which protects patients but doesn’t unfairly criminalise pharmacists.”

The RPS also said that pharmacists currently “lack a clear referral pathway” when adhering to the Cass Review recommendations and the prohibition order, calling for “timely access to specialist care pathways” for patients awaiting consultation, or who can no longer access medicines that they were previously taking.

The Department of Health and Social Care has been approached for comment.