Question to the Department of Health and Social Care:

To ask His Majesty's Government what guidance has been issued to GPs by (1) the Department of Health and Social Care, (2) its agencies, and (3) NHS England, about the practice of prescribing hormone treatments and other drugs, such as spiralactone and gonadotropin-releasing hormone agonists, to transgender individuals who are (a) older than 18 years old, and (b) younger than 18 years old.

In 2018 NHS England issued guidance to general practitioners (GPs) about the role of primary care in responding to requests for a shared care approach to prescribing hormone treatments to adult patients when the request is from an online private provider.

For patients who are under 18 years old, the NHS stopped the routine prescription of puberty blocker treatments in March 2024, following the findings of the Cass Review into gender services. Gonadotropin-releasing hormone (GnRH) analogues were subsequently restricted as part of an emergency banning order which took effect June 2024.

In August 2024, NHS England wrote to all GPs in England responsible for prescribing GnRH analogues, to clarify application of this new legislation in clinical practice-based scenarios. In December 2024, the Department announced that the order banning the use of puberty blockers for individuals younger than 18 years old would be made indefinite. A further update to NHS England’s guidance was provided to GPs that same month.

In May 2025, NHS England issued guidance that advised GPs not to support unregulated providers in prescribing hormone treatments for gender incongruence to children and young people under 18 years old.