Making doctors aware of government regulations: restrictions on the use of puberty suppressing hormones

Published 27 August 2024

The UK government has made indefinite a ban (subject to exceptions) on the sale and supply of puberty-suppressing hormones. Patients already established on these medicines by a UK prescriber for these purposes can continue to access them.

They will also remain available for patients receiving the drugs for other uses, from a UK-registered prescriber.

The government has confirmed that the legislation will be reviewed in 2027.

What does the legislation mean?

The legislation applies in England, Wales, Scotland and Northern Ireland. The regulations mean that no new patients under 18 can receive private prescriptions of gonadotropin-releasing hormone (GnRH) analogues for the purposes of puberty suppression in those experiencing gender dysphoria or incongruence.

The legislation applies to prescriptions written by UK private prescribers and prescribers registered in the European Economic Area (EEA) or Switzerland.

The order means that it is a criminal offence to supply these medicines to patients under the age of 18, except in the following circumstances:

  • The child or young person has been provided with a previous NHS prescription (for example, from the NHS Children and Young People's Gender Service or from an NHS GP or other primary care prescriber).
  • The child or young person has been provided with a private UK prescription from the UK that fulfils one of the following criteria:
    • the prescription is dated prior to 3 June 2024 (27 August 2024 in Northern Ireland)
    • it is a repeat prescription annotated 'SLS' by the prescriber and bearing the patient's age, but only when the initial prescription was issued in the 6 months prior to 3 June 2024 (27 August 2024 in Northern Ireland)
    • the prescription is endorsed 'SLS' by the prescriber and bears the patient's age, and is for a purpose other than treatment for puberty suppression related to gender incongruence or gender dysphoria

General practitioners (GPs) and other prescribers are only able to provide NHS prescriptions for GnRHa in the following circumstances:

  • The patient is aged 18 years or over; or
  • The patient is 17 years or under, and the purpose of the prescription is for a medical condition other than gender incongruence, gender dysphoria or gender affirmation; or
  • The patient is 17 years or under and has been issued with a prescription for GnRHa for puberty suppression in the 6-month period prior to 26 June 2024; then they may continue to be issued with prescriptions for GnRHa for that purpose on and after that date
  • The NHS prescription must be endorsed 'SLS' by the prescriber

    • The Department of Health and Social Care provide support and advice – including what to do if a young person currently taking these medicines is unable to access further prescriptions from their usual provider. They also include details of NHS England’s offer of a prioritised assessment by local NHS mental health services to children and young people in England who are not on the waiting list of the CYP Gender Service and whose access to puberty suppressing hormones may have been discontinued as a consequence of the legislation. This offer will be in place until 31 March 2025.

    NHSE has produced guidance for prescribers, pharmacists and dispensing doctors, as well as information for primary care. We encourage doctors, where relevant, to familiarise themselves with these arrangements.

    This statement was updated on 20 December 2024.