NHS Suspends Gender-Affirming Hormone Therapy for Adolescents Following Evidence Review
The National Health Service has implemented an immediate pause on new referrals for gender-affirming hormone treatment for 16 and 17-year-olds, effective from Monday 9th March 2026. This significant policy shift follows an extensive NHS England review which concluded that current evidence does not adequately support the continued provision of such treatments for this age group.
Treatment Details and Immediate Impact
Gender-affirming hormone therapy, which involves prescribing masculinising or feminising hormones to align physical characteristics with gender identity, has been available on the NHS for 16 and 17-year-olds diagnosed with gender dysphoria who meet specific clinical criteria. The treatment can induce irreversible physiological changes, including breast development through oestrogen administration or voice deepening via testosterone.
Professor James Palmer, national medical director for specialised services at NHS England, stated: "Following the Cass Review, NHS England commissioned an in-depth review of all available clinical evidence for using oestrogen or testosterone either alone or with other medications to treat gender incongruence and dysphoria. This review has established that the available evidence does not support the continued use of masculinising or feminising hormones to treat gender incongruence or dysphoria for young people under 18."
Cass Review Recommendations and NHS Response
The 2024 Cass Review into children's gender care, led by Baroness Hilary Cass, recommended "extreme caution" in providing hormone treatments to minors and emphasised the need for "clear clinical rationale" for administering hormones before age 18 rather than waiting until adulthood. NHS England's subsequent review found the evidence base too weak to determine whether such treatments are beneficial or harmful to adolescents with gender dysphoria.
NHS England has clarified that current patients aged 16-17 receiving cross-sex hormones may continue their treatment, but each case must undergo individual review with clinical teams. The health service is simultaneously launching a 90-day public consultation regarding plans to remove the treatment as a routine procedure for under-18s.
Broader Context of Youth Gender Care
This development occurs alongside other significant changes in youth gender healthcare provision. A clinical trial investigating the impacts of puberty blockers on children as young as 10, initiated in November 2025, was paused last month before any participants were recruited due to concerns about "unquantified risk" of "long-term biological harms." Furthermore, the use of puberty-blocking drugs to delay or prevent puberty was prohibited for under-18s in 2024.
The hormone treatment pause will remain in effect throughout the consultation period while NHS England reviews potentially thousands of responses before reaching a final policy decision. The health service continues to examine evidence regarding masculinising and feminising hormones for adult patients.
Stakeholder Reactions and Future Implications
Tammy Hymas, policy lead at advocacy group TransActual, expressed strong opposition: "Banning new prescriptions of gender-affirming hormones for 16 and 17-year-olds is a profound attack on young people's bodily autonomy with trans people yet again cruelly singled out by this government."
Conversely, Helen Joyce, director of advocacy at Sex Matters, supported the decision: "Under-18s are simply too young to consent to such irreversible, life-changing consequences. This pause now needs to be made permanent, as part of the long road back to sanity on gender issues for the NHS."
Professor Palmer emphasised that the NHS continues to offer specialist support for under-18s experiencing gender incongruence, including comprehensive mental health services and referrals to specialist children and young people's gender services where clinically appropriate. The health service has exercised what it describes as "extreme caution" in accordance with Cass Review recommendations when considering initiating hormone treatments for adolescents.
