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DOI: https://doi.org/10.58248/PB55 

Key Points

In recent years, demand for access to specialist gender identity services in the NHS by children and young people has increased. Some children and young people may receive hormones as part of a treatment plan for gender dysphoria.

Gender dysphoria refers to psychological distress from an incongruence between sex registered at birth and gender identity. To meet criteria for a medical diagnosis, the dysphoria must be associated with several factors, including, significant distress or impairment in daily life.

This POSTnote describes the hormone treatments used in the treatment of gender dysphoria, and summarises the evidence on the safety and the outcomes for children and young people. It also highlights stakeholder perspectives and recent legal cases.

  • Hormone treatments that block puberty are one medical intervention for children and young people with gender dysphoria. Other hormones that can partially irreversibly masculinise or feminise the body can be prescribed for those aged over 16.
  • A lack of high-quality evidence means that questions remain about the efficacy, safety and long-term outcomes of hormone treatments used in this context.
  • There are conflicting views about the use of these drugs as a treatment for children and young people with gender dysphoria. 
  • An independent review of Gender Identity Development Services in England (the Cass Review) is expected to report in late 2023. Its interim report, published in February 2022, did not make any policy recommendations on hormone treatments due to gaps in the evidence.
  • NHS England recently ran a consultation on an interim clinical policy on hormone treatments, on the proposition that they are not recommended routinely.

POSTbrief 53, published in August 2023, discusses the factors that shape gender incongruence and gender dysphoria, and the impacts on health services.

Acknowledgements  

POSTbriefs are based on literature reviews and interviews with a range of stakeholders and are externally peer reviewed. POST would like to thank interviewees and peer reviewers for kindly giving up their time during the preparation of this briefing, including:

Members of the POST Board*

Dr Katie Alcock, Lancaster University

Professor Susan Bewley, King’s College London*

British Psychological Society

Cass Review Team*

Professor Annelou de Vries, Amsterdam University Medical Centres

Gendered Intelligence

Professor Simona Giordano, University of Manchester*

LGBT Foundation*

Dr Una Masic, Gender Plus*

Mermaids*

Alex Ruck-Keene KC, 39 Essex Chambers*

Transgender Trend*

Dr Claudia Zitz, Gender Plus*

*Denotes people and organisations who acted as external reviewers of the briefing. 


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