UK policy on puberty blockers and hormone treatment for minors

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SUMMARY

A High Court judge rejected a legal challenge to the UK's Pathways puberty blocker trial on July 31, 2026, allowing the trial to proceed after its reapproval by regulators in June 2026. As of July 31, 2026, recruitment for the trial, which was initially paused in February 2026 due to MHRA concerns, is delayed until August 1, 2026, due to ongoing legal proceedings. The trial, which will include girls aged 11 and boys aged 12, was reapproved following protocol revisions and a House of Commons vote on June 23, 2026, that defeated an attempt to block it. Professor Jacob George was removed from involvement in the trial in March 2026 due to accusations of bias, and NHS England confirmed in March 2024 that puberty blockers would no longer be available as routine treatment for minors outside of research settings.

Timeline

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July 2026 — 3 developments

  1. UK High Court Rejects Legal Challenge to Puberty Blocker Trial; Trial Reapproved

    A High Court judge rejected a legal challenge to the Pathways puberty blocker trial on July 31, 2026. The trial was reapproved by regulators in June 2026 after revisions to its protocol, with recruitment delayed until August 1, 2026, due to ongoing legal proceedings. Claimants may appeal the decision.

  2. UK regulators reapprove children's puberty blocker trial after protocol revisions

    The PATHWAYS trial investigating puberty blockers in children has been reapproved by regulators following protocol revisions. Recruitment is not expected to start before August 1, 2026, due to ongoing legal proceedings. Some clinicians remain concerned that the modifications are insufficient and the risks outweigh the benefits.

June 2026 — 2 developments

  1. UK Parliament Defeats Attempt to Block Puberty Blocker Trial Under New Safeguards

    A vote in the House of Commons on June 23, 2026, defeated a Conservative attempt to block the Pathways clinical trial for puberty blockers. The trial will now proceed under tightened safeguards approved by the MHRA, following previous safety concerns and a recommended minimum age increase.

  2. UK Puberty Blocker Trial to Resume with Revised Protocols After Safety Review

    The UK's PATHWAYS clinical trial for puberty blockers is set to resume with revised protocols, allowing girls aged 11 and boys aged 12 to participate. This follows an agreement between King's College London and the MHRA, which had previously raised safety concerns and suggested a minimum age of 14. Recruitment for the modified trial is reportedly scheduled to begin in August 2026.

March 2026 — 1 developments

  1. MHRA removes Professor Jacob George from puberty blockers trial over bias accusations

    Professor Jacob George, chief medical and scientific officer at the MHRA, has been removed from further involvement in the Pathways puberty blockers trial due to accusations of bias. George had raised concerns that led to the trial being paused. The MHRA stated his removal was a precaution, despite his social media posts predating his appointment.

February 2026 — 3 developments

  1. MHRA pauses UK puberty blocker trial over participant wellbeing concerns

    The UK's PATHWAYS clinical trial into puberty blockers has been paused following concerns raised by the MHRA about the wellbeing of young participants. The MHRA has advised a minimum age of 14, citing potential long-term biological harms. Discussions are ongoing between the MHRA and King's College London, the trial sponsor, and recruitment will not begin until these issues are resolved. This pause comes amid legal challenges from campaigners who describe the trial as an "unethical experiment."

  2. MHRA raises "new concerns" about puberty blocker trial, recommends minimum age of 14

    The Medicines and Healthcare products Regulatory Agency (MHRA) raised "new concerns" about the PATHWAYS clinical trial into puberty blockers, recommending a minimum age limit of 14 due to "unquantified risk" of long-term biological harms. Consequently, the Department of Health and Social Care announced that preliminary work on the trial has been paused.

  3. Campaigners launch legal action to suspend puberty blocker trial over ethical concerns

    Campaigners, including Keira Bell and the Bayswater Support Group, launched legal action against the Health Research Authority and the Department of Health and Social Care, seeking to suspend the upcoming clinical trial of puberty blockers. They argued that the ethical approval process was flawed and that the trial posed risks to vulnerable children due to potential irreversible damage to fertility.

March 2024 — 2 developments

  1. NHS England restricts puberty blockers for children to research settings

    NHS England confirmed that puberty blockers would no longer be available as routine treatment for children experiencing gender-related distress. This decision followed a public consultation and the recommendations of the Cass Review. The use of puberty blockers would be confined to research settings, with any exceptions requiring an "Individual Funding Request" to demonstrate exceptional circumstances.

  2. NHS England pauses new hormone treatment referrals for under-18s due to insufficient evidence

    NHS England has paused new referrals for masculinising or feminising hormone treatment for under-18s, citing insufficient evidence. This follows the pause of a puberty blocker trial that had not yet recruited participants. The UK government later announced an indefinite ban on puberty blockers for individuals under 18 with gender dysphoria, deeming their use an unacceptable safety risk.

July 2022 — 1 developments

  1. NHS England closes Tavistock's GIDS clinic, citing safety concerns and overwhelming referrals

    NHS England announced the closure of the Gender Identity Development Service (GIDS) at the Tavistock clinic, citing concerns that a single specialist provider model was "not safe" and that the clinic was overwhelmed with referrals. The service was to be replaced by a network of regional centres to provide more holistic care and reduce waiting times.

September 2021 — 1 developments

  1. Court of Appeal overturns High Court ruling on puberty blockers for under-18s

    The Court of Appeal overturned a High Court ruling that had made it harder for children to consent to puberty blockers. The Tavistock and Portman NHS Trust won its challenge against the previous ruling, which had stated that doctors might need court authorization for treatments for under-18s. The appeal judges found it "inappropriate" for the High Court to issue such guidance, which had placed patients, parents, and clinicians in a difficult position.

December 2020 — 1 developments

  1. High Court rules puberty blockers experimental, restricts use for under-16s

    The High Court ruled that puberty blockers and cross-sex hormones are experimental treatments and cannot be given to children under 13 without court application, and are "very doubtful" for 14 and 15-year-olds. The ruling, stemming from a case brought by Keira Bell, stated that children under 13 are highly unlikely to be able to give informed consent, and it is doubtful that older adolescents fully understand the long-term risks. This judgment highlighted concerns about the lack of robust evidence for the benefits of these treatments.