UK Secretary Uses Emergency Powers To Criminalize Possession Of Puberty Blockers

On May 31st, letters went out from NHS England to parents of trans youth stating that they must immediately stop taking puberty blockers, and that possession will be considered a crime.

NHS England Southport, Google Street View 2023

On May 31, NHS England sent a letter to every patient on the waiting list for puberty blockers, stating that possession of such blockers will be considered a crime. The letter follows an edict issued by Conservative Secretary of State for Health and Social Care Victoria Mary Atkins and also mandates that transgender youth who obtained their puberty blockers through private doctors must discontinue their medication. This letter and edict mean that the United Kingdom now has some of the harshest policies targeting transgender youth of any liberal democracy in the world.

On May 29th, Atkins announced on twitter, “Today I have taken bold action to protect children following the Cass Review, using emergency powers to ban puberty blockers for new treatments of gender dysphoria from private clinics and for all purposes from overseas prescribers into Great Britain.” Following the announcement, she linked to an edict declaring an “emergency prohibition” on puberty blockers in England, Wales, and Scotland.

The prohibition relies on a decades-old law that allows for the emergency prohibition of medications without the need for a full legislative process; no vote was taken on the edict, and the order was issued just before parliament dissolved for the general election, meaning it could not be overturned. According to UK-based advocate Trans Safety Now, the last and only time such powers were used was in response to deaths among users of an herb found in some Chinese medicine in 1999. Jo Maugham, who leads the Good Law Project, stated about the use of these powers, “It is breathtaking that thousands or tens of thousands of loving families are going to be criminalized by a law made by a Minister, never approved by Parliament, subject to no consultation and the media is not reporting it."

On Friday, following the announcement, Lee Hurley of Trans Writes released a copy of a letter sent to families on the NHS waiting list for puberty blockers. The letter indicates that those receiving puberty blockers from the NHS can continue taking them. However, given the enormous wait lists, a substantial number of families opted to get their puberty blockers through private practitioners registered in the European Economic Area or Switzerland—a fully legal practice in the United Kingdom. For those receiving their care through those systems, the letter states, “You will need to stop taking GnRH analogues unless you are newly prescribed them by a UK-registered doctor, nurse, or pharmacist. These medications can be safely stopped and you do not need to be weaned off.”

Guidelines for transgender youth in May 31 letter

Critically, the edict does not only target providers; it also targets patients and their families. The letter states, “It will also be a criminal offence to possess these medicines, where the individual had reasonable cause to know that the medicine had been sold or supplied in breach of the ban.”

When asked about this provision, Jo Maugham stated, “It basically says puberty blockers are being treated like other illegal drugs like cocaine and heroin.” He then followed up with the applicable law, which indicates that those who violate the ban could be imprisoned for two years.

The decision comes following the publication of the Cass Review, a highly politicized document developed with a secretive list of advisors, some of whom were later found to be meeting regularly with political operatives of Republican Governor Ron DeSantis in Florida. These meetings were in support of a ban on transgender care in the state. One advisor, Dr. Riittakerttu Kaltiala, held numerous meetings with DeSantis’ handpicked anti-trans doctors, such as Dr. Patrick Hunter of the Catholic Medical Association, according to court documents challenging actions taken by Florida targeting transgender care. Even Dr. Cass herself attended at least one of these meetings. Both the Endocrine Society and the American Academy of Pediatrics have since issued statements rejecting the Cass Review, stating, “Medical evidence, not politics, should inform treatment decisions.”

The actions being taken by the United Kingdom government are extreme among liberal democracies. In the United States, no state has explicitly criminalized the possession of gender-affirming care medications. The closest any state has come is Texas, where in 2022, Governor Greg Abbott attempted to investigate the parents of transgender youth for child abuse. These investigations were subsequently blocked in court by Texas judges, who are notably quite conservative.

There may still be more avenues to access medication in the United Kingdom. The order does not cover hormone therapy, for instance, so some transgender youth who are taking puberty blockers could potentially opt to transition to hormone therapy earlier than planned. Additionally, puberty blockers can be administered via injection or implantation, which might provide alternative methods for those affected.

Gender GP, one of the largest private providers in the United Kingdom of transgender care, said in a statement, “We know that the interference in medicine and healthcare by the government will lead to serious harm for millions of patients and even death including those within the trans community. We remain committed to working with the government and the community to find solutions to prevent harm wherever it exists.”

Jo Maugham of the Good Law Project stated of a potential challenge to the edict, “An urgent legal challenge is being prepared to these highly irresponsible regulations and we will help to fund it,” requesting donations to support the challenge. As of noon on May 31, 2024, the crowdfunder was 70% funded.