Mike Nesbitt urged to give 'clear answers' on latest NHS trans drugs ban - amid serious health concerns

Mike Nesbitt’s department says referrals for hormone treatments to a now-defunct gender clinic stopped in 2020.

But it has not said whether hormone treatments – potentially linked to serious health problems such as cancer, heart attacks and strokes – will be available at the new ‘Lifespan’ service.

The Department of Health says it will work with the recommendations of the Cass Review – which expressly allowed for the controversial drugs to be prescribed to 16 and 17 year olds.

DUP health committee member Diane Dodds has called for greater clarity from the minister about the policies Northern Ireland’s new £800k gender service is operating under.

“NHS England has paused the use of cross sex hormones because of concerns around the harm caused.

“Therefore, it is only right that we have clear answers as to the approach here. I have tabled a number of questions to the Health Minister to establish exactly what the policy is within the Regional Lifespan Gender Service regarding the use of cross-sex hormones for those under 18.

“These are serious medical interventions. It is only right that the Assembly and the wider public have clarity on what approach is being taken in Northern Ireland and what evidence is informing these decisions, given the approach now being taken by NHS England”, the Upper Bann MLA said.

The latest NHS restriction on trans drugs for teenagers questioning their gender relates to cross-sex hormones, usually prescribed to 16 and 17 year olds – and after puberty blockers. The drugs are used to feminise the appearance of boys by giving them the female hormone oestrogen, and make girls appear more masculine by giving them testosterone.

NHS England says after an “in-depth review of all available clinical evidence”, it does not support their continued use, and no new referrals will be accepted.

At the weekend, investigative journalist Nick Wallis reported in the Mail on Sunday that “a recent internal NHS document... acknowledges that injecting oestrogen and testosterone can cause blood clots, breast cancer, heart disease, stroke and 'impaired sexual function'”.

Mr Nesbitt’s department was asked whether it will follow the English ban, but has avoided the question by saying referrals were paused to the previous children’s service in 2020. That happened due to staffing issues.

Asked if DoH had halted referrals for the drugs, a spokesperson said: “The Endocrine Pathway within Knowing Our Identity (KOI) was closed in March 2020 to any new referrals to the KOI service.

“The Independent Review of gender identity services for children and young people (the Cass Review) was published in April 2024. Belfast Trust continues to work with the Department of Health on the development of the Lifespan service model for Northern Ireland and the recommendations of the Cass Review”.

Asked if Northern Ireland will follow NHS England and consult on a similar policy here, DoH said: “Officials are currently considering the recommendations made by Dr Cass in her recent assessment of services in Northern Ireland and are awaiting the outcome of the ongoing Judicial Review in England of the clinical trial for puberty blockers.

“Dr Cass and her team have made recommendations, focusing on a number of key areas including the integration of Child and Adolescent Mental Health Services, clinical and social services within its current model of care for Children and Young people”.

Asked if the health minister intends to bring the issue to the Executive, and what will he advise fellow ministers as to the best course of action on cross-sex hormones, DoH talked instead about puberty blockers.

“The Minister has already agreed to consult with Executive colleagues following the outcome of the Judicial Review in England. In addition, the outcome of ongoing discussions between the Medicines and Healthcare products Regulatory Agency, England, and King’s College London regarding the safety and wellbeing of those due to be recruited to the PATHWAYS clinical trial will also inform those discussions”.

In the Cass Review of NI gender services, published last month, it was recommended that the service could provide masculinising/feminising hormones from age 16, “but the Review would recommend extreme caution. There should be a clear clinical rationale for providing hormones at this stage rather than waiting until an individual reaches 18”.

It also said “there would need to be consistency of approach to transition to hormones” between the NHS in England and Northern Ireland.