NHS England has now published its service specification and policy proposition, following its consultation process. These documents do not adequately meet the needs of gender variant children and adolescents. GIRES summarised these concerns in a presentation to the Mermaids seminar that was hosted in London by Lloyds Banking Group on 14 October 2016.

Previous Comments

The comments that GIRES previously made throughout the NHSE consultation process may be viewed below:

NHS England has not sent us revised versions of the documents on which we commented so that we could see whether it has amended its approach in response to our concerns. Instead, it has, without further consultation, obtained approval for its approach from the Clinical Priorities Advisory Group (CPAG), which reviews specialised treatments on behalf of NHS England:


We wrote a note which you can read here (in pdf format) to Sir Nick Partridge, Chair of CPAG, with signatures of support from both individuals and organisations, requesting that he consider our concerns regarding NHS England’s proposals for treating gender variant children and adolescents.  We do not know what, if any, effect that note had on CPAG's consideration of the proposals.

NHS England now intends to submit the proposals for final approval to its Specialised Commissioning Oversight Group (SCOG). Only after that will we be allowed to see them. NHSE does not propose to review the proposals until two years after they are published.

One of our key concerns is the arbitrary requirement that all young people must be at least 16 years old before being offered gender affirming medication. Actually, there is no justification for that or any other age requirement. Provision of this medication should be based on physical, psychological and social readiness criteria, excluding age, as well as properly informed consent. We have developed a short note on this subject:

Gender Affirming Hormones for Adolescents - Some Suggestions