All information on this page relates to children and young people from England and Wales, unless detailed otherwise.

If information is required in Welsh, please contact us by email.

An immediate pause on children or young person aged 16-17 being initiated onto masculinising or feminising hormones by the specialist Children and Young People’s Gender Service was announced on Monday 9th March 2026.

This decision has been taken in response to the completion of extensive independent evidence reviews in relation to safety, risks, benefits and outcomes of this treatment. More information on the evidence reviews can be found here https://www.england.nhs.uk/publication/consultation-feminising-and-masculinising-medicines-in-the-management-of-gender-incongruence-in-children-and-young-people-evidence-reviews/

The NHS had already placed restrictions on the prescribing of these medications, following the recommendations of the final Cass Report in 2024. Individuals would only be considered for these medications in cases where 'extreme caution' had been applied to clinical decision making, and where a national MDT had endorsed the recommendation for referral to an endocrinology team.

A 90-day consultation on a new draft policy has also been launched on Monday 9th March. More information on the consultation can be found here https://www.engage.england.nhs.uk/consultation/prescribing-masculinising-and-feminising-hormones/

We understand the uncertainty and anxiety that this action may cause if it was your expectation that you (or your child) would be referred to an endocrinology team for consideration of masculinising or feminising hormones.

The pause on the initiation of new prescriptions does not affect individuals who are already receiving NHS prescriptions for these medications. In these cases, prescribing may continue under the clinical supervision of an NHS-commissioned gender service

If you require support with your mental health, you should contact your GP and discuss these feelings and a referral to CYP mental health services. If you are already accessing CYP mental health services, then you can contact them directly.

All information regarding the latest advice from NHS England regarding hormones and the ban on puberty suppressing hormones can be found in the FAQ section of the website.

The waiting list

Referrals to Children and Young People’s (CYP) Gender Services can only be made by local NHS CYP mental health or Paediatric (England only) Teams.

If a child or young person is not already being seen by one of these teams, then their GP can make a referral to either team depending on the individual’s needs. The mental health or paediatric team are then able to refer on to CYP Gender Services.

There are currently 3 CYP Providers in the North West, South West and London and a fourth will open in the East of England by June. Two further services are planned to open later in 2026/27.

Once a young person approaches the top of the waiting list, the National Referral Support Service (NRSS) will make contact by email and text to offer a transfer to the nearest CYP Gender Service based on their home address.

Referrals are sent to the CYP Gender Services in batches, usually monthly, we are currently contacting Children and Young People referred around May 2022.

Please do not contact any of the CYP Gender Service providers about your referral as they will not have this information and will advise you to contact us.

Approaching 18 and ageing out of CYP Services

Young people with an English GP

The ageing out process takes place when a young person on the waiting list reaches 17 years and 9 months and is unlikely to be seen for an appointment before they turn 18, as they will no longer meet the age criteria for the Children and Young People (CYP) Gender Services.

When this happens, we will write to the young person and their GP to explain the situation and advise what happens next if a young person still wants to be seen by NHS gender services. It is recommended that the young person discusses available options with their GP, who can advise on whether a referral to an adult gender service or other appropriate support would be beneficial and explain how to access these services and where they are available. The letter will also explain that the referral to the CYP Gender Service has been closed due to no longer meeting the age criteria.

Please note that NHS England Adult Gender Clinics will honour the original referral date to the CYP Gender Service national waiting list, ensuring that all time spent on the national waiting list is not lost when transitioning between services. The age out letter to the young person and the GP confirms the original referral date and should be sent with the referral to the adult gender service to ensure the referral date can be accurately recorded. If the letter has been misplaced, then the young person, GP or adult gender service can contact us, and we will provide a copy.

Adult gender services will not accept referrals before the young person is 18, therefore the referral by the GP will need to be made on or after their 18th birthday. As we are not a clinical service, we are unable to make an onward referral on behalf of the young person. In addition, we do not hold recent medical information, and this is why we advise the young person and the GP to discuss whether an onward referral to an adult gender service is required plus any additional local adult support when the turn 18.

Young people with a Welsh GP

The ageing out process takes place when a young person on the waiting list reaches 17 years and 9 months and is unlikely to be seen for an appointment before they turn 18. They will no longer meet the age criteria for the Children and Young People (CYP) Gender Services.

In accordance with the Welsh protocol, the referral will be transferred to the NHS Welsh Adult Gender Service. The original referral and relevant notes will be shared with the Adult Gender Service, who will contact the patient in due course.

A copy of the letter will be sent to the patient and GP for their information and following the transfer of documentation to the Welsh Adult Gender service, the referral will then be closed.

Where to get support while you wait

Children, young people and their families are strongly discouraged from sourcing puberty suppressing or gender affirming hormones from unregulated sources or from on-line providers that are not regulated by UK regulatory bodies. More information can be found on the Frequently Asked Questions on this website.

We know that long waiting times can understandably cause anxiety and distress for young people and families.

If a child or young person is distressed, ask your GP to refer you to the local Children and Young People's Mental Health Service (CYPMHS), also known as Children and Adolescent Mental Health Services (CAMHS).

CYPMHS / CAMHS can offer support while you wait for your first appointment with the Children and Young People's Gender Services.

If a child or young person has been seen and discharged from a CYP Mental Health Service, then you can contact them directly as well as going to the GP.

Many areas, supported by the local authority and the NHS, are also developing services to support gender questioning young people. Information about local resources can usually be found by searching online for the name of your council and the words ‘transgender support’.

If you have any questions, please see the website FAQ page and chatbot which may be helpful. If the chatbot does not know the answer, you will be advised to email, and we will then reply and update the chatbot with the most asked questions.

• Frequently Asked Questions
• If you would like to use the chatbot please click on the icon at the bottom right of this page

We have gathered some additional resources that may provide support below regarding young people and gender matters, many of these are available for patients in Wales as well:

• NHS - Live Well

  The NHS Live Well pages provide advice for teenagers confused about their gender identity.

• Every Mind Matters

  Every Mind Matters provides support, including tips on how to improve your mental wellbeing.

• YoungMinds

  YoungMinds has a wealth of resources on their website, as well as providing dedicated crisis services. The YoungMinds Crisis Messenger provides free crisis support every day of the week, at any time, day or night. You just need to text YM to 85258. All texts are answered by trained volunteers, with support from experienced clinical supervisors. They also have resources for parents and carers as well.

• Papyrus

  Papyrus (Prevention of Young Suicide) provides advice and support for young people who feel like they want to take their own life, and all their advice is confidential. You can: call their helpline, HOPELineUK, on 0800 068 41 41 text them on 07786 209 687.

• MindEd

  MindEd is a free resource for parents, carers, health and education professionals regarding supporting children and young people with gender questions or distress. There is also more on different topics regarding children and young people to support their mental health.

• Samaritans

  Samaritans is an organisation you can ring at any time of the day or night. They'll help you and listen to how you're feeling. You can: call them on 116 123 or email them at jo@samaritans.org

• SHOUT

  SHOUT provides free, confidential, 24/7 text message support in the UK for anyone who is struggling to cope and anyone in crisis. You can text SHOUT to 85258. This service is free on all major mobile networks.

• ChildLine

  ChildLine provides a confidential telephone counselling service for any child with a problem. It comforts, advises, and protects. You can: call 0800 1111 any time for free have an online chat with a counsellor check out the message boards.

• The Mix

  The Mix provides a free confidential telephone helpline and online service that aims to find young people the best help, whatever the problem. You can: call 0808 808 4994 for free - lines are open from 11am to 11pm every day access the online community email The Mix.

• Healthier Together NHS Wales

  The site provides information for parents/carers, young people and professionals to improve the quality of care for children and young people in Aneurin Bevan University Health Board Advice/self-referral to SPACE Wellbeing :: Healthier Together.

• RCPSYCH

  The Royal College of Psychiatrists also has information for young people, parents and carers about young people's mental health.

Further information on help for children and young people can be found at nhs.uk.

Awareness of Online Harm for Children and Young People (CYP)

While the online world and social media may present opportunities for young people, they also present risks. Online channels can increase exposure to negative and harmful content including exposure to ideas and beliefs that may increase a young person's risk of self-harm and suicide by encouraging certain behaviours. There is also risk of exposure to online bullying.

Children, young people and their families are strongly encouraged to be careful regarding their exposure to online and social media content.

We know that a crucial step to better mental wellbeing is to connect with other people but it is important to avoid relying on technology or social media alone to build relationships. It is also important to avoid accessing websites or social media forums that may reference self-harm or suicide or increase the risk of these behaviours.

There are a variety of helpful resources to support young people and families to learn about online safety:

Online safety resources | Samaritans

Online harms: protecting children and young people | NSPCC Learning

Social Media & Mental Health | Guide For Parents | YoungMinds

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