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1647807

registered interest
date	26/06/2023
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Gender Dysphoria: Children
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what action they will take if any new organisation prescribes puberty blockers to children, other than as part of a clinical trial in accordance with the policy of NHS England.
tabling member printed	Lord Warner
uin	HL8786
answer	answer is ministerial correction date of answer 18/07/2023 answer text <p>All healthcare providers, whether they are providing an NHS funded or privately funded service, should follow clinical best practice and be registered with their professional body and any other regulators, as appropriate for that service. The Department will work with relevant regulatory bodies to ensure that any organisation and people prescribing puberty blockers are doing so in line with the regulatory framework and appropriate professional standards which any health care provider must legally meet.</p> answering member printed Lord Markham question first answered 18/07/2023 13:52:18 answering member 4948 label Biography information for Lord Markham
tabling member	1732 label Biography information for Lord Warner

1647808

registered interest
date	26/06/2023
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Gender Dysphoria: Children
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what regulatory arrangements are in place to ensure the safety of children and teenagers in respect of any private organisation providing puberty blocking hormonal treatment or gender surgery.
tabling member printed	Lord Warner
uin	HL8787
answer	answer is ministerial correction date of answer 17/07/2023 answer text <p>All healthcare providers carrying out regulated activity should follow clinical best practice and must be registered with their professional body and any other regulators, as appropriate, for that service. If a private organisation fails to meet the standards expected of it, then regulators including the Care Quality Commission have powers to inspect these services to determine whether patient safety is at risk or if best practice is not being followed.</p> answering member printed Lord Markham question first answered 17/07/2023 13:46:56 answering member 4948 label Biography information for Lord Markham
tabling member	1732 label Biography information for Lord Warner

1628968

registered interest
date	18/05/2023
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Gender Dysphoria: Children
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what measures they have in place to ensure that treatments for children diagnosed with gender dysphoria at the Tavistock Clinic follow NHS guidance, and that all drugs and treatments are accurately assessed for their long-term effect.
tabling member printed	Lord Pearson of Rannoch
uin	HL7952
answer	answer is ministerial correction date of answer 06/06/2023 answer text <p>All specialised services that NHS England commission must be provided in line with the relevant service specification that NHS England publish for those services. The Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust is commissioned in line with NHS England’s published service specification. An Independent Multi-Professional Review Group continue to review all referrals for puberty blockers for Gender Identity Development Service patients.</p><p>Following the Cass Review’s interim recommendations, NHS England has commissioned the establishment of a research protocol which will consider the long-term impact of puberty blockers. Children will be prescribed puberty blockers as part of this protocol once it is operational.</p><p>NHS England has also established a national Children and Young People's Gender Dysphoria Research Oversight Board to oversee future research into treatments offered to children diagnosed with gender dysphoria.</p> answering member printed Lord Markham question first answered 06/06/2023 14:55:12 answering member 4948 label Biography information for Lord Markham
tabling member	3153 label Biography information for Lord Pearson of Rannoch

1628969

registered interest
date	18/05/2023
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Gender Dysphoria: Children
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government whether parents are informed if their child expresses a desire (1) in school, or (2) in an NHS facility, to change sex; and if not, whether they intend to introduce a right for parents to be so informed.
tabling member printed	Lord Pearson of Rannoch
uin	HL7953
answer	answer is ministerial correction date of answer 06/06/2023 answer text <p>The Department for Education is working with the Minister for Women and Equalities to develop guidance to support schools in relation to gender questioning pupils. The Department for Education will publish a draft for consultation soon.</p><p> </p><p>The NHS England interim service specification and clinical policies in relation to a child or young person seeking hormone interventions require assent from the parents in addition to consent from the child or young person.</p> answering member printed Lord Markham question first answered 06/06/2023 14:54:21 answering member 4948 label Biography information for Lord Markham
tabling member	3153 label Biography information for Lord Pearson of Rannoch

1550162

registered interest
date	08/12/2022
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Gender Dysphoria: Children
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government how many children have been prescribed puberty blockers in each of the last 10 years.
tabling member printed	Lord Blencathra
uin	HL4140
answer	answer is ministerial correction date of answer 15/12/2022 answer text <p>Gonadotropin-releasing hormone agonists or ‘puberty blockers’ are used to treat several medical conditions in children and young people. These include precocious puberty, some forms of cancer, endometriosis and gender dysphoria. Information on the clinical indication for which these medications have been prescribed is not held centrally.</p><p> </p><p>The following table shows the number of identifiable patients where gonadotropin-releasing hormone agonists for all purposes for children aged under 18 years old has been prescribed and dispensed in primary and secondary care prescribing and dispensing in the community in England in each year from 2015/16 to September 2022. Data is not held prior to April 2015.</p><p> </p><table><tbody><tr><td><p>Financial year</p></td><td><p>Patients identified</p></td></tr><tr><td><p>2015/2016</p></td><td><p>885</p></td></tr><tr><td><p>2016/2017</p></td><td><p>987</p></td></tr><tr><td><p>2017/2018</p></td><td><p>1,047</p></td></tr><tr><td><p>2018/2019</p></td><td><p>1,072</p></td></tr><tr><td><p>2019/2020</p></td><td><p>1,048</p></td></tr><tr><td><p>2020/2021</p></td><td><p>936</p></td></tr><tr><td><p>2021/2022</p></td><td><p>864</p></td></tr><tr><td><p>April to September 2022</p></td><td><p>693</p></td></tr></tbody></table><p> </p><p>Source: NHS Business Services Authority</p><p> </p><p>Note:</p><p>Prescriptions have only been included where a National Health Service number has been identified during processing and an age has been recorded. The same patients may appear in multiple years.</p> answering member printed Lord Markham question first answered 15/12/2022 13:09:49 answering member 4948 label Biography information for Lord Markham
tabling member	497 label Biography information for Lord Blencathra

1543082

registered interest
date	16/11/2022
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Gender Dysphoria: Children
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what assessment they have made of the use of off-label puberty blockers; and how many children have been given off-label puberty blockers in the last five years.
tabling member printed	Lord Blencathra
uin	HL3451
answer	answer is ministerial correction date of answer 28/11/2022 answer text <p>Clinicians can prescribe medicines outside the licensed indication where it is considered the best treatment for the patient. Gonadotropin-releasing hormone antagonists are used in line with granted medical authorisations and ‘off label’ to treat several medical conditions in children, including precocious puberty, some forms of cancer, gender dysphoria and endometriosis. Clinicians are professionally accountable for prescribing decisions and to service commissioners.</p><p>Dr Hilary Cass is currently reviewing how the National Health Service prescribes puberty blockers to children and young people with gender dysphoria. Her interim review concluded that there is insufficient evidence currently available for any firm recommendations on the routine use and that further research is needed. NHS England and the National Institute for Health and Care Research are designing and commissioning a research protocol which will prospectively enrol young people being considered for hormone treatment. Information on prescriptions of puberty blockers dispensed in the community in England for gender dysphoria is not held centrally.</p> answering member printed Lord Markham question first answered 28/11/2022 13:37:45 answering member 4948 label Biography information for Lord Markham
tabling member	497 label Biography information for Lord Blencathra

1543083

registered interest
date	16/11/2022
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Gender Dysphoria: Children
house id	2
legislature	25277 pref label House of Lords
question text	To ask His Majesty's Government what assessment they have made of effect that puberty blockers have on the (1) mental, and (2) physical, development of patients when given to them as children.
tabling member printed	Lord Blencathra
uin	HL3452
answer	answer is ministerial correction date of answer 28/11/2022 answer text <p>Gonadotropin-releasing hormone analogues are used in line with granted medical authorisations and ‘off label’ to treat several medical conditions in children and young people. These include precocious puberty, some forms of cancer, gender dysphoria and endometriosis.</p><p>The Department is supporting a review led by Dr Hilary Cass into the gender identity services provided to children and young people, including the use of hormone treatments. Dr Cass has recommended that the National Health Service consider establishing a formal research programme which would prospectively enrol young people where the use of puberty blockers is being considered and follow their development into adulthood. NHS England supports this recommendation and will work with the National Institute for Health and Care Research to design and commission the necessary research protocol.</p> answering member printed Lord Markham question first answered 28/11/2022 13:39:05 answering member 4948 label Biography information for Lord Markham
tabling member	497 label Biography information for Lord Blencathra

1293760

registered interest
date	01/03/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Gender Dysphoria: Children
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government what plans they have to discourage the sale of (1) puberty blockers, and (2) cross-sex hormones, over the internet to children who do not have (a) a prescription, or (b) parental permission.
tabling member printed	Lord Lucas
uin	HL13759
answer	answer is ministerial correction date of answer 16/03/2021 answer text <p>We would expect all registered pharmacies and pharmacists to meet the regulatory standards set by the General Pharmaceutical Council or the Pharmaceutical Society of Northern Ireland when considering dispensing any lawfully valid prescription. This includes puberty blockers and cross-sex hormones.</p><p>The Department has agreed with the Care Quality Commission (CQC) to investigate changes to regulations that would allow the CQC to take enforcement action against online healthcare providers.</p> answering member printed Lord Bethell question first answered 16/03/2021 17:09:11 answering member 4708 label Biography information for Lord Bethell
tabling member	1879 label Biography information for Lord Lucas

1284591

registered interest
date	08/02/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Gender Dysphoria: Children
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the report by the Care Quality Commission (CQC) Tavistock and Portman NHS Foundation Trust Gender identity services: inspection report, published on 20 January, and the statement that “separate from our inspection the High Court made a ruling on the 1 December 2020 around capacity and consent of children receiving hormone intervention for gender dysphoria”, what discussions they have had with the CQC about undertaking a further review of the Gender Identity Services at Tavistock and Portman NHS Foundation Trust.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13090
answer	answer is ministerial correction date of answer 19/02/2021 answer text <p>The High Court ruling of 1 December 2020 is subject to ongoing legal proceedings and as such we are unable to comment.</p><p>The Care Quality Commission (CQC) shared the report on Tavistock and Portman NHS Foundation Trust Gender Identity Services (GIDS) with the Department prior to publication. The Department welcomes the report and is aware that the CQC will follow its normal process of monitoring and further inspection activity to further review the GIDS.</p><p>The CQC continues engagement with NHS England and NHS Improvement on their independent review of gender services for children and young people, led by Dr Hillary Cass on how care can be enhanced. The review will report later in the year. This report will cover issues such as how and when young people are referred to specialist services, clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.</p> answering member printed Lord Bethell grouped question UIN HL13091 HL13092 HL13267 question first answered 19/02/2021 11:42:40 answering member 4708 label Biography information for Lord Bethell
tabling member	2024 label Biography information for Lord Hunt of Kings Heath

1284592

registered interest
date	08/02/2021
answering body	Department of Health and Social Care
answering dept id	17
answering dept short name	Health and Social Care
answering dept sort name	Health and Social Care
hansard heading	Gender Dysphoria: Children
house id	2
legislature	25277 pref label House of Lords
question text	To ask Her Majesty's Government, further to the report by the Care Quality Commission (CQC) Tavistock and Portman NHS Foundation Trust Gender identity services: inspection report, published on 20 January, what assessment they have made of the statement in that report that the High Court ruling on 1 December 2020 about the capacity and consent of children receiving hormone interventions for gender dysphoria has not impacted its findings.
tabling member printed	Lord Hunt of Kings Heath
uin	HL13091
answer	answer is ministerial correction date of answer 19/02/2021 answer text <p>The High Court ruling of 1 December 2020 is subject to ongoing legal proceedings and as such we are unable to comment.</p><p>The Care Quality Commission (CQC) shared the report on Tavistock and Portman NHS Foundation Trust Gender Identity Services (GIDS) with the Department prior to publication. The Department welcomes the report and is aware that the CQC will follow its normal process of monitoring and further inspection activity to further review the GIDS.</p><p>The CQC continues engagement with NHS England and NHS Improvement on their independent review of gender services for children and young people, led by Dr Hillary Cass on how care can be enhanced. The review will report later in the year. This report will cover issues such as how and when young people are referred to specialist services, clinical decisions around how doctors and healthcare professionals support and care for patients with gender dysphoria.</p> answering member printed Lord Bethell grouped question UIN HL13090 HL13092 HL13267 question first answered 19/02/2021 11:42:40 answering member 4708 label Biography information for Lord Bethell
tabling member	2024 label Biography information for Lord Hunt of Kings Heath