The Care Quality Commission (CQC) has registered Gender Plus Hormone Clinic to provide hormone treatments to 16 and 17-year-old children.

This paves the way for other private clinics to be registered,  which would offer controversial medical treatments with lifelong consequences to vulnerable teenagers. The decision of the CQC to license a private clinic, creates a significant risk of a two tier approach, with less protection for those who seek help from the private sector. This further risks undermining the work of the Cass review for NHSE practice.

I want the court to set aside the registration by the CQC of Gender Plus Hormone Clinic to provide hormone treatment for teenagers. I also hope that this litigation will prevent the registration of other private clinics providing this controversial treatment. I want to ensure that those under 18 years old, do not suffer irreversible, lifelong harms both physical and psychological, from taking a controversial hormonal treatment which is not evidenced as safe or effective.

Why I am asking for this Judicial Review

I was in the NHS for nearly 40 years and I am now a psychotherapist in private practice. I have worked with people who present with issues around  their gender identity for over 20 years. In my clinical experience of working with children and young people, I have not, to date, encountered a 16 to 17-year-old who I would have assessed to be sufficiently fully informed and psychologically ready to make such a life changing, potentially harmful decision. They are in the process of development from child to adult which involves significant mental and physical adjustments. Many of the young people with gender dysphoria/incongruence have no clear understanding of their underlying motivations to take cross, sex, hormones. However they are usually very aware of the discomfort they experience, and often hold a strong belief that the medication will help them feel better. They hope a change to their physical body will bring about a comfort in their mind. Some also receive strong messages from certain groups that medication is the answer to their difficulties which creates an urgent pressure on them and those around them for a solution. As a result, they are rarely able to give a full, in-depth psychological consideration to the implications and consequences of commencing a physical treatment, which is known to have serious, harmful side-effects, and, as yet has a very low level evidence base for it's efficacy and safety.

Under its current registration by the CQC, Gender Plus Hormone Clinic (GHPC) is not prevented from providing GnRH analogues (blockers) for the purpose of suspending puberty. There are some 16-year-olds who have not reached pubertal maturation. Further, the GPHC  has said that it would prescribe puberty blockers “alongside oestrogen therapy to achieve feminising effects”. The NICE report (National Institute of Clinical Excellence) and the Cass review both state that this treatment model is not proven. 

There is also considerable risk of complications due to this powerful medication. There are many known side-effects, including blood clots, gallstones, vaginal atrophy and male pattern baldness for females and potential loss of fertility, amongst many others. 

The evidence base

The Cass review was commissioned by the NHS to provide a comprehensive review of the appropriate treatment for children and young people with gender dysphoria. The Cass Review sought advice from  the National Institute for Health and Care Excellence (NICE) which conducted two separate evidence reviews.

Neither of them has found sufficient evidence to support the use of either puberty blockers or cross sex hormones as safe and effective.

In her interim report published in February 2022, Dr Cass has emphasised the gaps in the "evidence base regarding hormone treatment" (Para 1.41). Although some of her observations related specifically to puberty blockers, she also addressed cross-sex, hormones, and hormone treatment more generally. She said, among other things:

"The Review is not able to provide definitive advice on the use of puberty blockers and feminising/masculinising hormones at this stage, due to gaps in the evidence base; however, recommendations will be developed as our research programme progresses. 

“The lack of available high-level evidence was reflected in the recent NICE review into the use of puberty blockers and feminising/masculinising hormones commissioned by NHS England, with the evidence being too inconclusive to form the basis of a policy position” (para 5.21)

“At present we have the least information for the largest group of patients – birth- registered females first presenting in early teens” (para 5.11).

Your help:

I need your help to ensure that the registration of GPHC is cancelled and the other private clinics are unable to prescribe this controversial treatment to children under 18. We should not be careless or look away from the potential harms this medical treatment might cause to childrens previously healthy bodies. 

Please support me with the legal fees required to mount a judicial review and challenge the  CQC decision. I was the original claimant who started the Kiera Bell JR with Mrs A and our application on that occasion was successful in providing further scrutiny and attention in this area of paediatric healthcare. That judicial review potentially helped prevent irreversible harms to much younger children too as it led to a much wider scrutiny of the model of treatment in the GIDS.

I have assembled an expert legal team and will be lodging my claim with the High Court in the next few days. Please join me in seeking to protect vulnerable young people and share this crowdfunder link. I know these cases keep coming but we need to protect the next generation. 

My X (twitter) handle is @sueevansprotect

Thank you very much.