Restrictions on puberty suppressing hormones

Information for children and young people under 18 who are taking gonadotropin-releasing hormone analogues (GnRH analogues).

Gonadotropin-releasing hormone analogues (GnRH)

Gonadotropin-releasing hormone analogues (GnRH analogues), commonly referred to as puberty suppressing hormones or puberty blockers when prescribed as a treatment for puberty suppression in under 18s.

The Cass Review

The UK Government introduced emergency restrictions on 29 May 2024 on the sale and supply of GnRH analogues when they are used to suppress puberty as part of treating gender incongruence or gender dysphoria in children and young people under 18.

These restrictions were introduced in response to the Cass Review which was commissioned by NHS England. The review was conducted to make recommendations on how to improve NHS gender identity services for children and young people.

The recommendations of the review will ensure:

  • that children and young people who are questioning their gender identity or experiencing gender dysphoria receive a high standard of care that meets their needs
  • the care is safe, holistic and effective

The Cass Review highlighted that the quality of evidence for prescribing GnRH analogues to suppress puberty is poor and the risk of short or long-term harm is unclear.

The new restrictions apply to medicines that consist of or contain buserelin, gonadorelin, goserelin, leuprorelin acetate, nafarelin, or triptorelin. This includes, but is not limited to medicines sold under the brand names:

  • Decapeptyl®
  • Gonapeptyl
  • Depot®
  • Salvacyl®
  • Prostap®
  • Staladex®
  • Zoladex®
  • Synarel®

Changes made by the UK Government

From 3 June 2024, it’s a criminal offence to sell or supply (prescribe or dispense) these medicines to individuals under the age of 18 years.


The ban applies except in the following situations.

The child or young person has an NHS prescription

Additional changes to NHS prescribers in GP practices will come into force shortly.

The child or young person has a private prescription from a prescriber registered in the UK that fulfils one of the following criteria:

The first prescription to start treatment was dated before 3 June 2024. This could have been an initial prescription or a repeat prescription. In this situation, the prescription can still be dispensed. In practice, unless it is a repeat prescription, it will need to have been issued within the previous 6 months to still be valid.

Or, the prescription is written on or after 3 June 2024 for the treatment of gender incongruence of dysphoria in which case the child or young person must have started treatment before 3 June 2024. In addition to those who have started treatment, a child or young person is considered to have started treatment, even if they have not yet actually started to take the medicine, if they were prescribed it on or after 3 December 2023.

The prescription is for another condition

The prescription is to treat something other than gender incongruence or gender dysphoria.

From 3 June 2024, it’s a criminal offence to possess GnRH analogues if you know they’ve been sold or supplied in breach of this ban.

Other prescriptions

From 3 June 2024, private prescriptions for GnRH analogues from a prescriber registered in the European Economic Area (EEA) or Switzerland are banned from being prescribed in Great Britain in all circumstances for patients under 18.

Buying GnRH analogues from unregulated sources

You should not buy GnRH analogues or any other medicine from unregulated sources including:

  • the internet
  • friends
  • other dealers

Who will be impacted by these changes?

You may be impacted by the new UK Government policy if you’re a child or young person under 18 and either:

  • currently receive a prescription for a GnRH analogue from a prescriber registered in the EEA or Switzerland
  • intend to get a prescription from a prescriber registered in the EEA or Switzerland
  • are due to start a private course of treatment for gender incongruence or gender dysphoria in the coming months


The UK Government’s changes may cause worry and concern to some children and young people under 18 and their families. If the new restrictions are impacting your mental health you may want to seek support.

If you’re under the care of an NHS mental health service, you should contact your team. If not, you can contact your GP practice for help.

Childline provides a free, private and confidential service online and on the phone where you can talk about anything. They can be contacted on 0800 1111.

LGBT Youth Scotland can provide confidential advice and support, including one to one support and peer support, for those who are exploring their gender identity.

Breathing Space offers free and confidential advice for people experiencing low mood, depression or anxiety, whatever the cause. They can be contacted on 0800 83 85 87, 6pm to 2am Monday to Thursday; and 6pm Friday through the weekend to 6am Monday. Calls to Breathing Space are free from landlines and from mobile networks. You can also access which provides a wide range of information and advice about coping with low mood, depression and anxiety.

Samaritans on 116 123 provide confidential non-judgemental emotional support, for people who are experiencing feelings of distress or despair, 24 hours a day.

LGBT Health and Wellbeing offer individual support and provide information. Their staff offer support in accessing healthcare as well as providing mental health support.