The UK government has announced an extension to the “temporary ban on prescription and supply” of puberty blocking hormones to come into effect today (August 27), it announced last week (August 22).

The emergency ban on gonadoatrophin-releasing hormone will end in three months on November 26 and it has also been extended to Northern Ireland following an agreement from the Northern Ireland Executive. 

Read more: Pharmacists ‘must not be criminalised’ over puberty blocking hormones 

The extension of the ban applies to “the sale or supply of these drugs, prescribed by private UK-registered prescribers for gender incongruence or dysphoria to under 18s not already taking them [and] from prescribers registered in the European Economic Area or Switzerland for any purposes to those under 18”, according to the government. 

C+D previously reported the ban was in place from June 3 to September 3 and after a judicial review, the decision to introduce the emergency ban was upheld. 

Pharmacists may “unknowingly break the law” 

But the Royal Pharmaceutical Society (RPS) warned last month (July 31) that pharmacists “must not be criminalised” as it raised concerns that pharmacists in England, Scotland and Wales will not dispense the medication to people with gender incongruence and gender dysphoria because of a “fear of prosecution” if they “unknowingly break the law”. 

This is partly because the “medicines can still be legitimately supplied to under 18s for very early onset of puberty, to people under 18 with gender dysphoria already in treatment and to people aged 18 and over”, according to the RPS. 

Read more: From a lawyer: Emergency ban on the private prescribing of puberty blockers 

But the ban will criminalise pharmacists who dispense the medication unknowingly to a patient who may mislead them “about their clinical condition, age or identity”, the membership body said. 

This may “negatively affect patient care” as pharmacists will avoid dispensing so they don’t break the law, it added. 

The RPS said that the “speed at which the ban was issued” with no “advance ‘run-in’ period” means that pharmacists may be unaware of the ban and “inadvertently dispense a prescription”. 

Read more: GPhC: Pharmacists need ‘clear routes’ of referral for gender dysphoria patients 

It called on the government to “provide timely access to specialist care pathways to support patients” and find a solution that does not “unfairly criminalise pharmacists”. 

Guidance for pharmacists 

After the emergency ban was upheld, the General Pharmaceutical Council (GPhC) told C+D this month (August 1) that “the ruling does not change anything for pharmacists” and pointed to its guidance for pharmacists supporting children and young people with gender incongruence or dysphoria. 

Before the emergency ban was introduced, GPhC guidance published in May said that pharmacists should consider multiple factors to determine whether “a prescription is clinically appropriate for the individual patient”. 

Read more: Children exposed to topical testosterone risk ‘genital enlargement', MHRA warns 

“It is not enough for a prescription to be legally valid”, including those “from prescribers working in overseas gender clinics,” it added. 

It comes after health minister Karin Smyth responded in parliament (July 29) to a question about the UK’s position on prescribing puberty blockers compared to other European countries. 

Smyth said that “it is simply not possible for pharmacists to check whether prescriptions issued from overseas registered prescribers have been issued in a similarly safe and effective way”. 

“We know that some overseas providers who advertise their services do not follow this approach," she added. 

Read more: Passing the mic to transgender patients 

The GPhC said other factors include considering the relevant policies and guidance, taking note of the findings of the Cass Review, understanding whether the prescriber has “sufficient expertise” and is complying with regulations and taking into account any “risks” to the patient. 

In March, GPhC chief executive Duncan Rudkin said that pharmacists need “clear routes” of referral and easy access to “support and care” for children with gender incongruence or dysphoria after NHS England (NHSE) published its policy on puberty suppressing hormones (PSHs).