New Government Restrictions on the Use of Puberty Suppressing Hormones (GnRH Analogues) - Information for Prescribers

1) An emergency ban has been introduced (runs 3rd June to 3rd September) on private prescriptions of GnRH analogues for puberty suppression in those who are under 18 and experiencing gender dysphoria/incongruence. This applies to prescriptions written by UK private prescribers and prescribers registered in the European Economic Area (EEA) or Switzerland.

During this period it is expected that no new patients under the age of 18 will be initiated on these medicines for gender dysphoria/incongruence. Patients already established on these medicines by a UK prescriber for these purposes can continue to access them but any prescriptions issued from 3 June 2024 are to be marked with the person’s age, annotated by the prescriber with “SLS”, and in the case of prescriptions issued before that date, for the person to provide proof of identity and age.

2) Additionally, In England from 26 June 2024 there will be an indefinite restriction on General Practitioners supplying prescriptions for GnRH analogues - whether in NHS or private, except in the following circumstances:

• The patient is aged 18 years or over; or
• The patient is under 18 years old, and the purpose of the prescription is for a medical condition other than gender incongruence/dysphoria; or
• The patient is under 18 years old and has started treatment with these medicines, and for these purposes they will be treated as having started treatment if they have been issued with a prescription for these medicines since 3 December 2023, even if they have not yet started taking the medicines.

How will this affect the prescribing of GnRH analogues (buserelin, gonadorelin, goserelin, leuprorelin acetate, nafarelin or triptorelin) in Vision?

Please note that ‘gender dysphoria/incongruence’ is NOT currently a licensed indication for any of the GnRH analogues.

All NHS and private prescription for GnRH analogues now need to be endorsed as SLS (Selective List Scheme) by the prescriber. In Vision, the SLS flag on GnRH medicines will be visible in July.

Private prescriptions will need to be annotated (either electronically or by hand) as specified in 1). Vision will not be set up to print a prescriber endorsement on a private script.

Decision support for patient eligibility will not be implemented within the system and it is the responsibility of the prescriber to be aware of these legislation changes.