Cross-sex hormones (CSH) have a significant impact on the bodies of young people.

TESTOSTERONE for girls produces the secondary sex characteristics of men and boys including a deepened voice, facial and body hair along with an increase in muscle growth and an enlarged clitoris. Potential harms may include damage to bones, poor cardiovascular health, loss of fertility and a higher risk of diseases including cervical cancer.

ESTROGEN for boys enlarges chest tissue to give the appearance of breasts and redistributes fat around the body. Potential harms may include an increased risk of blood clots and testicular cancer. Boys who have taken puberty blockers before the age of 12 followed by estrogen are unlikely to ever achieve orgasm.

Impaired sexual function in both males and females can cause frustration, depression and anger.

LGB Alliance is relieved that the NHS will now not routinely prescribe these powerful drugs to under 18s but alarmed that unscrupulous private providers continue to target vulnerable children and their families.

NHS England has warned GPs against a shared care arrangement – an arrangement whereby a specialist might tell a GP that a child should receive testosterone and a GP would prescribe the drug and provide that child’s on-going care – with “any unregulated provider”. Anne Trans Healthcare Ltd and GenderGP are specifically named as posing an “on-going safety risk to children and young people in the UK”.

It is impossible to know how many children and young people are accessing CSH from these, and other, private providers.