Pharmacists “must not be criminalised” after a recent decision to uphold an emergency ban on puberty blocking hormones, the Royal Pharmaceutical Society (RPS) warned last week (July 31).

The membership body 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”.

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

The emergency ban, which is in place from June 3 to September 3 according to Community Pharmacy England (CPE), makes it a criminal offence to supply puberty blockers - although there are some exceptions.

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”, the RPS noted.

 

“Negatively affect patient care”

 

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.

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

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”.

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 last week (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.

It comes days 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.

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

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.

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”.

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

Read more: Passing the mic to transgender patients

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).