The Times and the BBC revealed last week (October 6) that parents of transgender children can obtain puberty blockers and sex hormones on prescription by GenderGP, which is owned by Hong-Kong-based company Harland International. Parents could place orders for these medicines from online pharmacy Clear Chemist, which is based in Aintree, Merseyside and is owned by RB Healthcare Ltd.

The Times article suggested that the service offered by the two providers allowed people to circumvent some safeguards that are in place to protect children who receive the medicines through NHS routes. GenderGP said it operates entirely legally and Clear Chemist said its collaboration with the clinic had not previously been deemed a regulatory issue.

The General Pharmaceutical Council (GPhC) said it was “looking into concerns raised about Clear Chemist as a matter of urgency” in a statement last week (October 8).

“We carried out a targeted visit of the pharmacy earlier this week and looked in detail at whether the pharmacy was meeting the required standards, including in relation to managing risks relating to the services it is providing and in safeguarding vulnerable patients. We are now considering what further regulatory action to take,” it said.

Clear Chemist said it is “temporarily” suspending fulfilling prescriptions from GenderGP and stressed in a statement on October 9 that while “this interim decision” was not enforced by the GPhC, it is “seeking to engage with” the regulator on the matter.

The pharmacy said it took the decision “with a heavy heart” and has asked GenderGP to “issue paper prescriptions that can be fulfilled at any other pharmacy” to ensure continuity of care, it said.

Clear Chemist said the GPhC had already noted its collaboration with GenderGP during its “last inspection” and that “no remedial actions were needed” then.

Alternative pharmacy providers

GenderGP said it has “identified a number” of pharmacies that can offer the service to patients “of all ages while Clear Chemist refines the process by which it will operate moving forward”, it said in an update to patients on its website on Saturday (October 10).

These pharmacies have received training to “maximise their skills and knowledge in helping transgender patients”, and GenderGP will signpost to them when local pharmacies “feel unable” to fulfil these prescriptions, a spokesperson told C+D today (October 12).

Children under the age of 18 with suspected gender dysphoria are generally referred to the Gender Identity Development Service (GIDS) at the Tavistock and Portman NHS Foundation Trust, which has one site in London and another in Leeds.

Children using these NHS services receive a detailed clinical assessment that could take “several months”. Those who have “lasting signs of gender dysphoria and who meet strict criteria may be referred to a hormone specialist” before they start taking medication, according to the NHS.

Comply with UK regulations

“Although Clear Chemist already meets the regulatory standards required by the GPhC, we actively welcome the opportunity to review its guidance with it around the provision of medication for transgender patients,” Clear Chemist added.

Meanwhile, the GPhC urged pharmacies to ensure that UK national prescribing guidelines are complied with when pharmacies under its jurisdiction work with non-UK registered providers.

“We also expect pharmacy owners to make sure they do not work with online providers who are trying to circumvent the regulatory oversight put in place within the UK to ensure patient safety throughout the healthcare system,” the GPhC added.

In response to The Times’s and BBC’s investigations, GenderGP said in a statement on October 6 that the UK media is perpetuating the myth that the “NHS is the only legitimate route to specialist care”.

The company claimed the publications did not enquire about the “terrible state of trans healthcare in the UK or the levels of distress faced by trans youth in our country”.

GenderGP owner Harland International said that GenderGPs medical specialists are “regulated in their own country” and the company “operates entirely within the law and follows international published guidance on the care of transgender patients of all ages”.

“There is no published UK medical guidance on this subject,” it added.