In April 2025, NHS England (NHSE) instructed a Brighton-based GP surgery to stop prescribing masculinising and feminising hormones to children under 18 who were experiencing gender incongruence, or distress surrounding their gender identity. A joint NHS Sussex and NHSE investigation was announced in June because of “concerns” over the prescribing practices of Dr Sam Hall and the WellBN practice. The official terms of reference state that there are “indications that patient harm may have occurred”. The New Statesman can reveal that multiple health authorities, including the General Medical Council (GMC) and NHSE, have been aware of concerns relating to these same practices dating back at least five years. At both a national and local level, the NHS has known that WellBN has been prescribing outside of all NHS guidelines for young people, and yet no one has taken meaningful action.
As of May 2025, up to 139 children (under 18) were in receipt of either irreversible hormones or drugs to block their puberty, or both, from Brighton’s WellBN practice. While the majority being prescribed hormones – testosterone for girls wanting to appear more masculine, oestrogen for males wishing to feminise their bodies – were aged between 15 and 17 and a half, official records show some were under 13 years old. We do not know the exact age of the youngest. Children this young have never been approved for hormones in NHS specialist gender services. It is no longer legal to issue new prescriptions of puberty blockers (officially known as gonadotropin-releasing hormone agonists, or GnRHa) in the UK for treatment of gender-related distress outside of an NHS research trial. The New Statesman understands that WellBN did not initiate the prescribing of puberty blockers for any of these children but continued it after taking over their care from private providers.
The investigation will initially focus on children currently being prescribed. A second phase will then give “further consideration” to trying to identify others “who were under the age of 18 at the time of being prescribed medications” but who are now adults. It’s unclear how high that number might be. Hall has stated publicly that between 2019 and 2025, the number of trans and non-binary patients (adults and children) on WellBN’s books grew from 60 to 2,500. Hall, a trans man who moved from hospital care to general practice in 2019 in part to help improve trans healthcare, told Trans Pride Brighton during a YouTube interview that he saw his arrival at WellBN as “a bit like a Pied Piper moment. As soon as I joined the practice, other people sort of came.”
This publication can reveal that concerns around the safety and welfare of children under Hall’s care were first raised with NHSE in 2020 by other medical staff working in Sussex. Professionals were concerned by safeguarding concerns relating to certain children, Hall’s lack of specialist knowledge, and that prescriptions were occurring outside of specialist NHS gender services for children. Hall and WellBN openly state that they follow the “informed consent” model of care for young gender-questioning patients, which removes any type of mental health assessment from the process of obtaining hormones or the need to see a specialist. The individual is seen as the expert on themselves. Doctors should provide information on hormone treatment so that the individual can make an informed decision about their own care. As Hall puts it, “This isn’t about you having an assessment to see if you’re trans… you shouldn’t have to jump through hoops. You shouldn’t have to explain yourself to anyone. You certainly shouldn’t be psychiatrically analysed.”
As a result of the 2020 complaint, an internal NHSE investigation was conducted. It concluded there were no professional concerns over Hall’s actions. Instead, the report pointed to the long waiting lists faced by children to be seen by NHS specialist services and appeared to imply that the concerns might have been underpinned by transphobia. Further concerns from parents of a 16-year-old in receipt of a hormones prescription followed in the summer of 2023, and later that year James Palmer – head of the NHS’s specialised services, which cater for patients with rare or complex conditions – met with the family to hear their story. It’s understood that in February 2024, both NHSE’s medical director and its medical director for primary care were briefed on the situation and further steps were being considered. In March 2024, I published details of Hall and WellBN’s prescribing of hormones to under-18s outside of NHS guidelines in my book, Time to Think. At no point during this period did NHSE place any restrictions on the actions of Hall or his colleagues.
An NHS spokesperson said: “We have listened carefully to concerns from both professionals and parents about the treatment of children with gender incongruence by the WellBN Clinic in Brighton. This has informed some of the major steps we have taken to transform the way the NHS provides gender healthcare for children and young people.” The spokesperson confirmed, “NHS professional standards teams have undertaken a number of investigations.”
When the first of at least three complaints was raised with the regulator General Medical Council (GMC) in 2021, the latter organisation cited the earlier NHSE report as reason for taking no action against Hall. Yet the New Statesman understands that, as part of the complaint, the GMC was provided with documentation purporting to show that Hall had, at this time, prescribed puberty blockers to several children under the age of 16 and was considering hormone treatment for those aged 16 and older.
Two further complaints were made to the GMC, both by parents of 16-year-olds being prescribed hormones by Hall and the WellBN practice. Again, the GMC found no case to answer. The most recent complaint, submitted in October 2024, explained that the child concerned had forged their parents’ signature to obtain their first hormone prescription and was receiving specialist help for mental health difficulties. It also referred to the Cass Review into youth gender services – the findings of which were accepted in full by NHSE – which urged “an extremely cautious clinical approach and a strong clinical rationale for providing hormones before the age of 18”. The GMC’s brief response, sent in February 2025, said that one of its decision-makers was “assured that the matters contained in your complaint do not raise concerns that Dr Hall poses either a risk to patients or undermines the public’s confidence in doctors”. As a result, the GMC would “not take the matter any further and will close our enquiry with no further action”.
A GMC spokesperson said that where concerns are raised about a doctor, its investigators “review all relevant information available to them, including records of all previous complaints and decisions”. Decisions, it continued, are made “on their merit, and in the interest of maintaining confidence in the professions we regulate and patient safety”. The GMC is aware of the ongoing investigation into WellBN and is ready to assess any information NHSE and NHS Sussex make available to it. The NHS confirmed that it was “aware of two GMC referrals in 2021 and 2025”.
Just as the GMC and NHSE have known of Sam Hall and WellBN’s prescribing practices for half a decade, so too has the local NHS in Sussex. Indeed, in a letter sent by Hall and his fellow GP partners at WellBN to NHS Sussex, seen by the New Statesman, the doctors say they have been “formally commissioned” by NHS Sussex to prescribe hormones to 17-year-olds and over since 2022. Moreover, the letter, dated 15 April 2025, states that the WellBN team “have been initiating treatment for gender incongruence with full transparency and with your express knowledge to 16[-year-olds] and over for the past 5 years”. Speaking to Trans Pride Brighton in July 2025, Hall said: “I’ve been doing [it] for the last five years with the full knowledge of everybody in the system… What’s changed? Nothing. I’m not doing anything different.”
What had changed is that the NHS was facing legal action. Less than two months after the GMC had concluded – for the third time – there were no safety concerns surrounding Sam Hall’s practices at WellBN, NHS England came to a completely different conclusion. In a document seen by the New Statesman, dated 8 April 2025, NHSE told the Sussex Integrated Care Board (NHS Sussex) that it was their view that “the approach adopted by WellBN sits neither within the scope of a specialised [gender] service commissioned by NHS England” nor was it within the treatments offered under the General Medical Services contract. (This outlines the core health services GPs are required to provide.) As a consequence, WellBN, of which Hall was one of three GP partners until his departure at the end of June 2025, “should be instructed to cease offering the prescription of exogenous hormones for gender incongruence” to 16- and 17-year-olds.
NHS Sussex passed on a slightly different message to the Brighton GP practice, however. It required WellBN to “immediately cease from offering, arranging or otherwise facilitating the prescription of exogenous hormones for gender incongruence… to any new patients [my emphasis] aged under 18”. There had been no such caveat that existing prescriptions could continue in NHSE’s instruction; the Sussex Integrated Care Board inserted it. Prescriptions are continuing to be issued to children while the investigation is under way. The New Statesman is aware of new three-month prescriptions being issued in July.
“For my son, it’s disastrous,” one parent told the New Statesman. Their male-born child identifies as female and has been prescribed oestrogen and a testosterone blocker by WellBN for ten months. “It’s heartbreaking,” they added. “He is completely disengaged. He can no longer evaluate situations properly, or risk. He has lost a lot of the talents he used to have and there is a noticeable decline in his cognitive abilities reflected in his school performance.” This parent insists their child has noticeably declined in the past four months, after NHSE instructed NHS Sussex that prescriptions should cease. Their child continues to receive hormones, as WellBN was told by the local NHS to cease issuing prescriptions to new patients only. “It’s getting much worse. The body changes have become more manifest, and he has become obese. But his global functioning, I mean, he is dysfunctional.” Moreover, there has been no promised improvement in mental health. If anything, they have seen their child decline.
[See also: Hilary Cass interview: “Do I regret doing it? Absolutely not”]
While WellBN’s young patients have not complained about the practice’s prescribing model, some of their parents are extremely anxious at the potential harm being done to their adolescent children. In May, the New Statesman revealed the contents of two expert witness reports provided in a separate court case that had helped persuade the Health Secretary, Wes Streeting, to ask NHSE to look again at whether there might need to be further restrictions on the prescribing of hormones to those aged 16 and 17. The authors of those reports, doctors Professor Riittakerttu Kaltiala and Professor Jovanna Dahlgren, have directly worked with hundreds of gender-questioning children. Both are employed by specialist youth gender clinics in Finland and Sweden, respectively.
They warned of severe health risks associated with prescribing hormones to children and evidence of serious health difficulties for those on hormones for extended periods of time. Finland’s Kaltiala argued that the use of exogenous hormones, “is not safe to any minors”. “It is not possible to conclude that treatment with cross sex hormones is safe for under 18-year-olds, and having reached age 16 makes no difference to this,” she said, adding that existing research did not verify “the assumed psychosocial and mental health benefits of cross-sex hormones initiated during developmental years”. (Defending its practices in a letter to NHS Sussex, WellBN argued that it was not in breach of contract because trans and non-binary people could “rightly be considered to be ill with a condition (gender incongruence) from which recovery is expected… We see better mental health outcomes, restoration of ability to function in society, and fewer patients requesting surgical intervention.”)
The paediatric endocrinologist Dahlgren explained how Sweden’s doctors are no longer advised to prescribe hormones to those under 18 and cited research which highlighted that trans women (“natal males”) had a substantially higher risk of ischemic stroke, venous thromboembolism (VTE) and heart attacks. Dahlgren noted: “If the treatment is started in young years, many years with daily treatment with cross sex hormones will increase the risk of cardiovascular disease… and stroke… [and] can decrease fertility, impair liver function and increase the risk of cancer in both genders.” The hormone expert added that, “The consequences of prescribing cross sex hormones in individuals under the age of 18 years are that the body and the brain are permanently marked/changed with both known and more unforeseen consequences.”
After five years of unheeded warnings, an investigation is now under way into the activities of Dr Sam Hall and WellBN. But is anything likely to change? The investigation is led by NHS Sussex “with the support of NHS England”, according to its terms of reference. Yet both organisations have been aware of all of the issues under investigation for years, and chose to do nothing until this year. It has been suggested by some parents of children prescribed hormones by WellBN that these two bodies should themselves be looked into as part of the investigation.
There have been months of delay between NHSE issuing its demand in April that WellBN cease prescribing and the investigation being announced in June. Responding to this, WellBN issued a statement through its website, insisting that its children’s service “is grounded in core medical ethics, including respect for bodily autonomy and the right to make informed choices”. The NHS has confirmed that, as of 25 August, not even the initial stage of reviewing individual children’s medical notes has begun, but should start “in the coming weeks”. It is not known how long the process will take to complete. The NHS insists the investigation is independent, and will be conducted by a review panel, led by an independent chair. It will report to NHS England and NHS Sussex. The team has been identified by both healthcare bodies and includes a clinical psychologist, paediatric nurse and a GP, as well as two senior psychologists employed by NHS children’s gender services.
In the meantime, children – some under the age of 13 – are still receiving prescriptions for hormones and puberty blockers with, in the case of the former, certain irreversible changes happening to their bodies. When the investigation has been completed, NHSE has agreed to “urgently expedite transfer of care of individuals into an NHS-commissioned service” – either an adult gender clinic for those aged 17, or a children’s hub for those younger. Children under 16 and on hormones will not be able to continue receiving prescriptions on the NHS, nor will those whose puberty blocker treatment started after the ban came into force. Both will have their medications safely withdrawn. WellBN will, however, be able to continue prescribing to those whose treatment with puberty blockers began before the ban. It’s understood that decisions about withdrawal of hormones will only be undertaken once clinical supervision is in place.
An NHS spokesperson said: “Our clear priority, and the focus of this investigation, is to ensure that children and young people are receiving safe and appropriate care.” Having been made aware that concerns about WellBN date back some five years, a spokesperson for the Department of Health and Social Care said that it took the concerns raised regarding prescribing practices at WellBN clinic “extremely seriously” and was “committed to ensuring that all healthcare providers follow appropriate clinical protocols and safeguards when treating young people”. The spokesperson continued, “Where concerns are raised about patient safety, we will not hesitate to take decisive action to protect children and hold those responsible to account.”
Whatever the outcome, should this investigation find that any child has been harmed as a result of WellBN’s medical approach to gender-questioning youth, none of the organisations responsible for protecting these young people and ensuring they receive safe care will be able to say it could not have been prevented. Not the NHS, not the GMC, nor the government. They were warned. Repeatedly. And did nothing.
[See also: The rage of Dominic Cummings]
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