A landmark legal battle is set to play out in the High Court this week as an ex-Tavistock clinician and a mother of a teenage girl challenge England’s healthcare watchdog over its decision to approve and highly rank a controversial private gender clinic.
The case, which campaigners say could reshape the future of gender care in the UK, accuses the Care Quality Commission (CQC) of “rubber stamping” the work of Gender Plus - a private clinic offering cross-sex hormones to children as young as 16 - in contravention of NHS guidance and the landmark findings of the Government-backed Cass Review into gender services.
Critics say the CQC’s decision to rate the clinic as “Outstanding” overall and “Good” for safety flies in the face of growing evidence that hormone treatment for gender dysphoria in young people carries significant risks and should be approached with extreme caution.
The judicial review, brought by Susan Evans - a former nurse and psychotherapist at the now-shuttered Tavistock Gender Identity Development Service - and the mother of a 16-year-old girl, will be heard at London’s High Court on June 24 and 25.
It is believed to be the first legal challenge of its kind against the CQC’s approval of Gender Plus.
The claimants say the hormone clinic has a licence to treat gender dysphoria - distress when someone believes their gender is different from the one they were assigned at birth - without the strict safety protocols deemed necessary by the NHS.
Evans said: “The use of cross-sex hormones to treat gender dysphoria carries risks including severe cardiovascular issues, fertility problems with risk of sterility, auto-immune diseases, various cancers (testicular, breast, thyroid), pancreatitis and liver disease.
“The Cass Report has recommended that extreme caution be exercised in the prescribing of these drugs, with very careful consideration of their long-term impact.
“The NHS guidelines require a second opinion from a (specialist team of experts) Multi-Disciplinary Team.
“This private clinic, led by ex-Tavistock clinicians who have publicly criticised the Cass Report, does not have that safeguard.
“In my view, this represents a significant risk for vulnerable teenagers.”
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It is believed to be the first legal challenge of its kind against the CQC’s approval of Gender Plus
GETTYThe challenge comes after the publication of the Cass Review in 2024, an independent investigation led by paediatrician Dr Hilary Cass, which concluded there is “insufficient evidence” to support the routine use of hormone treatments for young people.
The review prompted NHS England to halt routine prescriptions of puberty blockers - hormones that prevent puberty - outside a formal research trial.
The NHS also ruled that strict criteria now have to be followed if cross sex hormones are prescribed, which it says should be done under ‘extreme caution’ and only after approval by an independent team of experts.
Gender Plus, which employs former Tavistock staff, was granted CQC registration in January this year and ranked “Outstanding” in December, months after the Cass findings were released.
Aidan Kelly (left) with nurse consultant Paul Carruthers - members of staff at the first private gender clinic for young people in England to be registered with the health watchdog, The Gender Plus Hormone Clinic, based in Birmingham. The clinic was registered with the Care Quality Commission (CQC) in January and treats people aged 16 and older, including through prescribing gender-affirming - masculinising or feminising - hormonesPAThe clinic, which operates in London, Birmingham, and Dublin, prescribes cross-sex hormones to young people aged 16 and above.
Lawyer Paul Conrathe, who is representing the claimants, told GB News: “This exposes the reality of a two-tier system in gender medicine.
“The NHS has implemented strict rules based on the best available evidence. Meanwhile, a private clinic led by activist clinicians has been approved by the CQC.
He added: “This isn’t just about red tape - it’s about the safety of vulnerable children.
“The CQC has a legal duty to safeguard patients. This case will shine a light on whether extreme caution has been exercised in prescribing these powerful, life-changing drugs.
The case comes at a critical time after the Health Secretary Wes Streeting commissioned an urgent review into hormone prescribing in the private sector, with findings expected next month.
Retired consultant paediatrician Dr Hilary CassPAInsiders say the Gender Plus case could influence future policy.
One mother supporting the legal action, whose identity is protected for legal reasons, said: “Parents are being sidelined while private clinics push through life-changing treatments. The idea that a regulator could label this ‘safe’ is chilling.”
The Tavistock Clinic, which was closed in 2024 following the Cass interim report, had been the sole provider of NHS gender services for children and adolescents in England.
It is now being replaced by two new regional hubs with a focus on psychological care and safeguarding.
Gender Plus has insisted it follows all the recommendations of the Cass review.
Dr Aidan Kelly, Consultant Clinical Psychologist and Director of the Gender Plus Hormone Clinic, said: “As a committed provider of safe, effective, essential healthcare to the transgender community, regulation has always been an important measure of our legitimacy.
“Our multidisciplinary team has decades of combined experience of working with young people and our commitment to providing the best possible service is what resulted in both our CQC registration in January 2024 and the subsequent Outstanding rating in December 2024.
“I look forward to a positive outcome so that we can continue to deliver the essential, regulated care that younger transgender people so desperately need.”
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