The risks to human health and the environment from individual chemicals are assessed and regulated at a national level by the relevant authorities, including the Health and Safety Executive, the Department for Environment, Food and Rural Affairs, the Food Standards Agency, and the Environment Agency. These controls apply across England, including in the Yeovil constituency and Somerset. Therefore, the UK Health Security Agency (UKHSA) has not undertaken specific risk assessments of endocrine disrupting chemicals (EDCs) at a constituency or county level.

UKHSA keeps the evidence on the potential health impacts of environmental pollution, including EDCs, under review. The Government also works with international partners, including the World Health Organization and the Organisation for Economic Co-operation and Development, to ensure approaches reflect current scientific understanding.

The Department for Environment, Food and Rural Affairs states that the concern for EDCs, which have been linked to numerous human health and wildlife impacts, is a complex scientific issue. The national policy approach to risk assessment and management makes use of the best available evidence to maintain high standards of protection. The Department for Environment, Food and Rural Affairs commissions research and engages with the scientific community, experts within our regulatory bodies, and non-government organisations to build an understanding of EDCs.

Legalisation is clear that all toys must be safe before being placed on our market. The government is aware of the growing concerns regarding endocrine disrupting chemicals (EDCs). This is a complex scientific issue, and we will be seeking views in our upcoming call for evidence on toys.

Regarding bisphenols, Bisphenol-A (BPA) is recognized as a UK Category 1B reproductive toxicant under UK REACH) and is banned in toys. Government regularly reviews the safety of substances used in consumer products and will take further action if needed to ensure only safe products are sold on our market.

The approach for assessment, diagnosis, and care planning, including patients with other presentations, are described in NHS England's published service specification for National Health Service adult gender clinics, which was adopted in April 2020 following a comprehensive public consultation, respondents to which included medical bodies, professional associations, and regulatory bodies. There is currently no specific data field that records the number of patients who are prescribed cross-sex hormones and who have comorbidities.

On 8 May, the UK Government announced a landmark economic deal with the United States, making the UK the first country to reach an agreement with President Trump. This delivers on the commitment by the Prime Minister and the President on 27 February to agree an economic deal in our respective national interests.

The deal protects jobs in the automotive, steel, aluminium, pharmaceutical and aerospace sectors - sectors that employ over 320,000 people across the UK. For the first time ever, this deal will also open up exclusive access for UK beef farmers to the US market.

We have always been clear that this Government will protect British farmers, secure our food security and uphold our high food, animal welfare and environmental standards in trade deals. That is exactly what we have done and will continue to do. Imports of genetically modified beef or hormone-treated beef will remain illegal. Any agricultural imports coming into the UK will have to meet our high sanitary and phytosanitary (SPS) standards.

There will be no changes to labelling requirements as a result of what has been agreed so far within the UK-US agreement.

Strict regulatory controls govern medicinal products for human use, including their manufacture, distribution, retail sale and supply, and advertisement. The medicines referred to cannot be advertised directly to the public, and any online offer to sell or supply them to a patient would likely contravene the Human Medicines Regulations 2012.

Instances of United Kingdom-based non-compliant activity relating to the online advertising, sale, or supply of medicines are reviewed by the Medicines and Healthcare products Regulatory Agency (MHRA) on a case-by-case basis, and appropriate action taken. Enforcement options include removal of the offending weblink, remedial intervention to bring the owner into compliance, or a criminal investigation and possible prosecution.

The MHRA also works closely with partners to prevent medicines from entering or being traded in the UK illegally. The MHRA’s Fake Meds campaign encourages people in the UK to use safe and legitimate sources when buying medication online. The MHRA also promotes the reporting of suspicious medicinal products and adverse side effects via its Yellow Card scheme. Further information on the Fake Meds campaign and the Yellow Card scheme is available, respectively, at the following links:

https://fakemeds.campaign.gov.uk/

https://yellowcard.mhra.gov.uk/

The Department commissions research through the National Institute for Health and Care Research (NIHR). The NIHR is not currently funding any specific research into the impact of hormonal changes on neurodiverse women, but welcomes funding applications for research into any aspect of human health. Applications are subject to peer review and judged in open competition, with awards being made based on the importance of the topic to patients and health and care services, value for money, and scientific quality.

In developing its guideline on the diagnosis and management of menopause, published in 2015, the National Institute for Health and Care Excellence (NICE) considered the effectiveness, including risks and benefits, of testosterone in the management and relief of menopause-related symptoms including vasomotor, musculoskeletal and psychological symptoms, as well as altered sexual function. The guideline recommends that testosterone supplementation should be considered for menopausal women with low sexual desire if hormone replacement therapy alone is not effective.

NICE is currently updating its guideline on the diagnosis and management of menopause, which it expects to publish in February 2024. During its surveillance and scoping process, NICE did not identify any substantive new evidence on the use of testosterone beyond the existing recommendations. NICE discussed the need for evidence in this area with the National Institute for Health and Care Research (NIHR) who have agreed to scope new research. The NIHR launched the research call in December 2022 and more information on is available at the following link:

https://www.nihr.ac.uk/funding/22170-testosterone-for-the-treatment-of-menopause-symptoms-beyond-altered-sexual-function/32031

No specific assessment has been made. The National Institute for Health and Care Excellence is the independent body that develops authoritative, evidence-based guidance for the National Health Service.

The Department commissions research through the National Institute for Health and Care Research (NIHR). Subject to receiving high-quality applications, the NIHR expects to commission a new policy research unit dedicated to reproductive health to inform policy. An evaluation of health technology and apps for women has been identified as a potential topic for this unit. Applications are currently being reviewed, with the unit expected to operate from January 2024.

The issue of endocrine disrupting chemicals (EDCs), which have been linked to numerous human health and wildlife impacts, is scientifically complex. There is uncertainty surrounding the effects of EDC exposure from both an environmental and human health perspective, and we are contributing to international efforts to address the evidence gaps. We are considering the evidence available and drawing on a range of expertise with the aim of improving testing and identification of EDCs and assessing measures to further understand and manage the risks they pose.

The identification of intrinsic chemical hazards is a principal requirement of the classification, labelling and packaging regulation (CLP). The hazard classes in CLP cover physical, human health and environmental hazards. Endocrine disrupting properties are not captured by a specific CLP hazard class because they are a result of a mode of action rather than an intrinsic hazardous property. However, chemicals with human health endocrine disrupting properties are effectively covered in CLP by the closely related CMR (carcinogenic, mutagenic, toxic to reproduction) hazard classes.

The hazard classification of a chemical is often used as a starting point for specific controls or protective measures and is the basis for many regulatory and legislative provisions in the risk management of chemicals. Endocrine disrupting properties are specifically taken into account by the regulatory regimes covering the use of pesticides and biocides, where identification of such properties prompts specific control measures.

The Environment Agency (EA) has worked over the last five years with the water industry via United Kingdom Water Industry Research (UKWIR) to understand better and quantify levels of hormones in pre- and post-treatment effluents containing human waste from wastewater treatment works. This will continue in the next phase of work due to start in 2020.

A study report, reference number 18/EQ/01/13, is available from UKWIR https://www.ukwir.org/eng/search-uk-water-industry-research-reports

The EA also monitors hormones in watercourses as part of a surveillance network of substances on an EU Watch List.

The Environment Agency (EA) has previously carried out an extensive research programme into the feminising effects of hormones in treated sewage on wild roach populations (Rutilus rutilus) (https://www.gov.uk/government/publications/the-identification-of-oestrogenic-effects-in-wild-fish).

In the autumn of 2019 the EA will be publishing the results of research undertaken recently to investigate the current levels of feminisation in similar fish populations, as a comparison to the previous study.

Reducing environmental exposure to potential endocrine disrupting chemicals (EDCs) is not straightforward. Both naturally occurring and synthetic substances may have such properties. Some EDCs may have beneficial health or societal applications. These include the phytoestrogens present in foods such as soya and ethinyl-oestradiol, an active ingredient of the contraceptive pill.

Research has indicated that ethinyl-oestradiol and natural human hormones via sewage treatment effluent can have negative, impacts on fish in UK freshwaters. In response, the Department collaborated with the Environment Agency, Ofwat, the Drinking Water Inspectorate and the water industry in the Endocrine Disruption Demonstration Programme (EDDP) from 2006 to 2010. The EDDP aimed to evaluate the effectiveness of conventional and “advanced” sewage treatment in removing these chemicals. The results demonstrated that the improved processes put in place over the last 15 years or so to meet stringent ammonia standards have reduced the risks from endocrine disrupting substances.

DEFRA continues to address this issue with the Environment Agency and other partners, bringing together emerging science and environmental evidence to determine what further actions are needed.

Some suspected endocrine disrupting chemicals, including several pesticides, are subject to long-standing regulations because of specific toxic effects, which may be due to endocrine disrupting activity. There is also a ban on antifouling paints based on tributyltin (TBT) compounds that were found to cause significant endocrine disrupting effects in some marine organisms.

There are longstanding provisions under EU legislation to subject potentially dangerous chemicals, including endocrine disrupters, to a risk assessment. Where risks are identified, European-wide measures can then be taken to control them. For example, this has been done with the chemical nonylphenol and the flame retardants octa- and penta- BDE (bromodiphenyl ether).

EDCs can also be subject to the authorisation procedures under the EU Registration, Evaluation, Authorisation and Restriction of Chemicals (REACH) Regulation, which aims to substitute hazardous chemicals unless there are good socio-economic reasons to justify their continued use. EDCs are also controlled by EU legislation on plant protection and biocidol products. DEFRA is actively collaborating with other Government Departments and agencies in the development of EU regulatory criteria for EDCs. We are also working in the Organisation for Economic Co-operation and Development to produce new scientifically-based test methods for the identification of these substances.

The Drinking Water Inspectorate, on behalf of the Secretary of State for Environment, Food and Rural Affairs, my right hon. Friend the Member for Meriden (Mrs Spelman), has carried out and published a risk assessment on endocrine disrupting chemicals, including oestrogen hormones. The most recent evidence shows that it is highly unlikely that these substances are present in drinking water. In addition, water companies are required by law to risk assess each water supply and to test the raw water for any substances that might be present at a level of concern to public health.

Oestrogens are natural hormones and as such will be found in foods of animal origin such as meat, eggs and milk. Oestrogenic hormones are produced naturally by some plants. Very low levels of various synthetic chemicals with oestrogenic activity can also be present in some foods. Any takeaway food comprising one or more of these ingredients may contain traces of oestrogens. The Food Standards Agency has not conducted any survey to assess the levels of oestrogens in takeaway foods and has no plans to do so.