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A pharmacist who refused to make a supply of prescribed hormone therapy to a transgender patient has been suspended for six months by the General Pharmaceutical Council.

The August fitness to practise hearing concerned a consultation that took place on October 3, 2024 while Niall Thomas Murray Murray was working a locum shift as responsible pharmacist at Superdrug on Guildford High Street. 

A transwoman referred to in the case report as Patient A came to the pharmacy to collect her repeat prescription of progesterone 100mg capsules and Estradot patches, which were prescribed by her GP and a consultant who coordinated her treatment under a shared care agreement. The patient had received these medicines from the pharmacy for around 18 months. 

After speaking to Patient A, Mr Murray went into the dispensary. After some time, a “visibly upset” trainee dispenser came out to the shop floor and told Patient A that she could not dispense the medicine as her manager would not allow it, but said Patient A could speak to the pharmacist.

After going to the back of the queue and waiting for roughly 15 minutes, Patient A spoke to Mr Murray, who offered to take her to one side to conduct their conversation.

Suspecting that Mr Murray did not want other customers to overhear his reason for not supplying the medication, she decided to record the conversation. She described feeling angry but remaining outwardly calm.

Mr Murray told Patient A that the prescribed medications were for post-menopausal biological women only, based on the summary of product characteristics and information in the BNF, and that he would not put his name to the supply.

He characterised his decision as indicating he would not be involved in the supply, denying that this amounted to a ‘refusal’.

He told Patient A he had a relative who had de-transitioned after experiencing difficulties, adding that his decision was ‘nothing personal’.

Mr Murray, who also said on the recording that he had not taken the coronavirus vaccine and had encouraged others not to do so, became upset upon being told that the conversation had been recorded.

Patient A, who subsequently moved her nomination to an online pharmacy, complained to Superdrug and to the GPhC as she was concerned Mr Murray might ‘prejudge’ other transgender patients.

She noted that Mr Murray asked no questions about her medical history and concluded that he had made his decision on the basis of physical appearances. The trainee dispenser also raised the matter with superiors following the incident.

Mr Murray made no note of his decision on Patient A’s PMR, which he subsequently acknowledged was remiss of him; nor did he make any attempt to contact the patient’s GP.

In her evidence, the trainee dispenser said she had been shocked at Mr Murray saying he ‘did not believe’ in supplying hormones to transgender patients, as none of the locum pharmacists she had previously worked with made a similar refusal. 

Patient A’s consultant also gave evidence to the FtP committee. When asked if the drugs had been prescribed off-label, he replied that this treatment was consistent with WPATH guidelines.

He also said it is “absolutely necessary to replace the sex hormone after the removal of both testes” as otherwise there is a risk of osteoporosis, cognitive issues and muscle waste. Patient A had had gender reassignment surgery prior to the October 2024 incident.  

In a written statement given to the GPhC in April 2025, Mr Murray again cited the indications listed in the SPC and BNF, which he said have “no references or addenda suggesting alternative uses for male patients,” and said he had “determined that it was clinically inappropriate for me to be involved in the supply”. 

He added: "I wish to emphasise that I did not refuse the prescription; rather, I made a professional decision to decline involvement in the supply of the medications.”

However, the FtP committee found that this “professional decision” did amount to a refusal to supply medication which, based on the evidence of the patient’s consultant, was clinically indicated.

The committee determined his conduct towards Patient A had been discriminatory, elaborating that in failing to raise the matter with her GP, record his decision on the PMR or ask her questions about her medical history, he “treated Patient A less favourably than others”.

However, it did accept his evidence that he had provided a clinical justification for his decision.

It found that although Mr Murray’s conduct could be remediated, there was no evidence he has taken steps to prevent it being repeated in the future.

The committee imposed a six-month suspension order, advising Mr Murray that making an apology to Patient A and providing a reflective account acknowledging the impact of his conduct would assist his case when it comes before the reviewing panel.