Unlicensed medication is used by a wide variety of people. It is particularly common in paediatric and geriatric care, as some drug manufacturers do not want to pay to license their medications for younger and older users. This is because there tends to be less overall use of most medications in younger and older people, and so drug manufacturers make less money by licensing them for these groups. The same thing happens in transgender healthcare - because transgender people are a minority, it is not profitable for drug manufacturers to license medications specifically for their use. As a result, a great deal of medication in transgender healthcare is prescribed off-licence.
This means that being able to safely prescribe off-licence is a common and important part of good medical practice. It also means that a lack of understanding around the use of unlicensed medication can lead to effective treatments being withheld or underused.
Because transgender healthcare is often not a priority for drug manufacturers, few medications are licensed specifically for this use. As a result, off-licence medication use is considered best medical practice for transgender healthcare and recommended by both the General Medical Council (GMC) and the General Pharmaceutical Council (GPhC) in the UK.