Prof Gary Butler

Prof Gary ButlerTel: 020 3447 9455

University College Hospital

Children and young people's endocrinology, Children and young people's services

Professional background

Professor Gary Butler is Consultant in Paediatric & Adolescent Medicine and Endocrinology at University College Hospital in London and holds an Honorary Personal Chair in Child and Adolescent Health at the UCL Great Ormond Street Institute of Child Health.

He qualified at St Thomas’s Hospital Medical School in London, and after junior positions in paediatrics, he trained in paediatric endocrinology in Edinburgh at the Medical Research Council Human Genetics Unit and the MRC Reproductive Biology Unit, and also at the Edinburgh Royal Hospital for Sick Children. His principal research interests were the evaluation of growth and puberty in boys with extra X and Y chromosomes (doctoral MD thesis), the process of normal growth and treatment with growth hormone and testosterone, and the neuroendocrine control of how puberty starts. He produced several high profile and still frequently referenced publications.

Subsequently he directed the paediatric endocrine centre for Wales based in Cardiff. He conducted research on visual neurophysiology in adolescent diabetes. He was then appointed to lead paediatric endocrinology in the North East of England in Leeds. There he additionally developed a strong interest in undergraduate and postgraduate education. As a result of which he became Foundation Professor of Paediatrics in Reading University until government cutbacks to medical education.

On return to London in 2009, he established an adolescent endocrine service at UCLH with special focus on disorders of puberty with specialist clinics for gonadotropin deficiency, Klinefelter syndrome, and growth disorders. He is also the clinical lead for the UK adolescent gender identity development service taking an international lead in the standards of care for transgender children and adolescents. He is acknowledged as an international expert in these areas.

He led the redesign of the UK Royal College of Paediatrics school age growth charts, incorporating concurrent puberty assessments. His very popular Oxford Specialist Handbook of Paediatric Endocrinology and Diabetes second edition is to be published in 2019.

A former General Secretary of the British Society for Paediatric Endocrinology and Diabetes (1999-2002) he led both the NICE appraisals for growth hormone treatment in children. He is actively involved in the European Society for Paediatric Endocrinology as a member of the Executive Council and Chairman of the Clinical Practice Committee (2009-2016), and now chairs the Gender Dysphoria Working Group. He has taught as a faculty member on several ESPE Winter Schools, and for six years edited the evidence-based medicine chapter of the ESPE Yearbook.

Research interests

Clinical interests

  • Adolescent and paediatric endocrinology in general
  • Growth problems
  • Puberty and fertility problems in adolescents
  • Gender identity problems in children and adolescents
  • Klinefelter syndrome
  • Adolescent general health problems

Research interests

  • Normal Growth in Children including growth chart development
  • Methods of assessment of puberty by voice analysis
  • Development of the immune system during puberty (jointly with the UCL Centre for Adolescent Rheumatology)
  • Predictive treatment in adolescence of infertility problems (gonadotropin deficiency and Klinefelter syndrome)
  • Efficacy and safety of growth hormone treatment


Top peer-reviewed publications

  • Butler G E, Walker R F, Walker R V, Teague P, Riad-Fahmy D, Ratcliffe S G. Salivary testosterone levels and the progress of puberty in the normal boy. Clin Endocrinol 1989; 30: 587 - 596.
  • Wu F C W, Butler G E, Kelnar C J H, Sellar R E. Patterns of pulsatile luteinising hormone secretion before and during the onset of puberty in boys: a study using an immunoradiometric assay. J Clin Endocrinol Metab 1990; 70: 629 - 637
  • Butler G E, McKie M, Ratcliffe, S G. The cyclical nature of prepubertal growth. Ann Hum Biol 1990; 17: 177 - 198.
  • Ratcliffe S G, Butler G E, Jones M. Edinburgh study of growth and development of children with sex chromosome abnormalities IV. In: Evans J A, Hamerton J L, Robinson A, Eds. Children and young adults with sex chromosome aneuploidy. Follow-up, clinical and molecular studies. March of Dimes Birth Defects Foundation. Birth Defects: Original Article Series. New York: Wiley-Liss, 1991; 26 Number 4: 1-44.
  • Butler G E, Sellar R E, Walker R F, Hendry M, Kelnar C J H, Wu F C W. Oral Testosterone Undecanoate in the management of delayed puberty in boys: pharmacokinetics and effects on sexual maturation and growth. J Clin Endocrinol Metab 1992; 75: 37 - 44.
  • Sheppard L, Eiser C, Davies HA, Carney S, Clarke SA, Urquhart T, Ryder MJ, Stoner A, Wright NP, Butler G. The effects of growth hormone treatment on health-related quality of life in children. Hormone Research 2006;65:243-249. Commentary reply p 252.
  • Debra Fayter, John Nixon, Suzanne Hartley, Amber Rithalia, Gary Butler, Mary Rudolf, Paul Glasziou, Martin Bland, Lisa Stirk, Marie Westwood. A systematic review of the routine monitoring of growth in children of primary school age to identify growth-related conditions. Health Technol Assess. 2007 Jun;11(22):iii, xi-xii, 1-163.
  • Howard SR, Butler GE. An analysis of the clinical and cost effectiveness of growth hormone replacement therapy before and during puberty: should we increase the dose? Horm Res Paediatr. 2013;79(2):75-82. doi: 10.1159/000346687. Epub 2013 Feb 13.
  • Leger J, Olivieri A, Donaldson M, Torresani T, Krude H, van Vliet G, Polak M, Butler G; ESPE-PES-SLEP-JSPE-APEG-APPES-ISPAE; Congenital Hypothyroidism Consensus Conference Group. European Society for Paediatric Endocrinology consensus guidelines on screening, diagnosis, and management of congenital hypothyroidism. J Clin Endocrinol Metab. 2014 Feb;99(2):363-84. doi:10.1210/jc.2013-1891. Epub 2014 Jan 21 and Horm Res Paediatr. 2014;81(2):80-103. doi: 10.1159/000358198. Epub 2014 Jan 21.
  • Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, Michigami T, Tiosano D, Mughal MZ, Mäkitie O, Ramos-Abad L, Ward L, DiMeglio LA, Atapattu N, Cassinelli H, Braegger C, Pettifor JM, Seth A, Idris HW, Bhatia V, Fu J, Goldberg G, Sävendahl L, Khadgawat R, Pludowski P, Maddock J, Hyppönen E, Oduwole A, Frew E, Aguiar M, Tulchinsky T, Butler G, Högler W. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab. 2016 Feb;101(2):394-415. doi: 10.1210/jc.2015-2175. Epub 2016 Jan 8 and Horm Res Paediatr. 2016;85(2):83-106. doi: 10.1159/000443136. Epub 2016 Jan 8.
  • Allen DB, Backeljauw P, Bidlingmaier M, Biller BM, Boguszewski M, Burman P,Butler G, Chihara K, Christiansen J, Cianfarani S, Clayton P, Clemmons D, Cohen P, Darendeliler F, Deal C, Dunger D, Erfurth EM, Fuqua JS, Grimberg A, Haymond M, Higham C, Ho K, Hoffman AR, Hokken-Koelega A, Johannsson G, Juul A, Kopchick J, Lee P, Pollak M, Radovick S, Robison L, Rosenfeld R, Ross RJ, Savendahl L, Saenger P, Toft Sorensen H, Stochholm K, Strasburger C, Swerdlow A, Thorner M. GH safety workshop position paper: a critical appraisal of recombinant human GH therapy in children and adults. Eur J Endocrinol. 2016 Feb;174(2):P1-9. doi: 10.1530/EJE-15-0873. Epub 2015 Nov 12.
  • Swerdlow AJ, Cooke R, Beckers D, Borgström B, Butler G, Carel JC, Cianfarani S, Clayton P, Coste J, Deodati A, Ecosse E, Gausche R, Giacomozzi C, Hokken-Koelega ACS, Khan AJ, Kiess W, Kuehni CE, Mullis PE, Pfaffle R, Sävendahl L, Sommer G, Thomas M, Tidblad A, Tollerfield S, Van Eycken L, Zandwijken GRJ. Cancer risks in patients treated with growth hormone in childhood: the SAGhE European cohort study. J Clin Endocrinol Metab. 2017 May 1;102(5):1661-1672. doi: 10.1210/jc.2016-2046
  • Butler G, De Graaf N, Wren B, Carmichael P. The Assessment and Support of Children and Adolescents with Gender Dysphoria Arch Dis Child (online April 2018).
  • Rachel L Knowles, Juliet Oerton, Timothy Cheetham, Gary Butler, Christine Cavanagh, Lesley Tetlow, Carol Dezateux. Newborn Screening for Primary Congenital Hypothyroidism: Estimating Test Performance of Different TSH Thresholds J Clin Endocrinol Metab (in press 2108)
  • Rahul Ghelani, Cheryl Lim, Caroline Brain, Mary Fewtrell, Gary Butler. Sudden sex hormone withdrawal and the effects on body composition in late pubertal adolescents with gender dysphoria. Horm Res Ped (in review).

Selected chapters and books

  • Butler G Normal Growth and its Disorders. Oxford Textbook of Endocrinology 3rd Ed; OUP 2018; in press.
  • Butler G. Hormone treatments in transgender children and adolescents. In The Transgender Handbook Eds WP Bouman and J Arcelus. Ch 17 p 217. Nova Science 2017.
  • Butler G. Endocrine approach to the non-binary adolescent. Genderqueer and Non-Binary Genders (Critical and Applied Approaches in Sexuality, Gender and Identity). Eds Christina Richards, Walter Pierre Bouman, Meg-John Barker. Palgrave Macmillan 2018.
  • Butler GE, Kirk JMW Oxford Specialist Handbook of Paediatric Endocrinology and Diabetes (OUP January 2011; 2nd Edition 2019).


GMC/GDC number: 2735810