Photo of Professor Gary Butler

Professor Gary Butler

Telephone:

Email:

Location:

  • University College Hospital

GMC/GDC number:

2735810

Professional background

Professor Gary Butler is a consultant in paediatric and adolescent medicine and endocrinology at University College Hospital London and holds an Honorary Personal Chair in Clinical Paediatrics at the UCL Great Ormond Street Institute of Child Health.

He was given the European Society for Paediatric Endocrinology Outstanding Clinician Award in 2020 as a result of his clinical expertise and significant national and international developments in the clinical practice of paediatric endocrinology. This is the highest award for a clinical doctor in this field.

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.

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 (puberty hormone) deficiency, Klinefelter syndrome, and growth disorders. He is acknowledged as an international expert in these areas and lectures in the UK and internationally.

He led the redesign of the UK childhood and adolescent growth charts, incorporating concurrent puberty assessments. His very popular Oxford Specialist Handbook of Paediatric Endocrinology and Diabetes second edition was published in March 2020.

A former secretary general 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 (ESPE) as a member of the Executive Council and Chairman of the Clinical Practice Committee (2009-2016) producing international guidelines for improving standards of care in particular on congenital hypothyroidism. He is currently Chair of the Gender Incongruence Working Group.

He has taught as a faculty member on several ESPE Winter Schools, and currently on the Summer School teaching faculty, and for six years edited the evidence-based medicine chapter of the ESPE Yearbook.

Clinical interests:

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

Specialties

Research interests

  • Normal growth in children including growth chart development
  • The outcomes of hormone treatment in adolescents with gender incongruence
  • Development of the immune system during puberty (jointly with Adolescent Rheumatology team)
  • Treatment of infertility problems in adolescents (gonadotropin deficiency and Klinefelter syndrome)
  • Efficacy and safety of growth hormone treatment

Publications

Top 10 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.
  • 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.
  • 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 and Horm Res Paediatr. 2014;81(2):80-103.
  • Butler G, De Graaf N, Wren B, Carmichael P. The Assessment and Support of Children and Adolescents with Gender Dysphoria. Arch Dis Child 2018 July;103:631-636.
  • Gary Butler, Tymoteusz Turlejski, Gillian Wales, Linda Bailey, Neil Wright. Growth Hormone Treatment and Health-Related Quality of Life in Children and Adolescents. A National, Prospective, Controlled Study. Clin Endocrinol (Oxf). 2019 Aug;91(2):304-313.
  • Lars Sävendahl, Rosie Cooke, Anders Tidblad, Dominique Beckers, Gary Butler, Stefano Cianfarani, Peter Clayton, Joël Coste, Wieland Kiess, Anita C.S. Hokken-Koelega, Claudia E. Kuehni, Kerstin Albertsson-Wikland, Annalisa Deodati, Emmanuel Ecosse, Ruth Gausche, Claudio Giacomozzi, Fabienne Landier, Marc Maes, Roland Pfaeffle, Grit Sommer, Muriel Thomas, Sally Tollerfield, Gladys R.J. Zandwijken, Jean-Claude Carel, Anthony J. Swerdlow. Mortality after childhood Growth Hormone treatment – the SAGhE study. Lancet Diabetes and Endocrinology 2020 Aug;8(8):683-692.

Peer-reviewed publications (last 5 years):

  • Swerdlow A.J., Cooke R., Albertsson-Wikland K., Borgström B., Butler G., Cianfarani S., Clayton P., Coste J., Deodati A., Ecosse E., Gausche R., Giacomozzi C., Kiess W., Hokken-Koelega A.C.S., Kuehni C.E., Landier F., Maes M., Mullis P., Pfaffle R., Sävendahl L., Sommer G., Thomas M., Tollerfield S., Zandwijken G.R.J., Carel J.-C.
  • Description of the SAGhE Cohort: A Large European Study of Mortality and Cancer Incidence Risks after Childhood Treatment with Recombinant Growth Hormone. Horm Res Paediatr Vol. 84, No. 3, 2015 (DOI:10.1159/000435856).
  • D Allen, P Backeljauw, M Bidlingmaier, B Biller, M Boguszewski, P Burman, G Butler, S Chernausek K Chihara, J Christensen, S Cianfarani, P Clayton, D Clemmons, P Cohen, F Darendeliler, C Deal, D Dunger, E M Erfurth, J S Fuqua, A Grimberg, M Haymond, C Higham, K Ho, A R Hoffman, A Hokken-Koelega, G Johannsson, A Juul, J Kopchick, P Lee, S Malozowski, M Pollak, S Radovick, L Robison, R Rosenfeld, R J Ross, L Savendahl, P Saenger, H Toft Sorensen, K Stochholm, C Strasburger, A Swerdlow, M Thorner. Growth Hormone Safety Workshop Report: a critical appraisal of recombinant human growth hormone therapy in children and adults. Eur J Endocrinol. 2016 Feb;174(2):P1-9. doi: 10.1530/EJE-15-0873.
  • 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. and Horm Res Paediatr. 2016;85(2):83-106. doi: 10.1159/000443136.
  • 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 2018 July;103:631-636.
  • 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. 2018 Aug 2. doi: 10.1210/jc.2018-00658.
  • Swerdlow AJ, Cooke R, Beckers D, Butler G, Carel JC, Cianfarani S, Clayton P, Coste J, Deodati A, Ecosse E, Hokken-Koelega ACS, Khan AJ, Kiess W, Kuehni CE, Flück CE, Pfaffle R, Sävendahl L, Sommer G, Thomas M, Tidblad A, Tollerfield S, Zandwijken GRJ. Risk of meningioma in European patients treated with growth hormone in childhood: results from the SAGhE cohort. J Clin Endocrinol Metab. 2018 Aug 17. doi: 10.1210/jc.2018-01133.
  • Caimari F, Kumar AV, Kurzawinski T, Butler G, Sabbaghian N, Foulkes WD, Korbonits M. A novel DICER1 mutation in familial multinodular goitre. Clin Endocrinol (Oxf). 2018 Jul;89(1):110-112. doi: 10.1111/cen.13613.
  • Kate Webb, Hannah Peckham, Anna Radziszewska, Madhvi Menon, Paola Oliveri, Fraser Simpson, Claire T. Deakin, Sophie Lee, Coziana Ciurtin, Gary Butler, Lucy R. Wedderburn, Yiannis Ioannou. Sex and pubertal differences in type 1 IFN pathways associate with both X chromosome number and serum sex hormone concentration. Front. Immunol., 15 January 2019 | https://doi.org/10.3389/fimmu.2018.03167
  • Butler G, Wren B, Carmichael P. Puberty blocking in gender dysphoria: suitable for all? Arch Dis Child 2019;0:1–2. doi:10.1136/archdischild-2018-315984
  • Skordis N, Butler G, de Vries M.C, Main K, Hannema S.E. ESPE and PES International Survey of Centers and Clinicians Delivering Specialist Care for Children and Adolescents with Gender Dysphoria. Horm Res Paediatr 2018;90:1–6 https://doi.org/10.1159/000496115
  • Gary Butler, Tymoteusz Turlejski, Gillian Wales, Linda Bailey, Neil Wright. Growth Hormone Treatment and Health-Related Quality of Life in Children and Adolescents. A National, Prospective, Controlled Study. Clin Endocrinol (Oxf). 2019 Aug;91(2):304-313. doi: 10.1111/cen.14011.
  • Joseph T, Ting J, Butler G. The effect of GnRH analogue treatment on Bone Mineral Density in very young adolescents with gender dysphoria from a large national cohort. J Pediatr Endocrinol Metab. 2019 Oct 25;32(10):1077-1081. doi: 10.1515/jpem-2019-0046. 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.  J Ped Endocrinol Metab 2020 Jan 28;33(1):107-112.
  • C Eckert-Lind, AS Busch, JH Petersen, FM Biro, G Butler, EV Brauner, A Juul. Worldwide secular trends in age at pubertal onset among girls assessed by breast development: a systematic review and meta-analysis. JAMA Pediatrics 2020 Feb 10;174(4):e195881.
  • Lars Sävendahl, Rosie Cooke, Anders Tidblad, Dominique Beckers, Gary Butler, Stefano Cianfarani, Peter Clayton, Joël Coste, Wieland Kiess, Anita C.S. Hokken-Koelega, Claudia E. Kuehni, Kerstin Albertsson-Wikland, Annalisa Deodati, Emmanuel Ecosse, Ruth Gausche, Claudio Giacomozzi, Fabienne Landier, Marc Maes, Roland Pfaeffle, Grit Sommer, Muriel Thomas, Sally Tollerfield, Gladys R.J. Zandwijken, Jean-Claude Carel, Anthony J. Swerdlow. Mortality after childhood Growth Hormone treatment – the SAGhE study. Lancet Diabetes and Endocrinology 2020 Aug;8(8):683-692.
  • Michael Shmoish, Alina German, Nurit Devir, Anna Hecht, Gary Butler, Aimon Niklasson, Kerstin Albertsson-Wikland, Ze’ev Hochberg. Prediction of adult height by machine learning technique. J Clin Endocrinol Metab (in press).
  • Gary Butler. Incidence of gynaecomastia in Klinefelter syndrome adolescents and outcome of testosterone treatment. European Journal of Pediatrics (submitted)
  • Polly Carmichael, Gary Butler, Una Masic, Tim J Cole, Bianca L De Stavola, Sarah Davidson, Elin M. Skageberg, Sophie Khadr, Russell Viner. Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PlosOne (submitted)
  • Wai Gin Lee, Gary Butler, Rebecca McLaren, Roland Morley, Ephia Yasmin, James Barrett, Nim Christopher, David Ralph, Tina Rashid, Polly Carmichael, Pippa Sangster. Urological considerations for the use of GnRH analogues in transgender adolescents. BJU International (submitted)
  • N de Gruijter, A Radziszewska, Peckam H, Jury E, Naja M, Butler G, Ciurtin C. A systematic review exploring the bidirectional relationship between puberty and autoimmune rheumatic diseases. Current Rheumatology Reports (submitted)
  • Eilis Kennedy; Chloe Lane; Hannah Stynes; Veronica Ranieri; Lauren Spinner; Polly Carmichael; Rumana Omar; Victoria Vickerstaff; Rachael Hunter; Talen Wright; Rob Senior; Gary Butler; Simon Baron-Cohen; Nastasja M. de Graaf; Thomas D. Steensma; Annelou L.C. de Vries; Bridget Young; Michael King. Longitudinal Outcomes of Gender Identity in Children (LOGIC): A study protocol for a retrospective analysis of the characteristics, profile and outcomes of children and young people referred to gender identity development services in the UK and the Netherlands. BMJ Open (submitted)

Chapters and reviews:

  • Butler GE. Management of Delayed Puberty. Paediatrics and Child Health, 2015;25:314-318.
  • Butler GE. Children and adolescents with non-binary gender. In: Gender queer and non-binary genders. Eds Christina Richards, Walter-Pierre Boumann, Meg-John Barker 2018. ISBN-13: 978-1137510525
  • Butler GE. Hormone treatment for transgender children and adolescents. In: The Transgender handbook. A guide for transgender people, their families and professionals. Eds WP Bouman and J Arcelus. Nova Science, New York. 2018;217-226. ISBN:978-1-53611-843-8
  • Butler G. Infant, child and adolescent auxology. In Encyclopedia of Endocrine Diseases 2nd Edition Ed Ilpo Huhtaniemi. Elsevier 2018. ISBN: 9780128121993. https://doi.org/10.1016/B978-0-12-801238-3.65209-1
  • Butler G. Assessing tall stature. Paediatrics and Child Health 29(7):293-296 01 Jul 2019
  • Butler G. Normal Growth and its disorders. Oxford Textbook of Medicine 6th edition March 2020 Section 13.7.1
  • Butler G, Purushothaman P. Delayed Puberty. Minerva Pediatrica August 2020.
  • Butler G. Recognising normal and disordered growth. Oxford Textbook of Endocrinology 3rd Edition Ed J Wass, W Arlt, R Semple. OUP 2020.

Principal author:

  • Butler GE, Kirk JMW. Oxford Specialist Handbook of Paediatric Endocrinology and Diabetes. OUP 2011.  2nd Edition published March 2020