Six charities have dropped the Duchess of York as a patron or ambassador after an email from 2011 emerged in which she called sex offender Jeffrey Epstein her “supreme friend” and seemed to apologise for her public criticism of him.

Julia’s House, a children’s hospice charity, was the first to remove Sarah Ferguson, the former wife of Prince Andrew, saying it was “inappropriate” for her to continue in the role.

Later on Monday, the Teenage Cancer Trust, Natasha Allergy Research Foundation, the Children’s Literacy Charity and Prevent Breast Cancer also announced they had dropped the duchess as patron.

The British Heart Foundation also said she would no longer be the charity’s ambassador.

A spokesperson for the duchess said she was not commenting on the charities’ decisions.

On Sunday, the Mail and Sun newspapers published a 2011 email from the duchess to Epstein, which appears to have been sent after she had publicly claimed to have broken off contact with him.

In the email, she appeared to privately apologise for her public rejection of Epstein, saying: “You have always been a steadfast, generous and supreme friend to me and my family.”

That seemed to contradict her public denunciation of Epstein in an interview earlier that year, in which she had said her involvement with him had been a “gigantic error of judgement” and that: “What he did was wrong and for which he was rightly jailed.”

A spokesperson for the duchess said her subsequent email to Epstein, describing him as a friend, had been sent because she was trying to counter a threat from him to sue her for defamation – and that she still really regretted any association with him.

“This email was sent in the context of advice the duchess was given to try to assuage Epstein and his threats,” said a statement from her spokesman at the weekend, when the email to Epstein had been published.

The email exchange was several years after Epstein’s jailing for sex offences in 2008.

The duchess became patron of Julia’s House charity – which serves families in Dorset and Wiltshire – in 2018 and had visited one of its hospices.

The Natasha Allergy Research Foundation, launched after teenager Natasha Ednan-Laperouse died from a severe allergic reaction to eating a baguette, asked the duchess to become a patron when it was founded in 2019.

She joined forces with Prevent Breast Cancer in 2024 following her own breast cancer treatment the year before, and has been a patron of the Teenage Cancer Trust for 35 years.

Prince Andrew, the Duke of York and ex-husband of the duchess, stood down as a working royal and lost his royal patronages after challenges over his association with Epstein, including in a BBC Newsnight interview in 2019.

The contact with Epstein had continued after he had been released from jail – with Prince Andrew being photographed with Epstein in New York’s Central Park in 2010.

There has been increasing pressure in the US for the release of any information about Epstein and his famous connections, which has seen more details emerging, including messages sent to him in alleged “birthday book”.

Epstein died by suicide in jail in New York in 2019, while awaiting trial on sex trafficking charges.