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Feminism: Sex and gender discussions

Hilary Cass sent a document to every single MP and Peer, justifying and defending the puberty blockers trial

815 replies

SingleSexSpacesInSchools · 10/07/2026 13:28

https://x.com/JamesEsses/status/2075512549248745744?s=20

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James Esses (@JamesEsses) on X

🚨Breaking🚨 Last night, in what is significant overreach for a backbench Peer, Hilary Cass sent a document to every single MP and Peer, justifying and defending the puberty blockers trial. I have posted below the full document for people to read. He...

https://x.com/JamesEsses/status/2075512549248745744?s=20

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BonfireLady · 11/07/2026 11:58

Tottenhamhotflushes · 11/07/2026 11:45

Gender incongruence is the medical term for when a person's internal gender identity does not align with the sex they were assigned at birth.

My understanding is gender identity is based on a purely individual perception so I couldn't give you a one size fits all but my own personal one is I see both reproductive & behavioural characteristics defining my gender.

Reproductive characteristics are physical and relate to biological sex. That's got nothing to do with gender, because gender identity (for anyone who believes they have one) is separate from biological sex. "Gender" is the way of describing what people are identifying into, because it refers to societal and cultural norms, most typically associated with each sex.

That leaves us with behavioural characteristics..... or sex-based stereotypes as they can also be known. So does that mean you believe that these define your gender (identity)? If so I completely agree with you that this makes sense. For anyone who believes they have a gender identity, I can't think of any other way it could be defined.

Tottenhamhotflushes · 11/07/2026 11:57

AimsAndObjectives · 11/07/2026 11:38

Perhaps....maybe.....

You are giving the trial designers the benefit of the doubt. Fifteen years ago I suspect many of us would have done the same. However, given the GIDS debacle, the obvious capture of large parts of the NHS by ideologists, the vested financial interests and the increasingly loud voices of the desisters and detransitioners you can perhaps, maybe understand our reluctance to accept the trial protocols without question.

I appreciate the challenges of bias provide but I also appreciate that there have been methods in modern times to mitigate scientific bias like peer reviews, transparency, reproducibility, methodological standards & analysis. It's not as if these studies can't be scrutinised & critiqued so its in the interests of those conducting them to act according to acceptable scientific practices.

There's every incentive to produce sound work that serves to build trust in the scientific community.

AimsAndObjectives · 11/07/2026 11:56

NullaEffugium · 11/07/2026 11:53

As recorded in medical files. I doubt parents are going to be truthful about any illegal usage. In addition, for these children if they were not enrolled in a clinical trial, I am 100% convinced their parents would then get the illegal ones and give them to their child.

Any evidence for these claims? Genuine question

spannasaurus · 11/07/2026 11:53

NullaEffugium · 11/07/2026 11:45

Yes, thank you, I wasn’t very clear. I am on the fence about the ethics of drug testing on children that are below the age of consent for medical procedures. Especially when I consider the parenting these children have.

It is not ethical to test drugs on children, but we are in a situation where it is happening anyway and the only way to stop it long term is to prove how unsafe puberty blockers really are.

Do you not think it would be better to study the outcomes of children who have already been given puberty blockers rather than give them to more children.

The Cass report also recommended that this data linkage study be carried out.

NullaEffugium · 11/07/2026 11:53

BettyBooper · 11/07/2026 11:50

Children who have already taken PBs or any kind of hormones are automatically excluded from the trial.

So yes, additional children will be harmed.

As recorded in medical files. I doubt parents are going to be truthful about any illegal usage. In addition, for these children if they were not enrolled in a clinical trial, I am 100% convinced their parents would then get the illegal ones and give them to their child.

NotBadConsidering · 11/07/2026 11:51

Tottenhamhotflushes · 11/07/2026 11:48

Carve outs are not how medical standards work. That's why they are standards. Consistency in standards needs to be maintained across treatments.

Can you name another treatment that is still given to children that has such questionable ethics around it?

Do you have an answer to my question as to whether you think THIS is ethical?

Is it ethical to sterilise a child without any certainty a) the child will definitely grow up and identify as someone who wishes they hadn’t gone through puberty and b) it will help them with their distress about that?

NullaEffugium · 11/07/2026 11:51

BettyBooper · 11/07/2026 11:47

A better way would be to track all the children who have already been given PBs. But for reasons we aren't doing that.

Again, why was the (allegedly) independent chair of a review into treatment plans for 'gender incongruent' children pushing for a PB trial two years before her review was concluded?

This is anything but neutral and is seeped in the acceptance of GII.

No that’s not a better way because depending on self reporting can’t replace the controlled medical environment of a clinical trial. That would be like an opinion survey and utterly useless at proving whether puberty blockers in general are unsafe.

BettyBooper · 11/07/2026 11:50

NullaEffugium · 11/07/2026 11:42

Yes, I am making as assumption but assumptions can’t be used as evidence of harm. The fact is children are already being given illegal versions by the parents with no doctors or any kind of medical monitoring. Children are currently guinea pigs for puberty blockers via a black market. No additional children will be harmed than are already being harmed and bringing some into a clinical environment and tracking it all could prevent future harm to other children.

Much of the harm I can deduce is reversible if it is detected early enough, you can’t do that without a clinical trial.

The current state of things where they are banned but there’s not enough evidence to shut down the illegal versions on the black market and not enough evidence to convict parents of child abuse is unsustainable.

Children who have already taken PBs or any kind of hormones are automatically excluded from the trial.

So yes, additional children will be harmed.

BonfireLady · 11/07/2026 11:50

Tottenhamhotflushes · 11/07/2026 11:37

Can you expand? I'm not sure what you mean.

Yes, happy to do so.

Unless I've got you mixed with another PP, you started off pointing out that GIDS won its appeal against Keira Bell, demonstrating that its process of selection was robust. Then when challenged on that you seem to be suggesting that at least some of the GIDS staff were competent at correct selection (i.e. you were acknowledging that failures happened)..... then pointed towards Scandinavia as having everything sorted on this front.

So we've gone from GIDS being great to actually it probably wasn't and the implication that all we need to do is copy Scandinavia's selection methodology when recruiting for this trail. That's a lot of goalpost shifting.

TwoLoonsAndASprout · 11/07/2026 11:49

Meant to say thank you @BettyBooper for flagging that Cass had been pushing for a trial before the review started (do you remember where you saw this?).

In a way, we are lucky that the review was as damning as it was, given her bias.

NullaEffugium · 11/07/2026 11:49

I suppose there are precedents, we as a society must have tested drugs/vaccines/cancer treatments on children in the past and obviously they can’t all have been a success. Some clinical trials must have harmed children.

Tottenhamhotflushes · 11/07/2026 11:48

NotBadConsidering · 11/07/2026 11:36

Why does it always get derailed to “but other treatments!”? Can’t you stay focussed?

What about THIS treatment? Is it ethical to sterilise a child without any certainty a) the child will definitely grow up and identify as someone who wishes they hadn’t gone through puberty and b) it will help them with their distress about that?

Carve outs are not how medical standards work. That's why they are standards. Consistency in standards needs to be maintained across treatments.

NotBadConsidering · 11/07/2026 11:48

Tottenhamhotflushes · 11/07/2026 11:45

Gender incongruence is the medical term for when a person's internal gender identity does not align with the sex they were assigned at birth.

My understanding is gender identity is based on a purely individual perception so I couldn't give you a one size fits all but my own personal one is I see both reproductive & behavioural characteristics defining my gender.

So expand on this.

If a girl has a “boy internal gender identity”, how is that defined?

behavioural characteristics defining my gender.

What behavioural characteristics might these be?

BettyBooper · 11/07/2026 11:47

NullaEffugium · 11/07/2026 11:34

I’m on the fence because wouldn’t a clinical trial most likely prove that puberty blockers are unequivocally unsafe? Then we can stop all this back and forth of not proven safe, potentially unsafe and there would be ample scientific evidence to enforce criminal investigations to close down the illegal sources of these?

Cass is right that many parents are forcing illegal puberty blockers on their children. That this is happening in the most unsafe way, behind closed doors and the government isn’t going to call it child abuse until we have rock solid proof it is harmful.

Having a clinical trial is in my opinion a neutral thing to do, doing a trial isn’t pro puberty blockers, because I know it will prove these things are extremely harmful and then we can protect these children with the full force of the law.

A better way would be to track all the children who have already been given PBs. But for reasons we aren't doing that.

Again, why was the (allegedly) independent chair of a review into treatment plans for 'gender incongruent' children pushing for a PB trial two years before her review was concluded?

This is anything but neutral and is seeped in the acceptance of GII.

Tottenhamhotflushes · 11/07/2026 11:45

BonfireLady · 11/07/2026 11:35

Indeed. I was once asked whether I would prevent my daughter from doing activities that weren't typically done by girls. For context this was by someone in Children's Services who was reacting to a safeguarding referral made by the school where I had been positioned as a risk to my (then) gender questioning daughter.

Luckily the lady I was talking to hadn't completely lost leave of her senses and we had a productive conversation about sex-based stereotypes.

I'm also interested in your answer @Tottenhamhotflushes

Gender incongruence is the medical term for when a person's internal gender identity does not align with the sex they were assigned at birth.

My understanding is gender identity is based on a purely individual perception so I couldn't give you a one size fits all but my own personal one is I see both reproductive & behavioural characteristics defining my gender.

NullaEffugium · 11/07/2026 11:45

BonfireLady · 11/07/2026 11:39

I’m on the fence because wouldn’t a clinical trial most likely prove that puberty blockers are unequivocally unsafe?

Yes, that would be the most likely outcome. But you're on the fence about the cohort of children needed to prove this, because some of them will probably access PBs anyway?

It's certainly an interesting take on things.

Yes, thank you, I wasn’t very clear. I am on the fence about the ethics of drug testing on children that are below the age of consent for medical procedures. Especially when I consider the parenting these children have.

It is not ethical to test drugs on children, but we are in a situation where it is happening anyway and the only way to stop it long term is to prove how unsafe puberty blockers really are.

NullaEffugium · 11/07/2026 11:42

TwoLoonsAndASprout · 11/07/2026 11:36

The question then is, if you are making an assumption that PBs are probably likely to be proven unsafe why would you test them on CHILDREN?

How many children is it ok to harm to test a drug that has every indication of being unsafe, so that we can definitely, definitely, we mean it this time, say it’s unsafe?

Yes, I am making as assumption but assumptions can’t be used as evidence of harm. The fact is children are already being given illegal versions by the parents with no doctors or any kind of medical monitoring. Children are currently guinea pigs for puberty blockers via a black market. No additional children will be harmed than are already being harmed and bringing some into a clinical environment and tracking it all could prevent future harm to other children.

Much of the harm I can deduce is reversible if it is detected early enough, you can’t do that without a clinical trial.

The current state of things where they are banned but there’s not enough evidence to shut down the illegal versions on the black market and not enough evidence to convict parents of child abuse is unsustainable.

BonfireLady · 11/07/2026 11:39

NullaEffugium · 11/07/2026 11:34

I’m on the fence because wouldn’t a clinical trial most likely prove that puberty blockers are unequivocally unsafe? Then we can stop all this back and forth of not proven safe, potentially unsafe and there would be ample scientific evidence to enforce criminal investigations to close down the illegal sources of these?

Cass is right that many parents are forcing illegal puberty blockers on their children. That this is happening in the most unsafe way, behind closed doors and the government isn’t going to call it child abuse until we have rock solid proof it is harmful.

Having a clinical trial is in my opinion a neutral thing to do, doing a trial isn’t pro puberty blockers, because I know it will prove these things are extremely harmful and then we can protect these children with the full force of the law.

I’m on the fence because wouldn’t a clinical trial most likely prove that puberty blockers are unequivocally unsafe?

Yes, that would be the most likely outcome. But you're on the fence about the cohort of children needed to prove this, because some of them will probably access PBs anyway?

It's certainly an interesting take on things.

AimsAndObjectives · 11/07/2026 11:38

Tottenhamhotflushes · 11/07/2026 11:24

From what I have read the candidates must have a confirmed diagnosis of gender incongruence that has been persistently experienced for at least 2 years & pass comprehensive physical (e.g., bone density check) and mental health assessments.

Perhaps revealing other details of qualification preferences risks patient privacy or maybe they left it more open to assess which kind of candidates were most likely to benefit.

Perhaps....maybe.....

You are giving the trial designers the benefit of the doubt. Fifteen years ago I suspect many of us would have done the same. However, given the GIDS debacle, the obvious capture of large parts of the NHS by ideologists, the vested financial interests and the increasingly loud voices of the desisters and detransitioners you can perhaps, maybe understand our reluctance to accept the trial protocols without question.

Tottenhamhotflushes · 11/07/2026 11:37

BonfireLady · 11/07/2026 11:30

As long as the goalposts can keep moving, the experiment can continue. If the goalposts stay still for too long, common sense creeps in and lots of people notice that it's mad to experiment on children given what's at stake for their future mental and physical health.

Moving them around creates just enough confusion for just enough decision makers to say that they back the trial, even if they feel uncomfortable. Some don't feel uncomfortable at all and seem oblivious to the goalposts moving. Others will be actively moving them.

For clarity, my comment is about goalposts moving around in general. The PP who is making comments where the net effect is that the goalposts have moved may not be aware that this is what's happening here. Equally, they might. Either way, the goalposts have moved and it's helpful to have it in this thread.

Question to @Tottenhamhotflushes : do you agree that the goalposts moved in the way Aims described?

Can you expand? I'm not sure what you mean.

NotBadConsidering · 11/07/2026 11:36

Tottenhamhotflushes · 11/07/2026 11:31

As I already mentioned upthread a good many medical treatments come with serious risks & side effects so this is no different. The reason why its ethical is because of the trade offs involved. I know HRT might give me a stroke, heart attack or cancer but from my point of view there's no point of living without quality of life.

Why does it always get derailed to “but other treatments!”? Can’t you stay focussed?

What about THIS treatment? Is it ethical to sterilise a child without any certainty a) the child will definitely grow up and identify as someone who wishes they hadn’t gone through puberty and b) it will help them with their distress about that?

TwoLoonsAndASprout · 11/07/2026 11:36

NullaEffugium · 11/07/2026 11:34

I’m on the fence because wouldn’t a clinical trial most likely prove that puberty blockers are unequivocally unsafe? Then we can stop all this back and forth of not proven safe, potentially unsafe and there would be ample scientific evidence to enforce criminal investigations to close down the illegal sources of these?

Cass is right that many parents are forcing illegal puberty blockers on their children. That this is happening in the most unsafe way, behind closed doors and the government isn’t going to call it child abuse until we have rock solid proof it is harmful.

Having a clinical trial is in my opinion a neutral thing to do, doing a trial isn’t pro puberty blockers, because I know it will prove these things are extremely harmful and then we can protect these children with the full force of the law.

The question then is, if you are making an assumption that PBs are probably likely to be proven unsafe why would you test them on CHILDREN?

How many children is it ok to harm to test a drug that has every indication of being unsafe, so that we can definitely, definitely, we mean it this time, say it’s unsafe?

BonfireLady · 11/07/2026 11:35

NotBadConsidering · 11/07/2026 11:26

confirmed diagnosis of gender incongruence

Now explain THAT without using sexist stereotypes applied to children.

Indeed. I was once asked whether I would prevent my daughter from doing activities that weren't typically done by girls. For context this was by someone in Children's Services who was reacting to a safeguarding referral made by the school where I had been positioned as a risk to my (then) gender questioning daughter.

Luckily the lady I was talking to hadn't completely lost leave of her senses and we had a productive conversation about sex-based stereotypes.

I'm also interested in your answer @Tottenhamhotflushes

Tottenhamhotflushes · 11/07/2026 11:34

AimsAndObjectives · 11/07/2026 11:20

Well you're the one suggesting GIDS staff were using correct self selection & screening. You are moving so many goalposts in your posts that I think you are losing track.

As I said, accurate self selection as well screening comes into to it. Were all GIDS staff complete incompetents or overwhelmed? I doubt it. Did some minors get more competent private help? Maybe. In any case, the studies I mentioned were done in Scandinavia not UK.

NullaEffugium · 11/07/2026 11:34

I’m on the fence because wouldn’t a clinical trial most likely prove that puberty blockers are unequivocally unsafe? Then we can stop all this back and forth of not proven safe, potentially unsafe and there would be ample scientific evidence to enforce criminal investigations to close down the illegal sources of these?

Cass is right that many parents are forcing illegal puberty blockers on their children. That this is happening in the most unsafe way, behind closed doors and the government isn’t going to call it child abuse until we have rock solid proof it is harmful.

Having a clinical trial is in my opinion a neutral thing to do, doing a trial isn’t pro puberty blockers, because I know it will prove these things are extremely harmful and then we can protect these children with the full force of the law.

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