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

So did they get more funding?
Because I checked, and at the beginning the funding was covering only the first two years.
https://archive.ph/5oS7Q
I'll try to dig more information when I have time.

The noise hurts my head.

It says in the bit I posted from the protocol that the NIHR has agreed to fund the extension study?

It also says :

This application for long-term follow-up will undergo the usual scientific evaluation and will be subject to regulatory approval.

So it's not certain at the moment.

Link to document so that others don't have to search for it as I did.

Microsoft Word - PATHWAYS Trial Protocol v3.2 18.06.2026 CLEAN

Exactly. What on earth is this trial for in the first place? There have always been girls who want to be boys and boys who want to be girls, but it's not possible to change sex, so what is this all about really?

(To answer my own question, it's all about validation for middle-aged transvestites.)

I’ve linked to it four times on this thread already.

I thought actually posting the relevant bit would help but still no.

But no matter how many times you post it, it still says:

This application for long-term follow-up will undergo the usual scientific evaluation and will be subject to regulatory approval.

So it's not certain to go ahead.

Anyway, @noblegiraffe , perhaps you could enlighten us about what the condition is they're trying to treat, why preventing puberty is the most appropriate treatment, and what a positive outcome would look like.

So what is this trial actually for, what will it actually show, what is "success" in this context....? And so on.

We don't run trials to establish that children who have had one foot amputated will have difficulty competing in foot-races, after all. It's not needed. And we certainly don't amputate one foot of each of a couple of hundred more children to see if we were right.

Have you actually tried reading the protocol where they go through all this? You might not like the answers but they do explain what they are doing and why.

This could be the counterweight part of the trial.

OK, I'll go through it and post my comments. You may not like them.

First we're presented with a graph showing the increase in the number of referrals for the non-illness of 'gender incongruence'. They mention the huge increase (which incidentally, and perhaps not coincidentally, began in around 2014 which was when CBBC first showed 'I am Leo', encouraging girls to identify as boys and suggesting that they could change sex). The graphs show that there has been a much greater increase in referrals of girls than boys.

The caption reads:
Figure 1 - The characteristics of young people seeking support in the United Kingdom (UK) have also changed over this time period. This means that the results of studies reporting on earlier cohorts of CYP may not apply to those currently accessing gender services.

So that's interesting. They imply that the results of previous studies might not apply to this cohort. Perhaps partly due to the fact that historically there have been far more male transsexuals than female, but girls now outnumber boys by about 3:1. I wonder if they suggest any reasons for this later in the document or are just stating it as a reason for doing this experiment while ignoring the results of previous studies?

So if the trial does run long term, and it would need to be 10-15 years to really get any useful answers, how does this help those who are getting PBs on the black market and in other countries worldwide? The proposed concept on this thread is once it’s done and shown to be a problem it will help put an end to the idea that PBs are good and other countries will then shut down the idea.

So if the long term outcomes are now what we are waiting for, it’s thousands of children who will be harmed by PBs in the interim, not just the few hundred in this study.

Alternatively, there can just be a ban for PBs for still yet to be defined gender reasons and prosecute those who defy this.

Next section

1.2.2 Puberty suppression and changes in care
Over the past two decades, changes in the age of presentation, ratio of male-female birth-registered sex and prevalence of people presenting with gender incongruence have coincided with changes in the available treatment, most notably the use of puberty suppression which had not previously been used for this purpose...Several possible benefits of GnRHa were hypothesised for CYP experiencing gender incongruence. These included reducing feelings of distress with one’s body developing secondary sexual characteristics (body dysmorphia) and related emotional distress and making any subsequent physical transition to the opposite gender more straightforward, potentially with less radical surgery.

Well, that's an outright lie. We all remember the video of Susie Green chuckling with her mother about how her son's penis "didn't have enough material" for the surgeon to do the usual penile inversion to make a fake vagina, and they had to use part of his colon instead. So the surgery is actually more complex and less likely to be satisfactory.

For girls who are now the majority of trans-identified children, the surgery issue is just irrelevant. Puberty blockers are not given until the child has commenced puberty, so girls will have some breast development, meaning that if they want a male-looking chest they will still have to have a mastectomy. What other secondary sexual characteristics are they trying to stop in girls? This medication is totally pointless for them.

You'd think they could have written a research protocol without filling it with lies in the first couple of paragraphs.

a systematic review reported that as few as 0-8% (including 2% of UK youth4) receiving GnRHa subsequently desisted from the treatment and a transitioning pathway. This rate of gender transitioning was substantially higher than those reported from earlier observational studies, prior to the use of GnRHa. This raised concerns about whether the intervention might itself be narrowing rather than increasing perceived choices regarding gender identity.

Some honesty here at least. So why are they doing this if they know it's likely to set those children on an irreversible pathway?

I notice that the first few paragraphs keep repeating the term "gender incongruence", but I haven't seen a definition yet. I'm going to look for the definition now.

I'm going to look for the definition now.

Good luck!

Here's the definition of gender incongruence (which I think was posted earlier in the thread):

1. Diagnosis of gender incongruence according to ICD-11, which includes:
a. Strong desire to be a different gender than the birth-registered sex.
b. Strong dislike of sexual anatomy or anticipated secondary sex characteristics.
c. Gender Incongruence persisted for a minimum of 2 years.
d. Strong desire to ‘transition’ and live as the experienced gender.

The problem with this definition (well, there are several problems really), is that they use both "gender" and "sex". Do they mean these to be synonymous or is "gender" in this definition actually distinct from "sex"?

Substituting sex for gender in part (a) sort of makes sense:
a. Strong desire to be a different sex than the birth-registered sex.

I can understand that some people might want to be the opposite sex, although this is obviously impossible. Using gender here instead makes it meaningless though without some description of how "gender" and "sex" relate to each other.

Part (b) is quite easy to understand, and in section 1.2.2 that I quoted in my previous post they describe this as body dysmorphia.

Part (d) really needs some more explanation. What is an "experienced gender" and how does someone "live as the experienced gender"?

If this is the condition they're treating, it's really not well defined at all, and it's not clear why damaging the healthy bodies of children is seen as the best treatment for it.

Just to add to my previous post, gender incongruence seems to be about impossible desires to be the opposite sex. It seems absurd to use medical and surgical treatment to try to change bodies to fulfil these desires, rather than psychological treatment to help children accept their bodies and their sex, leaving their healthy bodies undamaged.

Especially as all the research pre-Dutch protocol indicates that around 90% of gender-incongruent children will outgrow it by going through puberty, and most of them will end up being gay or lesbian.

I absolutely would. I'm not sure what's wrong with me but it was the most relaxing experience of my life. Totally shut up my brain. I'd be first in the queue for a free one. If I could pay to have one, I would.

PS, am enjoying your analysis @OldCrone!

I went looking for a bit more info on the pathways trial and read an interview with Cass and the SI in 2025 where Cass says:

While we don’t fully understand the cause—it’s not simply about being ‘born in the wrong body’—these children have always existed and we need to figure out the best way to support them,” she added.

How does she bloody know they’ve always existed? How does a scientist come up with this bit of narrative myth? Yes, older men presenting as women and some women dressing up as men are present throughout history but I’ve never heard about these trans children being found in history.

And referrals to gender clinics have fallen from 200 patients a month to just 30. This is not because demand has vanished, but because some gender incongruent young people—as MPs heard during a briefing about the trial—may be getting the drugs from other sources.

But maybe it’s because the pipeline to the Tavistock has been halted and so there are simply fewer girls being exposed to social contagion?

I've skimmed through the rest of the protocol, and I can't see anything which explains why they think this trial is necessary. They plan to experiment on children, and see if they suffer adverse effects, particularly with respect to their bones or brains, and ask them if they feel happier. That seems to be it.

But I am quite tired so I may have missed some details. I'll try and have another look at it tomorrow.

But I am quite tired so I may have missed some details.

You haven’t. It’s the massive elephant in the room. They can’t explain why it’s needed.

I've skimmed through the rest of the protocol, and I can't see anything which explains why they think this trial is necessary

"The observed changes in the population of CYP presenting at Gender Services, in terms of age, birth-registered sex and neurodevelopmental traits or disorders, means that clinical experience from and longitudinal follow-up earlier cohorts may not be applicable to the group of young people currently seeking care. Hence new research studies are needed. "

"Hence currently decisions about care are made in the context of very limited
evidence and against a background of strong personal preferences. This is
particularly pertinent for a condition in which intervention decisions rely heavily on the preferences of relatively young children and adolescents who are at a developmental stage intrinsically characterised by exploration of personal identity. Many healthcare professionals and parents/caregivers have expressed concerns about over-reliance on the views of CYP at this dynamic and formative developmental stage and request clearer and more objective clinical evidence to guide decision-making in the interests of longer-term positive outcomes."

"The question of any possible impact on brain development and cognition will be directly addressed, for the first time, in the PATHWAYS CONNECT and PATHWAYS HORIZON INTENSIVE studies."

"The observed changes in the population of CYP presenting at Gender Services, in terms of age, birth-registered sex and neurodevelopmental traits or disorders, means that clinical experience from and longitudinal follow-up earlier cohorts may not be applicable to the group of young people currently seeking care. Hence new research studies are needed. "

But this just translates as:

“The kids we puberty blocked previously are different to the kids wanting puberty blockers now, so we need research to see what puberty blockers does to this group.”

It doesn’t explain why puberty blockers are the treatment that we must research and not other things.

It also doesn’t explain why new research isn’t research into validity of the “gender incogruence” diagnosis or the reason they should be given puberty blockers, given such notable changes in patterns of kids who say they’re trans.

Many healthcare professionals and parents/caregivers have expressed concerns about over-reliance on the views of CYP at this dynamic and formative developmental stage and request clearer and more objective clinical evidence to guide decision-making in the interests of longer-term positive outcomes."

And again, how will an experiment of puberty blockers on these kids help combat the child’s view of what they think they are and what they think they need, any more than what we already know about this treatment from the multiple systematic reviews that have been done so far?

Child: “I am trans and really want puberty blockers.”

Gender doctor: “Multiple systematic reviews have shown that low certainty of benefit, that means it probably won’t help you.”

”Child: “You could do just one more study to make sure?”

Gender doctor: “You’re right! Because the systematic reviews done so far only looked at the previous population, not the current changing population because it’s so different and you can’t possibly apply that research done just in the last few years to the children of today!”

Mental. Absolutely mental, all of it.