I have read the protocol. That does not make the objection disappear.
”The protocol answers this.”
No, it describes the mechanism of the trial. It does not answer the central ethical problem: what positive outcome is actually possible here?
If a child has gender incongruence, the genuinely good outcome is that the child is no longer distressed by the reality of their sexed body. Puberty blockers cannot achieve that. Cross-sex hormones cannot achieve that. Surgery cannot achieve that. None of those things make a child the opposite sex. They only medicalise the child’s healthy body around a false premise.
”There is a distinction between consent and assent.”
Yes, legally there is. But that is not the same as saying this is ethically sound.
An 11-year-old cannot meaningfully understand the lifelong implications of interrupting puberty: fertility, sexual function, bone health, brain development, future regret, and dependence on further treatment. Calling that “assent” does not make it informed in any meaningful adult sense.
And parental consent has limits too. Parents cannot ethically consent to every possible intervention just because a child is distressed. The question is whether the intervention has a coherent therapeutic purpose and an acceptable risk-benefit balance. I do not think this does.
”This is not primarily to investigate what the drug does.”
That is not reassuring. The concern is not merely the drug in isolation. The concern is the pathway.
The trial itself is about suppressing normal puberty in children with gender incongruence. The endpoint is not “child reconciled to their body”. The wider pathway can include continued blockers or cross-sex hormones. That is exactly the issue.
”The child has had holistic care first.”
That does not solve the problem. It actually underlines it.
If a child is distressed, autistic, anxious, traumatised, bullied, struggling with sexuality, struggling with puberty, or struggling with body image, the answer should be careful whole-child psychological support. Not drugs to stop normal sexual development.
“Holistic care first” is not a moral permission slip to then medically interrupt puberty.
“They must have a diagnosis of gender incongruence.”
That is not a safeguard. That is the contested assumption.
A diagnosis saying a child strongly wants to be the other sex does not prove that affirming that belief medically is good care. A child can have real distress and still be wrong about the solution. Adults are supposed to protect children from irreversible or high-risk responses to distress, not build a medical pathway around them.
”They are counselled on the risks multiple times.”
Counselling a child about risks does not mean the child can grasp them.
An 11-year-old cannot properly weigh the possibility of future infertility or impaired sexual function against immediate distress about puberty. They have no adult frame of reference for what they are being asked to gamble with.
”It has ethics approval.”
Ethics approval is not a trump card. Many things have been approved by formal processes and later judged to be harmful, wrong or based on poor assumptions.
The real question is still: what is the positive therapeutic aim?
If the aim is “pause puberty”, that is not a health outcome. If the aim is “reduce distress”, there are safer ways to address distress. If the aim is “help transition”, then this is not neutral research, it is the first step on a medicalised pathway.
I do not accept that children should be used to test whether stopping normal puberty might make them feel better about an identity conflict. The best outcome is not a child becoming a lifelong medical patient. The best outcome is a child being helped, carefully and compassionately, to live peacefully in their own body.