Letter to NHS England and Wes Streeting about puberty blockers trial

[Harassedevictee]

From X

Sex Matters, @AllianceLGB, @Transgendertrd and @genspect have written to the Chief Executive of @NHSEngland to urge that the puberty blocker trial is cancelled.

@wesstreeting @karinsmyth

After UKSC, no promise can be made that medical treatment will enable a person to use opposite-sex facilities. The use of these drugs on children too young to understand this is ethically untenable.

https://x.com/sexmattersorg/status/1917630079427043428?s=61&t=W8z-NdrPTYy21FuiQuezcw

Letter added as photo so may take time to appear

I still fail to see how they are going to get consent. How can children consent?

Also, how are you going to test their psychological well-being? When you give them puberty blockers at ten and five years later they're still ten? With possibly a lower IQ.

It's absolutely bloody insane.

I can't see how a PB trial in children can possibly be ethical in any way. There's a large, if disparate body of information on the side effects of PB drugs and that's for children who had short term treatment, for precocious puberty.

Kidney malfunction, heart valve and other cardiovascular problems, stunted mental abilities, crumbling joints and bones, for example. How can anyone possibly sign off on that?

What's going to happen if they do develop those symptoms?

their teeth start falling out, they keep breaking bones. All irreversible.

It's utterly mad. Because they want to be the opposite sex!!

You don’t seem to understand Gillick competence.

There was an interesting (albeit short) parliamentary debate on the proposed puberty blocker trial yesterday, which asked some interesting questions, including the following:

Can there ever be a situation where it is ethical to run such a trial when the harms could be significant? It is important to remember that the children who would participate in this trial are physically healthy children who stand to have worse health by the end of it. This trial is in no way similar to a clinical trial for a cancer drug, where the patient is seriously unwell at the beginning of the trial.

Secondly, approximately 9,000 children and young people were treated by GIDS over the years, which provides a plentiful supply of data about the long-term outcomes for those who took puberty blockers and those who did not. Would the Minister please clarify matters and explain why a new trial is needed, given this abundance of data? Will she please provide an update on the exercise that is currently under way to obtain more data?

Thirdly, the current trial only proposes to look at outcomes over a two-year period. To put that into context, a child who starts puberty blockers at the age of 13 will only have their outcomes followed and assessed until the age of 15. That is not long enough to understand medium and long-term outcomes. A positive result for a 15-year-old might look very different for a 25-year-old, when physical health, sexual function and fertility are likely to be more important and relevant to them than when they were 15. Does the Minister agree that two years is not a sufficient timeframe to properly evaluate the impact of puberty blockers on physical and mental health? If this trial goes ahead, will she commit to funding and ensuring that there is long-term follow-up of these children into adulthood?

Fourthly, how many children will the trial be limited to, and what criteria will be used to determine which children are eligible and which are not? Is it possible that all eligible children will be included and prescribed puberty blockers as part of the trial? How many children in total does the Minister expect to take part in the trial over its duration? How will the trial establish an appropriate control group?

Fifthly, given that gender nonconformity sometimes correlates with same-sex attraction in adulthood, how will the trial safeguard those children who may simply be uncomfortable with their sexuality rather than experiencing true gender distress?

Sixthly, given the high rates of progression to cross-sex hormones following puberty blockers, will only children who agree not to progress to cross-sex hormones be accepted on to the trial, so that the impact of the puberty blockers on outcomes can be seen in isolation? If the answer is no, given the corresponding likelihood of impaired sexual function and loss of fertility, which are monumental ramifications, how will the children taking part in the trial be able to give consent?

Finally, will the Minister please provide details of other trials that have been approved for paediatric medical interventions with equivalent or similar diagnostic uncertainty, to reassure the public that moving forward with a trial in this situation has precedent?

@LonginesPrime thank you.

As per my pp this question is so obviously a first step before any trial:
Secondly, approximately 9,000 children and young people were treated by GIDS over the years, which provides a plentiful supply of data about the long-term outcomes for those who took puberty blockers and those who did not. Would the Minister please clarify matters and explain why a new trial is needed, given this abundance of data? Will she please provide an update on the exercise that is currently under way to obtain more data?

“

@LonginesPrime
Those questions are excellent.
Among the several absurd things of the trial design we've heard so far, the very short follow up, the lack of clear inclusion/exclusion criteria, and the lack of recognition of the cumulative risks of PB followed by cross sex hormones, stand out as totally mad.

Also, if the objective is to pass more easily, it's difficult to justify the use of PBs for girls.

The justification in girls is puberty blockers will save them the need for a future mastectomy.

So we are now finally close to say that a mastectomy is a procedure that carries risks and is better avoided? Has a discussion developed weighting the risks of PBs against the ones of a mastectomy?

LonginesPrime · Today 02:26

There was an interesting (albeit short) parliamentary debate on the proposed puberty blocker trial yesterday, which asked some interesting questions, including the following:

That's an excellent piece, I wonder how much coverage it's likely to get? It's certainly well researched and thought out, with all the most pertinent questions.

This letter does just that, clearly and coherently - so yes, you can.

There was no evidence for the safety of puberty blocking medication for gender questioning children, so it should not have been given other than perhaps as part of an experimental trial. Now there is no reason to prescribe it, so no evidence or trial of its use in this context is needed. (Of course, these drugs are still used conservatively to treat precocious puberty, where the effects are well monitored and well understood.)

As others have said, data exists and should be extricated from those who are refusing to provide it before anything else is considered.

Thanks to @LonginesPrime I’ve looked up the debate.

For the record there were two pieces of research

Summary
https://post.parliament.uk/research-briefings/post-pb-0055/

Summary https://post.parliament.uk/research-briefings/post-pb-0053/

Full report
https://researchbriefings.files.parliament.uk/documents/POST-PB-0055/POST-PB-0055.pdf

full report https://researchbriefings.files.parliament.uk/documents/POST-PB-0053/POST-PB-0053.pdf

plus the Hansard record
https://hansard.parliament.uk/commons/2025-04-30/debates/BDD8D9D9-05C9-44CB-A778-817BFFE10D77/GenderIncongruencePubertySuppressingHormones

This is a very revealing comment. Not referring to Poised but this argument about children has been driven by adults men who've transitioned in mid life and don't pass. They are determined to enforce the notion that children must have early access to pbs in order to pass.
Hence the tsunami of children being give these untested drugs and the catastrophic outcomes for them.

It's immoral and unethical.

The constructive tone of that parliamentary debate, with virtually no party-political nonsense, is a world away from PMQs or other setpiece occasions when they know that everyone will be watching on TV.

Wow so in 2009 only 51 children, 2/3rds male, were referred to GIDs. Research was watchful waiting saw 67-90% desisted after puberty. The tiny number left were the ones who considered transition.

I have always believed there was a tiny core of children/adults with gender incongruence/dysphoria who had existed for decades. This group still exists but since 2010 they have been swamped and forgotten by completely new cohorts of GI believers, social contagion of ROGD and Malaga airport devotees.

How much damage has been done in the last 15 years.

The short and long term effects of using these drugs to interfere with puberty are already well known as it's my understanding that it's been shown that interfering with early/precocious puberty might not always be a good idea.

With this cohort they are talking about using them in physically normal healthy children. It's madness.

I thought it was men who liked the idea of a 16yo who looks 12

This episode of Beyond Gender explains the issues with the proposed trial really well. It’s available on Spotify etc but thought YouTube most accessible link to share.

Great news that the subject has been discussed calmly in parliament, a good sign that it’s getting harder to handwave away concerns. Surely once the reality of what children are being asked to risk (when there is already so much data to be mined) will mean the plug is pulled on this. Many more people are watching now and spelling out the risks. Much harder to claim ignorance after the fact.

Those poor children and their parents should not be asked to consent to this.

ETA YouTube link being vetted - hopefully will be showing soon

How reassuing to hear that there are still some rational grown-ups in Parliament, given the Chapman panto this week.

The proposed two year trial is risible. Unless they know such a weak study will be slapped down by an ethics committee and then they can shrug and say "well, we tried"?

I think for some TRAs who do not themselves identify as trans, this is indeed the motivation. PIE all over again.

Thanks for the links. In the debate, the minister, Karin Smith, says

I assure hon. Members that the UK has, as we know, extremely rigorous and robust ethical approval pathways, and that no clinical trial can proceed without the necessary independent scientific approvals.

We already regularly use those processes to consider clinical trials in children so that we can evaluate new treatments for a whole range of conditions, including cancer, depression, respiratory infections, or any illness.

The only condition she mentions which is in any way comparable to gender dysphoria is depression. Would anyone even be considering recruiting depressed but physically healthy children for a trial of a drug which caused serious and irreversible physical damage to a child's body? Although I suppose in a way they are, as long as the child claims gender issues as the cause of their distress.

No, no discussion has developed because that would require gender clinicians to be circumspect about what they do and think that not giving puberty blockers might be an option. They only use the “prevent a future mastectomy” line because they have to come up with something to justify given them to borderline pubescent girls that disguises the “they’ve declared a male gender identity and that enough” real reason.

Read Hannah Barnes book.

It gets worse.

Thank you for linking this Hansard.
So good to see all the pertinent questions being raised!