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

The damage is off the scale. Once you consider not just the children/ young people embarked on this extreme self harm but add in their desperate parents, siblings and other family members, their friends and community, all struggling with the fears and other feelings about all this. It's literally broken families with transactivists & lobby groups cheering on parental alienation.

Yet it still continues.

I think this is also why the idea that children will kills themselves without PB was pushed so hard. These drugs are really harmful And the damage they do is weel understood and consistent across all cohorts. If they are being used to manage prostate cancer or endometriosis severe enough to cause bowel and kidney damage, then they are the lesser of two evils.

But in this cohort, where disease is absent? They have to proactively attach a story of harm to not using them otherwise there is simply no way to justify it.

I haven’t seen it mentioned anywhere - I just happened to spot it on Hansard while looking for something completely unrelated.

But I guess it’s only the start of the new process, and at this point there remain far more questions than answers.

Thanks for digging out the research, OP!

Absolutely. If gender clinicians were given a truth serum and asked why they give puberty blockers to children, they would say:

”Because the child wants them 🤷🏼‍♀️🤷🏻‍♂️!”

which is as crazy as it sounds.

This doesn’t get much discussion: the clandestine actions of clinicians and activist groups to facilitate desired hormone treatments under the ruse of other reasons.

In short, they’re sneaky fuckers.

Top story in the Times:
https://www.thetimes.com/article/800fc8c9-e7f0-438c-85d4-994a41d7b40f?shareToken=728ea3e8b758f7289783ca6f727ec069

@Igneococcus that is a powerful article about the latest position from independent medical researchers.

Worth noting they've had to stay anonymous for their own safety. Which Hilary Cass will understand after all the threats made against her.

Thanks for sharing @Igneococcus.

The report summary is here, but it looks like the actual report isn’t out yet (although please anyone shout if you’ve managed to find it). The Times article suggests it will be published at some point today, though.

Like our SC ruling, the summary uses extremely clear language, which I think is very helpful for identifying and discussing the actual issues on the table.

For example, it refers to:

Federal guidance titled “Gender-affirming Care and Young People,” which promoted the chemical sterilization and surgical mutilation of minors.

Couldn’t really be clearer than that.

That's not what the letter says. It is making the point that a medical trial of this nature is grossly unethical.

How do we know that "the most severe cases" won't be better off with mental health support and waiting till puberty is over?
We already have a natural experiment where children referred before X date were given them and after that weren't.
We can just compare those groups.

Exactly

I have tried several times, as a thought experiment, to design an ethical trial that would give good quality information.

Prior to the trial:
get retrospective data from people who have received puberty blockers followed by cross sex hormones about fertility, sexual function and bone density; about mental health; about body satisfaction
conduct animal studies to assess the risks
build an accurate estimate about suicide risk
Although retrospective/animal studies do not give good quality information, they would provide the parents/cares and children with some information for the informed consensus

Eligibility:
Pre-pubertal children without additional mental health problems and without a neurodivergent diagnosis (which could be confounding factors - same criteria as the Dutch protocol?), that do not show a pre-homosexual orientation? (very different from the Dutch protocol), that show a persistence of XX years of severe (how to measure it?) gender distress (as you can see, already trying to write the inclusion criteria is so difficult). Do we include or exclude girls?

Readouts:
mental health, persistence/desistance, during the study and for the subsequent 10? 15? 20? years (when would we see regrets about loss of fertility? age 30, 35?)
bone density, IQ, fertility, sexual function, and any other issues that we know can be impacted by PB (taking in account side effects for all other licenced GnRH uses)

Aim of the study:
improve mental health during the study? mental health overall for the duration of follow up? increase feeling of body satisfaction for the duration of follow up? increase social functioning?

As concerns mental health, social functioning, etc.. compared to which control group??

Virtually impossible.

The trial needs to be stopped by holding its designers' feet to the fire of scientific rigour. What is the null hypothesis? What is the condition being treated? Add to this the ethical concerns, for example the IQ drop found in girls who had been treated with PBs for precocious puberty in Mul et al's study. I'm not sure accessibility of opposite sex amenities needs to feature among the many reasons further PB studies shouldn't go ahead. So I'm ambivalent about this letter.

Good to see the lack of definitions mentioned.

Even the concept of “gender identity” lacks a clear definition that is not circular, the report says, describing this as “a serious problem, because the term figures centrally in the justification for medical interventions”.

Making the point that this "treatment" is being used for a condition which can't even be defined. Does "gender identity" even exist in any sort of objective sense? Mutilating and sterilising children because of an indefinable feeling that they claim to have is insane.

Given that no proper effort has been made by gender clinics to actually follow up their patients and look at outcomes I really can't see how you can justify exposing a new group of children to high risk, low benefit therapy for a condition strongly linked to childhood abuse, same sex attraction and/or autism/ADHD

Why would we believe it would be different a second time around given all the push back currently?

There is simply a loss of trust now.

Agree. You'd have to be very naive and wholly inexperienced in safeguarding not to ask the obvious question of who will the dating pool be of legal adults who still look physically like children - and there is a strong suspicion and emerging evidence that they may be neurologically and psychologically immature too, not having been through a typical developmental puberty. And who will not reach sexual maturity or have the capacity for arousal.

What's the dating pool of adults who would be interested in such a relationship and for what reasons? And what would you likely anticipate as the risks within that dating pool, because very sadly they won't all be white knights pure of heart.

The US gender dysphoria report is out.

I saw, it's awesome.

Worth a listen - Recent podcast (March 2025) "Beyond Gender" Stella O'Malley, Mia Hughes and Carrie Clark on the proposed UK trial:

"The only incluson criteria that have been made public so far are that the child must want puberty blockers, the child's parent must agree with them having puberty blockers, and that the gender dysphoria clinic say that the child should have puberty blockers."

"We know that roughly 9000 children went through the GIDS system, we know that maybe roughly 2000 children or so were on puberty bloockers, we have a control group. All we need to do is follow up how did those 9000 children get on."

"We heard from politicians that it [the new trial] is uncapped - most gender distressed teenagers would be part of this trial, several thousand people might be going to participate, and of course that's just GIDS. People arrive, they're set on a medical pathway, the assessment's not all that great, and they're in. I started looking for inclusion criteria and exlcusion criteria [for the new trial], the kind of things we would expect to see based on the evidence base that we already have, things like people with autism, and mental health difficulties who we know are at a higher risk of regret and detransition, whether they were going to be excluded; how they were going to control for things like having therapy at the same time so we weren't going to confound endocrine interventions with psychological ones, and it just didn't look as though any of these things were really being considered."

TL:DL "It looked like GIDS Mark II - we were just going to do this all over again"

(edited for typos and context)

There are many problems with the proposed UK trial. A key argument against a trial and indeed against the entire affirmative model is the documented high rate of natural resolution of gender dysphoria with normal puberty. There is no justification to use high risk treatments for a condition with a spontaneous remission rate of between 66-90%.

It's like treating a sunburnt arm with amputation.

UK politicians from both main parties accepted Cass because we mostly see this kind of research study as independent and objective even if Labour would have preferred different results.

I do wish Cass had insisted that we get the data linkage results before giving any more kids puberty blockers for gender dysphoria, inside or outside of a study.

Is the US Gender Dysphoria Review likely to be undermined or rejected because Trump? Or is the OASH generally viewed as non-partisan?

(edited to clarify)

The article suggested it was non partisan.

Another question is about clinical trial insurance:

What is clinical trial insurance?
Clinical trial insurance is an essential component of any medical research programme. It offers financial protection to both the researchers conducting the trial and the volunteers who are taking part, should unforeseen problems arise as a result. Usually, clinical trial insurance is a regulatory requirement so it’s important your policy provides a suitable level of cover for your needs.

I wonder who's paying the insurance for a NHS-sponsored trial , and if insurers have a say on the details of the protocol.

Does anyone know?