Why the NHS puberty blocker trial is appalling

[Soontobe60]

Stella O’Malley from Genspect telling it like it is - that a state endorsed trial of puberty blockers for gender dysphoric children should NOT go ahead.
the NHS are not walking into this nightmare blindly - there are enough experts out there telling them what will happen happen to these children if they’re given these life changing drugs.
https://x.com/genspect/status/1989896741358113127?s=61&t=gKvvk-rWmOlYFGMZN8QVvQ

https://questions-statements.parliament.uk/written-statements/detail/2025-11-24/hcws1088

Statement from Streeting.

That way we can see if puberty blockers do or do not help those with gender dysphoria, a real condition that causes considerable suffering

What is the condition though? If it is psychological why is it begin treated physically? 'Puberty blockers' are widely used to treat other conditions, so we know about many of the side effects, but here they are being used for a different purpose, to potentially preventing a child reaching sexual maturity.

It's more akin to allowing people to have limbs amputated to relieve their body dysphoria.

This includes the PATHWAYS trial, a carefully designed, randomised controlled clinical trial of puberty suppressing hormones for gender incongruence. This trial will involve young people being treated in NHS Children and Young People’s Gender Services with a formal diagnosis of gender incongruence.

So Wes, if you believe that the trial has been carefully designed, please do explain the meaning of 'gender incongruence' and why this is a condition that requires treatment.

I mean, in theory sure ... but

The children will not be consenting here, parents/guardians will on their behalf.

I do not understand how parents/guardians can ethically consent to a process that may leave these children sterile/never reaching sexual maturity/inhibiting physical and intellectual development. Do you?

The research we have doesn't at all suggest that outcomes will be positive but by using the usual short-term assessment period it may be possible to produce a larger than usual study that nonetheless drapes itself in rainbows & glitter.

The study should never have passed the ethics committee. Lifetime follow-up is possible for every participant who remains in the UK & that follow-up & its public reporting should have been the absolute minimum requirement for this hideous project.

IMO we should have stopped the prescribing of both GnRHas & cross-sex hormones to under 18s & instead returned to the sheep model.

So 2000 people have been through puberty blocker trials under the work of the Tavistock et al and not one bit of research has been published using their data?

Shame on them.

Don't forget the Tavi's abandoned trial that attempted & failed to reproduce the positive results in the original Dutch study. They abandoned it because it wasn't giving them the pretty metrics they assumed they should get.

No bloody wonder there's a Crisis of Replicability. 🙄

That way we can see if puberty blockers do or do not help those with gender dysphoria, a real condition that causes considerable suffering.

What is the criteria for judging if it 'helps'?

Is it A) they feel happier and want to continue on to cross sex hormones?

Or is it they B) feel happy now to accept their body and go through natural puberty?

If there was any evidence it might increase the chances of B) that might make this acceptable.

But this experiment has already been done and 98% had outcome A). Which we know leads to sterility and loss of sexual function.

How is that helping anyone?

I just cannot see anyone being clear that the best outcome for 'gender incongruence' is accepting your healthy body and not extreme body modification.

These are being treated as if they are both equally successful as long as you are 'happy'.

Not only that, but they claim they do t have any data - it wasn't collected.

I don't believe that, they must have some records. It should be possible to conduct some retrospective research but according to Helen Joyce the adult gender services [under whom these individuals would now belong for ongoing care] have refused to co-operate.

Edit: I meant Gillick competent not Granger criteria for consent of under 18s.

@MalagaNights I am no expert but I guess the same way mental health treatment is measured.

Of course it would be great if those with gender dysphoria could just accept their sex. It's not that simple.

So far no psychological treatment has been shown to help gender dysphoria.

Except perhaps where there are concurrent conditions so that's why it's so important to treat these which the Tavistock clinic wasn't.

So that's why I suggested an initial period of psychotherapy and psychiatric assessment and exclude certain concurrent conditions.

The trial has received comprehensive scientific, ethical and regulatory approval from the MHRA and from the Health Research Authority, including review by an independent Research Ethics Committee.

Let's see those documents, then.

Several trust wouldnt hand any data over to Dr Cass. I'm not sure what happened there in the long run.

Good point. But what is the trans equivalent of the "flat, modern country" for which medical transition would be a no-brainer? In Transutopia you need only declare your pronouns for everyone else to instantly start seeing you as the sex you want to be - why put yourself through an unnecessary pharmaceutical and surgical ordeal? More realistically, you'll be able to fool some, while the rest will play-act at being fooled from pity or fear. That doesn't seem a healthy situation - or a happy one - regardless of the proportion of people that are genuinely fooled.

But we do know 98% went onto cross sex hormones.

So the 'gender incongruence' persisted. It didn't 'help'.

And we know the serious impacts on health from cross sex hormones.

So what evidence are they expecting to see that could be judged as 'helping' or 'success' on how to treat these kids?

The only possible evidence is more evidence of what not to do, which is insane, evil and should be criminal.

I thought the standard was: "First do NO harm". Was I wrong?

A couple of excerpts from HoC debate last year on the subject:

https://hansard.parliament.uk/commons/2024-04-15/debates/AFE3A39A-3333-4790-AE30-776A474188C4/CassReview

'As recently as 2009, the NHS’s sole gender identity development service at the Tavistock and Portman NHS Foundation Trust received fewer than 60 referrals for children and young people, and just 15 for adolescent girls. Since then, demand has surged. By 2016, over 1,700 children and young people a year were referred—a 34-fold increase. More than half were teenage girls. In 2022, more than 5,000 children and young people were referred to gender identity clinics, and almost three quarters were female.

Dr Cass also found that there was a lack of robust data on what happened to the 9,000 children who were treated by gender identity services between 2009 and 2020. Many went on to continue their treatment at adult clinics, and the University of York had been due to research the long-term consequences of treatment they received as children, so that we can properly support them through their journey into adulthood. It was expected to provide important insights into the clinic’s work, including how many patients de-transitioned and how many were also diagnosed with a mental health condition or an autism spectrum disorder.

This Government took the unprecedented step of changing the law to make it possible for adult gender clinics to share medical data with the university. All bar one of the adult gender clinics refused to co-operate with this vital research. To quote Dr Cass, that is “unacceptable”, but I would go even further: I think it is deplorable and a dereliction of their professional duty. I am pleased to update the House that following the publication of Dr Cass’s report, I have been informed that all seven clinical leads for the adult gender services now intend to fully participate in this important work.'

Victoria Atkins, April 2024

'What has emerged in the Cass review is a scandal. It is a scandal that children and young people are waiting far too long—often years—for care while their wellbeing deteriorates and their childhood slips away. It is scandalous that medical interventions have been made on the basis of shaky evidence. It is scandalous that, despite all that, some NHS providers refused to co-operate with Dr Cass’s review. Perhaps the worst scandal of all is that the toxicity of this discussion means that people have felt silenced, and it required investigative journalism to prompt the review to take place. This particularly vulnerable group of children and young people are at the wrong end of all the statistics for mental ill health, suicide and self-harm. '

'The refusal of adult gender services to share data on the long-term experience of patients is inexcusable—as the Secretary of State said, it is deplorable. The data does not belong to them; it belongs to the NHS and, crucially, to patients. I welcome their coming forward now, but how was this allowed to happen, and what accountability does she think would be appropriate?

This report must provide a watershed moment for the NHS’s gender identity services. Children’s healthcare should always be led by evidence and be in the best interests of children’s welfare. Dr Cass’s report has provided the basis on which to go forward'

Wes Streeting, April 2024

Where is all the data that was promised then?

Yes transgender “health” services really need to move completely away from any ideological language. Children should be told that it’s not possible to actually change sex and that any changes are aesthetic/ superficial and that the law as it stands will not permit them to lawfully use the services of the opposite sex.

So far no psychological treatment has been shown to help gender dysphoria.

Where is the evidence of anyone attempting to help children accept their bodies?

We know that the waiting list for any kind of psychological treatment means it often just doesn't exist. Nobody pretends that CAHMS isn't over subscribed.

We also know that many children just grow out of gender dysphoria.

What is the rush?

Of course it would be great if those with gender dysphoria could just accept their sex. It's not that simple.

Puberty resolves 80% ofthegenderdysphoria.

If they had a drug that had those results they'd be handing it like smarties.

But because it's essentially, do nothing, watch and wait, it's dismissed. It's the hubris of the medical profession: we must fix this. Instead of: nature has a better solution if we allow it.

They could then see who persists and how to support them.

Puberty is the intervention. It should be obviously preferable to giving everyone medication 80% do not need and which has negative outcomes.

And to what end? What will we have proved here? Does India Willoughby seem happy to you? Medicalising a fetish or a mental health problem is not ever going to be the answer. Why the Hell did anyone ever think it was? We don't need a trial to tell us this ffs. It's obvious

Yes — there are studies, e.g. Wallien & Cohen‑Kettenis (2008) study, which found that among 54 children followed into adolescence/early adulthood, only ~27% retained gender dysphoria or around the figure you state.

But many of those who didn’t continue to meet criteria actually turned out to identify as same-sex attracted or bisexual. That suggests that, for a number of children, the distress may relate to sexuality, social context, or confusion rather than a persistent cross-gender identity. That could be where an initial period of psychological support or therapy might help clarify things.

Also: the diagnostic criteria in those earlier studies were quite broad, and sample sizes small. There is a big difference between transient or mild gender distress in childhood and long-term, severe gender dysphoria which persists despite support or intervention.

To draw an analogy: mild depression in children usually resolves over time without psychiatric medication. But children with severe or persistent depression often do need intervention, and delaying treatment until adulthood could lead to developmental or psychological harm. The same principle applies: not all gender dysphoria is the same, and we should consider carefully who is likely to persist, and when medical intervention might help.

Research suggests that children whose dysphoria does persist tend to have stronger, more consistent feelings of mismatch, described in ways that clearly differentiate them from those whose feelings shift over time.

These are precisely the children who might benefit from more medical intervention such as puberty blockers. That's why trials make sense. Rather than applying a one size fits all go through puberty approach.

Like I mentioned, these children are Gillick competent and absolutely should be told their distress might resolve I.e. with your stats and downsides. They should be told both sides, as should their parents. They are free to withdraw at any point in trials.

None of this makes it ok to give them to perfectly healthy children. Try again.

How are the children going to be differentiated? What criteria are going to be used to discern the same-sex attracted, or those with trauma-history, from those who appear to have a genuine mental health issue ?

Further to that - why stop puberty? Why not wait until after puberty? What are the 'benefits' to missing puberty?