Hannah Barnes Article: "Will the new puberty blocker trial put children at risk?"

[UtopiaPlanitia]

I thought it would be useful for this article to have its own thread - it would make it easier to find and to discuss:

https://www.newstatesman.com/politics/2025/12/will-the-new-puberty-blocker-trial-put-children-at-risk

"Asked whether she understood why there was concern about the trial and whether it would answer the questions she herself highlighted, Cass said: “Nobody is wrong on this. It’s a finely-honed decision, and, with justification, you could come down on either side of it.” She drew comparisons with the assisted dying debate taking place in the House of Lords: “Whether you are in support or against it, it’s an ethical decision about what you know, how many people you think you’re going to do something positive for against how many people might be harmed… and everyone makes their decision.” Cass explained that she had recommended a group of people should explore a trial, but that “I didn’t even necessarily anticipate whether or not such a trial would get through an ethics committee, or whether a group of academics would be able to even design a trial, given the circumstances that we’re in now. So, I didn’t prejudge whether it would happen… And if the ethics committee had said, despite everything, we don’t think this is an ethical approach, then I would have been content with that too.”

It seems she is admitting that opting for puberty blockers is a form of suicide.

I'm also frankly shocked by her admission to including a recommendation for a trial she herself didn't think was ethically possible to carry out. So many parts of her Review seem to contain sops to trans-identifying people and children. She seems unusually keen to ensure buy-in from the children and their parents in case they go outside the NHS.

She could have made stronger recommendations that the govt ban the use/purchase of PBs from ALL providers and international suppliers. Giving an NHS route to the drugs as a concession to determined families is just enabling self-harm in vulnerable children. Harm-reduction is not enough in this situation because use of these drugs for 'gender incongruence' is a harm that can be prevented/eliminated if there is coordinated enforcement.

I am looking forward to rereading it tomorrow as I have just skimmed it today. That quote from Dr Cass though really stuck out to me.

I'm also frankly shocked by her admission to including a recommendation for a trial she herself didn't think was ethically possible to carry out.

Did she recommend a trial? I haven't been able to find a specific recommendation for a trial in the Cass review. It says that puberty blockers should only be given 'under a research protocol', but not that such a trial is recommended. Where does it say this?

Hannah’s article is heavy reading. Unsurprisingly, given her intimate knowledge of the way things were allowed to unravel at the Tavistock, she really
digs deep into the flaws in this study. I was interested to see she spoke to someone who “is no longer part of the research team” who said:

“the early planning meetings were unlike any other clinical trial I’ve encountered. We could easily list all the potential harms to monitor and how to test for them, but we didn’t have a clear rationale for giving the drug in the first place”. Normally, they said, “you start with a strong rationale for how and why a treatment might help someone, and then think carefully about the possible downsides. It’s very unusual to start planning a trial without a well-defined outcome, especially in children.”

What Cass said about it was shocking as well. She is completely washing her hands of it, like “oh well, if the trial goes ahead, if it doesn’t go ahead, it’s all the same to me.”

What worries me is whether or not the children who are the subject of all this will have some comeback in future years if things go wrong or if they regret the treatment. I can’t see how they can give informed consent but presumably their parents are doing it for them? Are they being asked to state that they give consent and accept whatever the consequences might be?

I will be extremely angry, if I’m alive at the time, if the British taxpayer has to pay compensation for harm that occurs but that is known to be a risk currently. Particularly in view of the understandable response by Cass.

Agree. There seems to be concerns that simply were not addressed.

What a shambles. The fact that Hannah Barnes was barred from the initial briefing speaks volumes.
The fact that the Ethics Committee's judgement & rational is being kept secret is also telling.

What is evident is that this is a cohort of physically healthy children being experimented on by the State with potential risks to their future health and fertility being handwaved away. Medics and politicians under immense pressure from some of the most unsuitable adults to be anywhere near child healthcare, have decided that 12 year olds (pick your preferred age) and their parents are competent to assent / consent to these potential life long risks and harm.

How disappointing to see that that the removal of these "dangerous to children" activists from influencing child healthcare, which seemed possible when Cass was published, has turned out to be a sham. Transgender Trend has a helpful summary of what's been happening nehind the scenes in the NHS:

https://www.transgendertrend.com/puberty-blocker-trial-cass-activism/

Cass is a slippery character, isn't she? She speaks out of both sides of her mouth.

Here's a quote from her report: “This is an area of remarkably weak evidence, and yet results of studies are exaggerated or misrepresented by people on all sides of the debate to support their viewpoint.”

Gosh, naughty people on both sides of the debate, misrepresenting the studies!

But then later in the same paragraph Barnes quotes her as describing puberty blockers as “powerful drugs with unproven benefits and significant risks for children.”

How is it possible to say, simultaneously, that the evidence is "remarkably weak" and the studies are being "misrepresented", and then claiming that the drugs have "significant risks"? It's just nonsense. Is the evidence weak, or isn't it?

Oh, @MrsOvertonsWindow, Hannah commented on the “dangerous to children” activists too:

At a briefing on the new trial for parliamentarians on 3 December, Labour MP Jonathan Hinder pointed out that one member of the presenting panel, NHS England’s James Palmer, had been responsible for overseeing and developing youth gender services for more than a decade; Palmer had spoken publicly about it being a “<a class="break-all" href="https://archive.is/o/C4YbN/www.telegraph.co.uk/news/2018/06/04/nearly-two-million-britons-expected-question-gender-health-boss/" rel="nofollow" target="_blank">good thing” that so many young people were exploring their gender. “Why on earth is he anywhere near this trial?” Hinder asked, given Palmer had been in a senior position while the many problems at Gids unfolded, but did not act to stop it.

This board really should be named the Cassandra board, all the disasters forecast years in advance. How many women here said without very strong guidance ending the Tavi and moving it out to units would simply be removing one head from the hydra while the same team and issues just spread quietly out and crack on with the exact same processes, issues and activist control?

I've said many times, I will be staggered if the children and parents who go into this 'trial' are not very tightly tied into signed legal contracts preventing risk of any future legal claims for the harms that are inevitably going to occur: the question is really just how many and are they a worthwhile collateral damage for other children benefitting. The whole 'is it ethical/right' seems to be something everyone's washed their hands of. Which just continues to appall me.

They had to shop around for an ethics board that would pass it. The whole thing is already bent and badly set up. It's very obvious what it finds will be whatever it wants to find, it won't matter if the results are contentious since it's being set up from the start for them to be, and this will be a route straight back to medically harming and sterilising kids.

There does come a point when in sheer despair, when safeguarding children no longer seems to be fashionable, you have to throw your hands up and say that Darwin may have had a point.

They had to shop around for an ethics board that would pass it. The whole thing is already bent and badly set up. It's very obvious what it finds will be whatever it wants to find, it won't matter if the results are contentious since it's being set up from the start for them to be, and this will be a route straight back to medically harming and sterilising kids.

Agree, though it was notable that they seemed to have had great difficulty deciding what a "good" outcome would look like. Easy to think of possible bad outcomes - bone thinning, poorer mental health, cognitive decline relative to peer group. But good outcomes? What might they be?

It's astonishing. A 'trial' of a drug which has been used for decades for various conditions, whose effects and whose negative and serious side effects are well known. The trial is to treat physically healthy children with this drug for a condition which can't be defined, and nobody seems to know what a positive outcome would look like.

How can anyone actually defend this?

'These questionnaires will also be asked of all children attending NHS gender services as part of the wider Pathways research, encompassing around 3,000 children.'

I would like to know how researchers intend to compensate for the inevitable online 'coaching' of these children on how to answer the questionnaires. Those who have a vested interest in a positive finding for puberty blockers will almost certainly try to influence the answers through the myriad of online 'trans resources' and 'influencers' that many of these children are likely to be visiting.

As with so many trans related issues - the way Fife handled their little issue for example - you end up thinking, if someone sat down and intentionally wrote 'this is absolutely NOT the way to do it' they could not have come up with anything worse.

I think you're right, I think the Cass Review did not include a specific recommendation for a trial to be carried out.

However, since the Review was released journalists, activists and politicians have been saying that it recommended a trial and that incorrect information overwrote the original information in my head.

Excellent description for this board.

FWR predicted the behaviour of the Labour govt - lots of posters told us not to be sceptical and not to take on face value what Kier and Co were saying in the run up to the election. They told us that Kier had a secret special plan that would be great for women so we had better vote Labour to ensure it happened 🙄

We predicted that the Cass Review left too many loopholes for committed ideologues in the NHS, and private medicine, to continue on as before but we were told that it would all be fine because of the indefinite ban and that no-one would actually try to get a PB trial on children through an ethics board and that if they did try to do it then the ethics board would reject it 🙄

I'm in my 50s and I have lived through too much to listen to Pollyanna thinking from politically tribal people who tell us there will be jam tomorrow if we vote the correct way and listen to our betters.

How is it possible to say, simultaneously, that the evidence is "remarkably weak" and the studies are being "misrepresented", and then claiming that the drugs have "significant risks"?

I don't see any inconsistency in that.

From the NHS: Recommendation 6: The evidence base underpinning medical and non-medical interventions in this clinical area must be improved. Following our earlier recommendation to establish a puberty blocker trial, which has been taken forward by NHS England, we further recommend a full programme of research be established. This should look at the characteristics, interventions and outcomes of every young person presenting to the NHS gender services.

• The puberty blocker trial should be part of a programme of research which also evaluates outcomes of psychosocial interventions and masculinising/feminising hormones.
• Consent should routinely be sought for all children and young people for enrolment in a research study with follow-up into adulthood.

NHS England » Children and young people’s gender services: implementing the Cass Review recommendations

Thanks. Yes, it is there, Recommendation 6 on p35. I don't know how I missed that before.

The fundamental problem is with longterm outcomes. According to the Pathways protocol, it's not possible to follow up previous child & adolescent gender clinic patients. However they simultaneously will be following up all the new child patients in their trial in future research studies (but not in this trial which is only short term). Both these statements cannot be true.

They can't usefully follow up patients who were "treated" in the past because the clinic didn't keep proper records.

Is there any evidence for "They had to shop around for an ethics board that would pass it."?

It was mentioned in one of the articles released on this last week, linked on one of the two or three threads on this subject, woman journalist and I think it was the Telegraph or Times.