Streeting declares the puberty blocker trial 'safe'

[ArabellaSaurus]

https://archive.ph/CFzK4

'On Monday, Mr Streeting reiterated that he was not “comfortable” with the trial, which involves more than 200 people under the age of 16, but said there were significant “checks, balances and safeguards” that made it safe.

He told Sky News: “The thing I’ve had to continually weigh up is that for lots of people who have been through this sort of gender identity treatment, they describe it as life-affirming and life-saving. But there is an understandable degree of public anxiety and concern.

“The crucial reassurance is that not just anyone will be able to sign up to this trial. They will go through extensive assessment by expert clinicians locally that will be reviewed nationally, and every young person would need to assent.
“They’re not old enough to consent. They would need to assent, and they would <a class="break-all" href="https://archive.ph/o/CFzK4/www.telegraph.co.uk/news/2025/12/17/children-cannot-consent-puberty-blocker-trial-wes-streeting/" rel="nofollow" target="_blank">need the consent of parents.

“And so there are lots of checks, balances, oversights and safeguards and constant monitoring in a way that disgracefully wasn’t there before. That’s what gives me the confidence and assurance of knowing this trial is safe.

“There is a debate about whether this is the right thing to do. I understand that, and there’s one thing we’ve learnt about this particular area of policy is that we shouldn’t silence, debate, dissent, disagreement.

“So we’ll continue to have that, and we’ll continue to be subject to scrutiny and challenge.”

Mr Streeting admitted that the children who will be involved in the trial are “very young” and that the drugs are “very strong”.

But he claimed he had tried to take the “politics out of what has been an extremely <a class="break-all" href="https://archive.ph/o/CFzK4/www.telegraph.co.uk/news/2025/11/25/nhs-puberty-blockers-trial-repeat-tavistock-whistleblowers/" rel="nofollow" target="_blank">difficult and sensitive issue”.

Despite the research going ahead, the Health Secretary added: “I think there are still big questions about how we ever ended up in this situation where these sorts of drugs were being routinely prescribed with and we’re continuing to get into that and looking.
“There’ll be another study looking at what’s happened to that cohort of young people over time.”'

And there is also a large amount of information regarding adolescent gender dysphoria and puberty blockers in Finland where they have now desisted from using them.

Unbelievable! It's absolutely sickening.

The trouble with the proposed trial is that the control period is much too short to have any chance of answering the question. A control period of at least, say, five years would be necessary to show that puberty blockers are unequivocally harmful (or even beneficial for that matter, if there is any chance of that being true).

Puberty blockers propose two things - that puberty can be stopped and restarted at any age and that children can be permanently prevented from reaching sexual maturity with no long term impact.

The study period therefore needs to be at least 30 years.

I understand that there would be difficulties, but surely to God somebody must be interested in studying people who took these drugs for this purpose 10-20 years ago.

Puberty blockers propose two things - that puberty can be stopped and restarted at any age and that children can be permanently prevented from reaching sexual maturity with no long term impact.

You forget the third thing: that it proposes that it will have no impact of cognitive development. Puberty is not just about development of sexual maturity.

You forget the third thing: that it proposes that it will have no impact of cognitive development. Puberty is not just about development of sexual maturity.

Then …… that very mind that never got the chance to mature in the first stage will be the same immature mind that will make the decision to take further drastic steps such as cross-sex hormones and surgery in the second.

This point is made in this article about Finnish adolescent and child gender related services.

segm.org/Finland_deviates_from_WPATH_prioritizing_psychotherapy_no_surgery_for_minors

Wrong thread - whoops

This about the approach now taken in Finland. They now prioritise psychological interventions for gender questioning children.

In the rare instances where puberty blockers are allowed children must have had a long standing feeling of gender dysphoria from a young age, have been under a first line of psycho therapeutic treatment looking for comorbidities, and have reached Tanner stage 2-3.
Here is an excerpt from the article.

Before puberty, medical interventions based on gender identity are not recommended. Instead, psychosocial support should be provided as needed in services best suited to the child’s circumstances, such as school health services, family counselling, child mental health services, or child psychiatry in cases of severe psychiatric comorbidities.

For adolescents, the first-line treatment of GD is exploratory psychotherapeutic intervention within local services. This responsibility falls to any service working with adolescents. Before considering a referral to gender identity units, appropriate treatment of possible psychiatric comorbidities, as well as management of pedagogical and child welfare needs, is required. If medical gender reassignment remains a viable option after first-line interventions, a referral to the centralized GIS can be issued. Treatment for associated difficulties continues to be the responsibility of local services, both during and after specialized GIS assessments and any medical GR interventions.

Based on the originally published eligibility criteria of the Dutch model of care (Kozlowska et al., Citation2024), early medical intervention may be considered for childhood-onset GD that intensifies during puberty – provided there are no severe psychiatric comorbidities that could complicate identity assessment or affect the capacity for informed consent. The young person must also receive adequate developmental support to ensure medical intervention is conducted safely. GnRH analogues to suppress pubertal development may be considered after the early stages of puberty (following the original Dutch protocol: age > 12 and pubertal development in at least Tanner stages 2–3), with cross-sex hormones introduced as the individual approaches adulthood.

Will those selected for the Streeting trial have previously been under intensive psycho/social therapeutic care and scrutiny, with any confounding factors for their gender dysphoria screened out?

This was the article;
Medical gender reassignment in minors – why are we cautious in Finland?
Riittakerttu Kaltiala
Received 28 Jan 2025, Accepted 02 Jul 2025, Published online: 23 Jul 2025

www.tandfonline.com/doi/full/10.1080/17405629.2025.2533168

Animal studies are a good starting point for a drug to work out whether it does what we think it should do (e.g. does it disrupt puberty hormones) and are their any unexpected drastic side effects (e.g. increase in cancer rates, heart attacks). Beyond that animal trials are not much use because they differ too much from humans - you can't be sure the same effects will happen in humans. Then trials in humans happen to find out what doses can healthy humans tolerate (starting v. Small and working up slowly) - this is phase I trial. Then does it still do the thing you expect e.g. does it lower hormones in the short term - that is phase II. Finally there are large scale trials to check for 3-5 year range impact - does it do what you expect long term, what are the side effects. These trials are almost always in adults. Eg for one of the puberty blockers there is a phase III trial https://europepmc.org/article/MED/8908651/ here in the 1990s, which demonstrates what it does and what the expected 3-5 year side effects are. Once a drug passes these tests scientists dont need to repeat the animal stages again to check whether the drug also works for different conditions.

Given these drugs are already licensed for use, all the nessisary animal testing will have been done. The big question here is will the drugs work the same way in a teenage populate? The answer is also certainly yes for the main effect (lowering hormone levels), but there is uncertainty as to whether that will also achieve the real goal (making these kids feel happier with their bodies) and how bad are the unintended effects, particularly long term. The only reliable way to test this is doing large-scale trial in children with long term followup. However that is quite a scary prospect, so a lot of drugs get used "off-label", which is where a drug that we know is safe and useful in one context get used for other illnesses - this happens to children and pregnant women a lot!

What about looking at data on children who have already been given these drugs? Well if the data was collected together (which is surprisingly difficult because of historical laws, the data being in lots of different places, and many of those people not wanting their data to be used in this way so deliberately opting out) but lets imagine we've spent the large amount to solve that. That still wouldn't give us a reliable answer because there was no randomisation in the treatment and no sensible control group to compare to. There is a risk that we get the wrong answer. E.g. if these drugs were more often prescribed to people with autism, then it might look like the drugs caused difficulty with getting jobs and increased mental health issues, but that is actually an effect of the autism. Alternatively if people who were wealthier are more likely to get the drugs (e.g. because their parents had more resources to get private treatment) then it might look like the drugs reduce heart attacks and cancer rates, but it's really an effect of the family wealth - this last issue is particularly dangerous as it can hide increases in bad side effects.

Annoyingly the only good answer for medicating children with any drug is either do randomised controlled trials (with risk of harm to children) OR use drugs off label (with risk of harm to children. Or we do neither and stop using almost all medications in children (definite harm to children!)

The goal of ethics committees is to try to work out when the risk of harm to children from doing the study is roughly the same as the risk of never using the medication or using it only off-label. It's considered at the population level - it is okay to allow some children to be in a trial if the overall information gained will reduce risks enough in others. I'm not saying they made the right decision here, but the bits of the write up that seem to be worrying people are what I would expect ethics committees to be saying about any approved study.

The 'ethics' committee never asked or answered the question of 'should we sterilise some kids because they say they are unhappy'.

All the wrangling over testing and blind testing and animal testing - they know what these drugs do as that's why they have chosen them in the first place.

The medication is being given to stop puberty when there is no medical condition that requires puberty to be stopped.

How can it pass an ethics committee when there is no medical harm to the children if the medication is not given. Tying the fate of all medication given to children to this pointless trail is not acceptable, if there is a medical condition that could be treated by a medication so be it but this is not it.

Humans need to go through puberty, that's not something that can be changed by humans, it's a natural part of life. You can not change sex, there is no medication that can achieve that so it pointless having a medical trail for it.

The goal of ethics committees is to try to work out when the risk of harm to children from doing the study is roughly the same as the risk of never using the medication or using it only off-label.

What would be the risk of harm to children from never giving harmful medication to physically healthy children for a condition which we are told is not a medical condition at all (and according to Hilary Cass in an interview this morning, is a condition which is all about gender stereotypes)?

It's considered at the population level - it is okay to allow some children to be in a trial if the overall information gained will reduce risks enough in others. I'm not saying they made the right decision here, but the bits of the write up that seem to be worrying people are what I would expect ethics committees to be saying about any approved study.

What risks do you think might be reduced in others?

Nobody has yet even described in medical terms what the condition actually is, other than some children not liking to conform to stereotypes. Which is a 'condition' which has been in existence forever, and until recently nobody thought those children needed to be medicated and sterilised.

I'm talking about how trials work in general & how ethics committees work. Not arguing for the validity of this trial - these are questions you need to ask that committee/the researchers.

The goal of ethics committees is to try to work out when the risk of harm to children from doing the study is roughly the same as the risk of never using the medication or using it only off-label.

No that is not the goal of the ethics committee. Its use off-label is not relevant. The risk of harm of using a drug is always bigger than never using it. There can be no harm from not using a drug. The first question is are we as certain as we can be about both the potential benefits and harms of a drug using our understanding of the science behind their impact on the whole body and from using other methods including animal studies, cell studies and its use in different populations or off label? The next question is based on that understanding are we confident that the balance of risks and harms is at least as good as the best available alternative? It is not ethical to compare a treatment to nothing if there are alternatives available (like psychotherapy). Then you must ask is this study capable of answering the question concerning the benefits and harms and does it use the fewest patients necessary to give it adequate power? The answer to all those questions is currently ‘no’.

Actually, I missed out the very first question: what is it trying to treat? At the very first you need to be clear exactly what problem you are trying to solve and this study also fails at that point.

A trial that is not valid cannot ever be ethical.

Note: I'm talking about trials/drugs in children in general, not this trial.

"The risk of harm of using a drug is always bigger than never using it. There can be no harm from not using a drug."

That is simply not true. Think about when we discovered antibiotics and vaccines, or even paracetamol - if we had banned them in children because we didn't know relative harm/benefit of using them, then we would have caused massive harm allowing children to remain ill & in pain.

"Its use off-label is not relevant."

It can be. For example, if a drug is being widely used off-label to treat something and seems to be effective, it may not be ethical to do a trial where the control is no treatment/standard treatment. E.g. imagine we have a newish antibiotic that is known to be better than current treatment for conjunctivitis in adults, and because of this lots of doctors have started prescribing it to the majority of child cases. Running a trial that is random assignment to (old treatment) vs (new treatment) could be considered too detrimental to the children in the old treatment arm, and a different design might be needed.

The purpose of the drug itself is unethical when it's used past an age at which puberty would normally be expected to start. Its purpose is to stop puberty.

Used prior to this (in precocious puberty) the drug is only a short-term intervention and puberty will start. In that context, its purpose is to delay puberty so that it starts at a more appropriate age. Used for gender dysphoria, its very purpose is to prevent puberty from ever happening.

The team running the trial has given the participants the option to do whatever they want after the two year period is over e.g. stay on PBs and/or take cross-sex hormones (depending on age).

There is no version of ethics where this can ever be OK. It is human experimentation, to allow a child to grow up as an adult without ever going through puberty.

Edited to remove unnecessary repetition.

My questions apply to all trials.

The drug does not cause harm if it is not used. The absence of benefit from a drug is not the same as harm caused by a drug.

It doesn’t matter if a drug is off-label or not, the same assessment must be made. Loads of trials have been done for widely used drugs, some have shown harm or lack of benefit. In your example for conjunctivitis, widespread off-label use of a new antibiotic should be cracked down on immediately. Antibiotic resistance is a huge issue and all antibiotics must be very carefully managed. In any case, given conjunctivitis is generally a self-limiting resolving condition for which antibiotics are already regularly overprescribed, but for which first-line antibiotics are effective at shortening duration, there would be no ethical reason not to prescribe old antibiotics as an arm of a trial (most recent trials of antibiotics for acute bacterial conjunctivitis have been against placebos).

https://www.telegraph.co.uk./news/2026/02/20/child-puberty-blocker-trial-paused/

Paused!

Tell us again how safe the Streeting Puberty Blocker Trial is?

And adding this for reference - three people gave final sign off to ethics approval.

https://www.hra.nhs.uk/about-us/news-updates/pathways-trial-minutes-and-decision-correspondence/

From Hannah Barnes

Phew let’s hope the pause becomes a stop

“The MHRA has now raised new concerns – directly related to the wellbeing of children and young people – and scientific dialogue will now follow with the trial sponsor.
“As the evidence is now being interrogated by clinicians, preparations for the trial have been paused while the MHRA and clinical leaders work through these concerns.”

NEW concerns 🤬

Absolutely nothing new about the concerns that people who care about children and safeguarding have been raising for YEARS.

Only ONE person attended all three meetings? And Streeting has been defending the trial as having gone through rigorous approval processes. For goodness sake.

Charlatans is a good word.