Hilary Cass sent a document to every single MP and Peer, justifying and defending the puberty blockers trial

[SingleSexSpacesInSchools]

https://x.com/JamesEsses/status/2075512549248745744?s=20

There are ten images on X, sorry can't add them all here, or upload a file with it all in.

There are plenty of places prescribing them legally and prosecuting the illegal ones (who seem to be abroad) won’t do anything to help the kids where it’s legal.

Meanwhile, back in the real world, we have laws. It's illegal to supply these drugs to children in the UK (how many times do I need to tell you that?)

Most people, fortunately, comply with laws. Those who don't can be arrested and fined or jailed.

Harming more children to try to persuade people who are breaking the law that their actions are harmful is just insane.

Can we just stick to what's happening in the UK? The children in the UK are being harmed by adults in the UK. Even if the drugs are coming from abroad, their parents are in the UK. Before we try to fix the whole world, let's fix what's happening here.

Do you have any data on how many parents are buying these drugs from overseas? Since this is illegal, they would be giving these drugs to their children with no medical oversight and injecting them themselves. There can't be many parents doing this (I hope).

There are plenty of places prescribing them legally

Link to evidence please as prescribing PBs to under 18s for gender dysphoria/incongruence has been illegal in the UK since March 2024.

Harming more children to try to persuade people who are breaking the law that their actions are harmful is just insane.

This ⬆️ And, in addition to prosecuting those that break the law by obtaining these banned drugs, to paraphrase a PP (I apologise for forgetting who wrote it), we should be analysing the hell out of the data that already exists.

It was a few pages back now but TwoLoons' proposed (parody) "2 cigarettes a day for 2 years" trial remains the perfect analogy here.

To extend it further, to match the parallel of the real world we're in today, imagine that there was no data available to say whether smoking was harmful or not, just a few people hypothesising that there may be long term harm. Imagine also that there's big money behind keeping people smoking and lots of information in the media (today it would be social media) about the positive benefits of smoking from a young age.

Would anyone advocate trials on children? Or would they take any data that was available on adults that had started smoking as children and analyse that?

It beggars belief that anyone who thinks it's highly likely that PBs are harmful thinks that more children should be experimented upon. Especially when the data set won't mean anything after two years' collection, unless there's a way to differentiate between those that went on to cross-sex hormones and those that had only ever taken PBs.

Regarding living in the real world, in what real world will children who've been fed constant messages, including in schools, that they can choose their own sex decide that after 2 years of being on PBs, it's time for the natural puberty to continue again? The trial is as pointless as it is harmful.

This comment is extraordinary. It is a shame that a debate on the clinical merits of the trial vs safeguarding lacuna has deteriorated into sexist insults.

Are you not an science teacher? And are you not female? These may be assumptions but have been inferred from a variety of your contributions across multiple threads. And your comments have typically been measured and thoughtful, yet here you’ve resorted to a classic sexist trope to dismiss another female poster who only said that no agreement was going to be reached.

And by now it is crystal clear that you believe in the need for this trial but it should be equally clear that others replying are not. So that’s that. What’s more to say? The only helpful aspect of the continuing debate is, for me, reading about other reasons for this trial to be stopped that I hadn’t thought about.

And like I've been saying, you can't do a proper analysis of a pile of crap.

And you’ve made posts like this one that rather rudely dismisses the many comments others have made in defence of the usefulness of the linkage study. As if you do clinical trials for a living. Do you? Some of these posters making those comments do clinical research for a living.

Thank you for pointing this out. I've been reading this thread with incredulity.

This may already have been addressed but:

1. the Tavistock was running a clinical trial - still delivering crappy data and more to the point sitting on it for years before being pressured to publish by the courts. In the meantime they opened access to pbs for all before the trial was finished
2. this takes no account of long term impact or the damage of xsh as these children now on a pathway to more harm
3. children already on PBs are not eligible for the trial so there will be up to 250 more children harmed and probably more as there’s no upper limit to participation (IIRC)

Lets keep kids off social media, whilst also never tackling the purchase of illegal drugs off the internet. Yay.

@DrBlackbird This comment is extraordinary. It is a shame that a debate on the clinical merits of the trial vs safeguarding lacuna has deteriorated into sexist insults.

Yes, it was a bit of a surprise to wake up to. I think our long-necked friend has a tendency to think she(?) is being witty, when she really isn't. Let's hope she doesn't behave like this in the classroom.

@DrBlackbird

Don’t worry your pretty little head about it. Not worth being ‘troubled’ over.

Yes, this is the comment that showed me that the poster doesn't appear to be arguing in good faith, and that actually there might be another agenda at work here. I doubt this poster knows anything about clinical trials.

There really isn't any reason for a comment like that unless you're really, really angry or feeling very, very superior. If you're arguing in good faith, and from a position of knowledge, why would either of those two emotions come into play? It's a puzzle.

And, yet, I suppose, some argue just for the sake of arguing.

Data management on clinical trials is extremely rigorous.

So what went wrong in the Tavistock trial? If the data management is always as rigorous as you say, then we'd already have the data from the Tavistock trial from about 15 years ago.

How can we be certain that the same thing won't happen with this one?

I've been reflecting on the "pretty little head" comment, having had a really upsetting experience myself some time ago, where I found myself out of kilter with what felt like the majority of posters on a thread. It related to my neutral stance on speaking to TW who drop into threads. Apart from one thread where I played the "character" of a TRA (which I'll admit was very enjoyable 😂), so as to highlight the ridiculousness of the comments that the TRA who was on the thread was making, I continue to take a neutral approach on whether or not gender identity is real when writing on this forum. I don't believe in it but many do, including some TW. Obviously others just pretend they do... for... reasons.

From my experience, if you're going against the tide while holding what you believe is a neutral position, it's a lonely ride. It felt like a pile-on when I experienced it. My reaction was to end up in floods of tears and leave for a month. I came back stronger but still resolute in my neutral position on gender identity belief. Plenty of people believe in things I don't and that's OK.

Instead of crying, an alternative reaction I could easily imagine having had is to have bitten back with a barbed comment. Perhaps this is what's happening here? @noblegiraffe that's meant to sound like a benefit of the doubt comment. Hopefully it doesn't come across as condescending. Is there anything to it?

I've seen you post lots as a teacher and your posts have mostly centred safeguarding. But this isn't the first time I've seen you bring in a "balance" that ultimately becomes anti-safeguarding. In this example it's anti-safeguarding to advocate for a trial that will highly likely harm children, even if it aims to save more. Especially so if you already think that PBs are harmful.

Edited for typo and clarity.

I was treating the ‘I find your posts troubling’ with exactly the level of seriousness it deserved.

I’ve spent a lot of time on this thread explaining my reasoning. You might disagree with it but I’ve not shied away from answering questions.

The reason I’ve been posting on this thread is because I read Cass’s document upthread and thought ‘fair enough - there’s bits I don’t agree with but she’s clearly thought about this reasonably’ to then read a thread about how she obviously has been receiving death threats and coerced into writing it, or she’s a mad trans activist who thinks she can turn little boys into little girls.

I’ve put quite a bit of time into explaining how it’s possible to support this trial going ahead without being a mad TRA, with actually having concerns about safeguarding kids and without being forced into it by death threats. So yeah, to have someone throw the ‘I find your posts troubling crap at me, I’m pretty contemptuous of that as a tactic. I hope that contempt came through in my deliberately flippant response. And if you didn’t like it, that was the point.

Clearly, some points of view are just worth more than others. I get it now. I don't think we've been having a debate or even an argument. We're being telt.

Ok, well, I don't have enough time in the day to put up with that, so anyway, thanks again @noblegiraffe for answering my question. It's refreshing to see that some people still have the courage of their convictions when advocating for experimentation on other people's children.

Good luck everyone with the "debate."

Great comment about anti - safeguarding @BonfireLady .

It felt like a pile-on when I experienced it. My reaction was to end up in floods of tears and leave for a month. I came back stronger but still resolute in my neutral position on gender identity belief. Plenty of people believe in things I don't and that's OK.

So sorry that you felt this way @BonfireLady when you’ve brought so much thoughtfulness and insight to these threads. And yes, I certainly can see that it feels like a pile on even if / when that’s not the intention.

I’ve put quite a bit of time into explaining how it’s possible to support this trial going ahead without being a mad TRA, with actually having concerns about safeguarding kids and without being forced into it by death threats. So yeah, to have someone throw the ‘I find your posts troubling crap at me, I’m pretty contemptuous of that as a tactic. I hope that contempt came through in my deliberately flippant response. And if you didn’t like it, that was the point.

Yes you have answered most questions and put across your views on Cass, that’s true. The deliberately flippant remark was, however, a common sexist trope. And yes some on this thread have conjectured about threats or Cass being a TRAs after all etc,

But I’m guessing many on this thread are just incredibly disappointed by her recent actions including creating a fictitious child to emotionally blackmail Lords into agreeing that decisions about these children ought to be clinical ones and not political ones. And disappointed and puzzled about her emailing all MPs.

The answer is likely simple human nature / human ego with her feathers being ruffled about the trial pushback and a certain amount of ego of ‘doctors know best’ along with an inability to appreciate how many doctors don’t know best.

There we are then. You agree with Cass on the trial. You’ve explained your reasons. You disagree with those who disagree with you about the likelihood of this particular trial achieving its stated aims.

Again, not sure there’s much more to said. In my view anyhow.

The reason I’ve been posting on this thread is because I read Cass’s document upthread and thought ‘fair enough - there’s bits I don’t agree with but she’s clearly thought about this reasonably’ to then read a thread about how she obviously has been receiving death threats and coerced into writing it, or she’s a mad trans activist who thinks she can turn little boys into little girls.

I think I was the first one to suggest on this thread that she might have been taking the death threats seriously and was trying to appease the TRAs. I was really trying to understand why following the cautious and measured approach of her report, she seems to have gone full-on TRA herself.

The anecdote about the fictitious 2-year-old is bizarre. If a child that age is transed, it's all about the parents. Surely she must see that? Instead of seeing this as the abuse it so clearly is, she presents it as a good reason for giving the child puberty blockers. It really does make her look as though she thinks little boys can be turned into little girls, as you put it, just as John Money did.

From the linked article:

"Despite the advice of leading experts from two separate gender identity clinics and the UCLH paediatric endocrinology team that I should be prescribed puberty blockers, the GP refused to dispense the prescription on the grounds of their ‘personal beliefs and ethics’. "

You'd think this clued-up determined person might have known you are allowed to change your GP. wouldn't you. And if he didn't, his mother should have done.

The problem I have with asking people who have done a hugely damaging thing on a whim that changes their entire lives, so much so that backing down might actually destroy their whole social network if they are 'fine' with the treatment is that there is no actual definable measures beyond 'I did it and I was right'.

And the reason is because there IS no definable measure of 'transness' in the first place.

It's not a study, it's a clinical trial.

A study can be anything anyone has decided to do. They could do an observational study where they give a drug to a handful of kids and then say they looked better and write that up. There doesn't have to be any regard for basic scientific principles to conduct a 'study' and that's why there's a lot of shitty, low-quality studies out there of the sort that people produce and say 'hah, this shows that vaccines cause autism' or 'homeopathy cures asthma' or whatever. You can also have better studies like the Finnish one. That took national patient data and carefully looked at what data fields could be used to answer questions about whether trans healthcare improved mental health. They matched their patients to controls, and they used a specific measure 'referral to severe psychiatric services' as their data point. Because it was a single, national dataset, everyone had the same data recorded in the same format. They were able to control for things like prior psychiatric history. It was a large sample size spanning a couple of decades. Pretty robust data and methodology but they still had to be careful to use words like 'associated with an increase in' rather than 'trans kids are more likely to'. They were, however, beholden to the data that they had rather than that they would like to have.

A clinical trial on the other hand is specifically designed in advance to answer a question about the efficacy and/or safety of a treatment. Patients are usually randomised to a treatment arm which is the drug under investigation, or a control group who are given the placebo (or for ethical reasons the next best treatment). Where possible, it's double blinded which means neither doctor nor patient know which medication they are getting to avoid bias. In this case because of the difficulties of blinding and placebos because the effects of puberty blockers are obvious, they are using a delayed treatment arm instead. The data that is collected is designed in advance to be the data needed in order to conduct the statistical analysis. No going 'bugger, we can't control for autism because we didn't record if they had it'.

Unlike when you go to the doctor and they type a bunch of stuff in a free text box, most data points in a clinical trial are coded so that they can be validated and analysed more easily.

And the data is cleaned to make sure that it is as complete and error-free as possible. I know someone who got called up for a covid jab as a 'vulnerable person' and he found out somehow his patient records had him as having had a transplant. Which he very much hadn't. Errors are always made when collecting data because people are human. On a trial, the data is reviewed and validated. Missing data is chased and inconsistencies are followed up (e.g. 'you have listed antibiotics as a concomitant medication but there's no associated adverse event' and they come back with 'there should be an ear infection recorded').

The locked database at the end of a trial contains data which has been collected to a much higher standard than your regular GP visit, so the statistical analysis that is run on it is generally much more robust.

A clinical trial on the other hand is specifically designed in advance to answer a question about the efficacy and/or safety of a treatment

The question of efficacy is what exactly?

We know these drugs stop puberty so they are effective.

We know thousands of side effects or effects as evidenced by the very short term use on other children due to their huge effects so have ample evidence of their lack of safety.

So what exactly is under investigation here?

There used to be a big problem with pharmaceutical companies running clinical trials, finding the results were not to their liking and then quietly shoving the results in a drawer.

Ben Goldacre led a huge campaign a few years back for an international trials register where you have to register your trial in advance and then people can check whether the results have actually been published.

Anyway, the law in the UK was introduced in April 2026 (handy) saying that all UK trials have to be registered, and results have to be published within a year.
I can't imagine that with the huge amount of interest in this trial that they'd get away with shoving it in a drawer anyway.

https://senseaboutscience.org/alltrials/

But this isn't the first time I've seen you bring in a "balance" that ultimately becomes anti-safeguarding. In this example it's anti-safeguarding to advocate for a trial that will highly likely harm children

See, this is a problem, @BonfireLady and endemic on this section. If people can't disagree with your points, they call you a TRA and if they can't pin you as being a TRA they say that you either actively harm kids, or don't care if kids are harmed.

What is interesting here is that I am being called 'anti-safeguarding' but when you review my argument, I am arguing for robust evidence collection that can be used to stop all prescriptions of puberty blockers, globally. Protecting thousands of kids from being prescribed them.

And the response is 'ah well, those clinicians aren't going to pay attention to clinical trial results anyway'. Well their regulators might. And what total disregard for those children. Not in the UK? Don't give a toss then.

Yes... it's not just that I disagree with Dame Cass, it's that I still can't follow her reasoning.When I read the review, the recommendation for the PB trial was just one among many and of all of the recommendations it seemed the least useful. Plus it was dependent on ethical approval which based on the rest of the report I didn't think could reasonably be given, and so I assumed it probably wouldn't.. And the evidence coming in later (e.g. from Finland) hasn't produced anything to change my mind, nor Dr Cass's as far as I know.

So I can't get my head round the fact that she and I seem to agree on the facts and the evidence but she still thinks the trial should go ahead. To me the rational evidence-based decision is still that this trial is not ethical. Standard ethical practice (which I am sure Dame Cass follows) doesn't allow the position that it's OK to sacrifice one group of children to gather data that protects another group. The ethics committee and Cass herself must believe there is a realistic prospect that this treatment is beneficial to the children in the trial. I don't believe that myself, and while I accept that Dame Cass genuinely believes that I still don't see what is the rational basis for her belief.

And the fact that Cass has moved so far from her cautious neutral position that she resorted to a silly and emotionally manipulative anecdote which she has now admitted was not even a real case - that's beyond disappointing, it's disturbing.