Pathways Puberty Blocker Trial - High Court Proceedings start 27th July

[FarriersGirl]

James Esses, alongside the Bayswater Support Group and Keira Bell, is involved in a High Court hearing beginning on July 27, 2026, seeking an emergency injunction and permission for a judicial review regarding the "Pathways" puberty-blocker trial. The JR itself is likely to be heard in the autumn if it gets the go ahead.

Although we have had quite a few threads discussing the Pathways trial more generally I thought it would be useful to have one for the court case. I'm not sure if we will have access to watch/listen as the representative from the Bayswater Group has been granted anonymity.

From TT:

AM - Jm takes pt we had not sought to rely on s28. He's wrong - set out in core bundle 1 p48. We expressly rely on failure to rely on R & B in HD. So squarely there.

AM - reference to contemporaneous trial docs - MHRA request and KCL response supp bundle 4 p 444
AM KCL 9/10/25 to MHRA - para 2 p644
MHRA's request based on CHM advice,

AM - Rejected and alternative proposed.
Pt is obvious - inclusion criterions - individ likely to benefit and expected by reference to various parameters.
J Expected not in HD parameters. Likely can mean a lot of different things. Likely in ordinary [nonlegal] parlance can mean a lot of things

From TT:

AM - some direct benfit IS to be obtained. No scope for likely.
J - you have got to reach a view that more likely than not.

AM SUP Bundle 4 p644 - reasonable prospect of benefit might be achieved

J - risk of turning clinicians into lawyers? same significance?

AM we know why they couldn't. They can't show direct benefit because of dearth of evidence - Baroness Cass

J - reflects that the clinicians were being honest?
AM yes.
Illustrated in Dr Cave's explanation as to why [missed]

From TT:

AM - p 333 middle of Dr Cave's WS. core bundle 2.

AM para 81 b - request and response traced through. She sets out what Dr AB, lead MHRA assessor. CIT reaching primary judgment - gives no reason why this response is adequate.

AM - "it wld be imposs for an individ clinicians to predict outcome of an individual trial - but only reasonable prospect" KCL recognising candidly unable to meet the request.

AM - candidly what patients pts are told abt the benefit. -pt info for participants. What might be good abt taking part
J - yr sub is correct interpretation can never do a CT unless you can say positively more likely for that child to benefit her.

From TT:

J - will beefit that child.
AM needs to be research based evid that indicates some beneft to the group as a whole
AM RB analysis for individ - HD emphasises risks must be minimal or some benefit to the individ.

AM - both conditions separately and together
AM - not a q of expert regulators - but what KCL cannot be shown that there will be beefots. Arguability of this point depends on yr constrctions of the regs {missed]

From TT:

J clarifies. Ground 1, 2 & 5.
AM KCL skeleton - and how they seek to respond to this point para 40.
J - a big circle around plausible?
AM yes and "potential".

AM - the DB point - in not by reference to group but plausible potential benefit (not likely).
Ongoing support - not restricted to those recruited for the trial,
AM - [missed] para 41 - assertion every individ must benefit is not and never has been our case.

From TT:

J so if a fatal disease that a child has, and drug has reasonable prospect but cldn't say more likely that not will ure and carries substantial risks.
AM not a trial. Cld use on a therapeutic basis. B&R.
J - not benefits or risk - para 10 - you have to be satisfied that it is going to benefit.

J back to HD. those incapable of giving consent - likely means n=more likely than not. In example of fatal disease, can't have a trial
AM - separate the DB to the group and R&B to the child

J - if likely means more likely than not. You cannot include child in the trial.
AM - control group not getting drug , then must show benefit. If reasonable chance of curing cancer, then not ethical to have control group.

From TT:

J - considering having trial for a drug that looks positive
AM - Personal benefit if not significant risks cld be chance

J - [missed]
AM - separate clinical decn outside trial.
J public benefit seeing if this drug is good drug or not

AM - group question is separate from individ.
J so concentrate on individ. might take weeks months off life of child. Can't say more likely than not. You could give drug clinically but not enrol in a trial.

From TT:

AM - yes
J cld be only opp for cure for this disease
AM a balancing exercise - condition 10.
J - I can quite understand a balancing exercise.

AM that criterion may be met. Take HD into account re minimal risks and DB

AM [missed] for children tere ust be some direct benefit for the group eg 20% of participants & separately weigh R&B for individ

AM - more likely than not in relation to para 10. HD 28 - informs conditions on informed consent

From TT:

AM - will need to rely on skeleton and will finish by 3pm.
J - start at 2pm.

@threadreaderapp
unroll

Well that was a bit of a marathon! Covering a lot of ground although the first part was rather dry legal chat on standing.

As I said upthread I can't C&P this pm so a willing volunteer would be good.

Nick Wallis is pasting his tweets to the link below which I shall try and follow on my phone later.

https://genderblog.net/live-tweets/

A few thoughts on this thread going forward. I think a lot of us found the TT tweets quite difficult to interpret as there was a lot of legal speak and a huge number of acronyms. I have had a look at Nick Wallis's tweets on GenderBlog and they are easier to understand as he uses less acronyms and applies some journalistic interpretation so they are worth a look.

This is not a criticism of TT who are obliged to report in the way that they do. Works well in ET's but less so in a case like this. I don't think there is much point in C&P tomorrow, those of you who want to can follow on X or nitter or Nick's Genderblog. Maybe we can use the thread to discuss the outcome which should be quite soon given it is an application for an emergency injunction.

Thank you for C&P

I didn't really understand it but thought a few of the Judge replies seemed reasonable

Will look at Nick Wallis and plant some seeds, he is doing great work alongside TT

Thanks for your efforts on this. Had a look at TT this morning and struggled to follow (me, not them!) and will look out for a synopsis-for-simpletons.

Thank you so much for doing what you have done with it.

Yes. Very different to following ETs.

Could still use the thread for any discussion, and people (especially any legal bods!) could add in their take on the days proceedings too maybe? Eg relevent judge replies as pp said above.

Very grateful to TT and Nick Wallis for putting it out there.

I guess there is no long wait for outcome on this either- so this thread is already set up for that discussion.

Am currently skimming through Nick Wallis' tweets. I really hope that this alone is enough to strike the whole thing out.

I hope that the judge will hopefully come to understand that these are healthy children. They are physically healthy and have distress about their bodies.

In other words, they have a mental health condition. The comparison isn't a weight loss drug, as per the hypothetical example given (as this relates to physical health), it's other mental health conditions related to distress about the body e.g. anorexia or bulimia.

We don't alter the body to make the mind healthy again.... and we don't experiment on children's bodies to figure out whether or not it could work.

My take, having read the JR application, published on TT, on the TT posts here and our Nick. ( I’ve this sort of legal argumentation as a law graduate)

The application made by the three parties is in a hearing to determine wether there case is strong enough to go to a Judicial review,

That is that their application has a reasonable prospect of success. But also wether in this particular hearing the Court can be persuaded to issue an interlocutor order. Which means a temporary injunction to stop the PB experiment from proceeding until a full hearing of the applicants case has been heard and decided upon.

So the applicants have quite a few hurdles to get over.

1 do they have legal standing to make it to judicial review ( the busy body test)

GLP failed on this test in the recent high court case

2 if they have sufficient interest, can the applicants get passed the rules set out for regulatory ethics bodies, in medical decision making. As there are strict rules and what can be challenged.

In this case the claimant argument is essentially the ethics committee and its overseer did not follow the very specific rules as set out in the Acts and the Helsinki rules.

3 the rules regarding minors are far more stringent and the claimants argue on the meaning of benefit to said, minors. They have to have a direct predictable benefit as individual participants, not a group interest or a wider public benefit in knowledge in conducting this “experiment”

4 Ethics committee and it’s overseer has not done sufficient research in to available data ergo the adult services outcomes which has never been explored.

So as a result there has been a lot of citations of cases on all the above issues, which, i have not bothered to follow up as i have no interest in becoming an expert in the field of ethics, nor do i have the time.

What i think we can hope for is that this preliminary hearing persuades the judge that there is a case to be heard, and accordingly issues an injunction.

happy to be disagreed with

HTH

Thank you! Very helpful.

It sounds like it all comes down to whether or not the ethics of child experimentation can be challenged in court. I bloody hope so!

There was a poster on a related thread who argued that this trial should go ahead for the wider good of society. Several of us, me included, were pointing out that it was unethical to experiment on individual children for a potential greater good. I likened it with Mengele, given he clearly thought his child experiments met this criteria.

I'm relieved that the law does not allow such a thing in the UK (and I hope Germany's law doesn't these days either).

From what i have extrapolated the Helsinki rules (HD) prohibit experimentation which is the nub, of the argument which Germany is signed up to.

A trial on children can not be allowed for the “wider good”

i am pretty sure that Cass has submitted a WS. Her argument, as expressed in the House of Lords, it transpires, holds no water.

What i like is in this application, her report is being chucked right back at her.

My DC has been part of a few medical research trials under the care of a specialist team. All of the points raised in the case so far were all covered in the paperwork we signed and the parts about being able to stay on a working treatment after the trial are critical. I wonder as this aren't seriously physically ill kids, are they taking a lighter touch, even subconsciously?

Possibly.... but surely it should be the other way round? They're doing something very serious to kids who are physically healthy that will potentially damage their health so surely they need to be much stricter?

The judge pushed back on the not seriously argument from the claimants, and stated they were a group who were seriously ill (interesting since TRAs argue they are not ill)

AH for the claimant responded that as a group or cohort they would have to demonstrate that each seriously ill person in the cohort would have to have a demonstrably likely benefit from PB. The judge said well at least most but not all.

I did not notice thus far that the argument that this was always off license on the grounds they might kill.

this was the basis of pescribing off license in the first place, that it was a life threatening condition, because they might kill themselves.

Being suicidal should itself kill any idea of the child being able to consent. If a child is suicidal then that must be treated first through appropriate mental health treatments.

It is off-license because of the lack of research. It takes research through trials for a drug to be licensed for a condition. Drug companies don’t want to do that probably because they know the outcomes and don’t want to be liable for them.

Have they discussed the fact that the trial won’t be able to show any outcomes due to short follow-up and confounding (not least pleasure at receiving a desired drug sooner rather than later)? The inability of the trial to provide the desired answers should be enough to make a trial unethical.

@BonfireLady

Yes I was there, and it seemed to me that for now, the Judge had not grasped that they are healthy children with a mental health condition.