Mick Hartley

Janice Turner in the Times – Don’t allow puberty blockers to sneak back in:

On Wednesday a reckless 13-year medical experiment was finally ended: no longer will troubled children, predominantly girls, be prescribed powerful drugs to stunt their developing bodies. Puberty blockers, which weaken bone density and arrest the evolving adolescent brain without any proven benefit to gender-confused children, are now banned.

The health secretary, Wes Streeting, deserves credit both for his diligence in sealing loopholes, such as quack private clinics prescribing from Singapore over Zoom, but also his moral courage. Already activists have camped outside his constituency office with cardboard coffins and histrionic signs saying “Keep trans kids alive”. Announcing the ban in parliament, he was assailed by the Green MPs Sian Berry and Carla Denyer, plus Labour’s Stella Creasy, for whom a four-year review of global evidence by the eminent paediatrician Baroness Cass isn’t enough. Nor is the retreat from prescribing these drugs by health services across Scandinavia and in France. Nor the grotesque truth that a child who progresses from puberty blockers to cross-sex hormones — as 99 per cent of cases do — is frozen forever in a body both infertile and incapable of orgasm.

Indeed, for activists no evidence will ever be enough. Their advocacy for puberty blockers isn’t based on medical benefits but emotions and irrational faith. These “progressives” still believe children — mainly future lesbians and gay men — are in the “wrong body”, which must be fixed by Big Pharma. Now they cry “discrimination” because the same GnRH (gonadotrophin-releasing hormone) drugs are used for other medical conditions. Which is like arguing if thalidomide is used against leprosy and blood cancers, it’s unfair pregnant women can’t take it for morning sickness.

But Cass has, unfortunately, left a loophole.

The terrible experiment has ended — almost. In her review, Dr Cass advocates banning puberty blockers except to participants in a clinical trial that will start recruiting in spring. Activists are seizing on this pledge as a back door to obtaining blockers. Denyer asked about the number of participants, and Streeting replied it was “not capped”. The National Institute for Health and Care Research is yet to decide the trial’s terms, and no wonder.

Indeed. What's the point? And how on earth would such a trial be set up?

Cass was in a bind. Having concluded that the quality of existing academic research was poor and short term — and perhaps to end all future disputes — she proposed a gold standard trial. But what proposition will it test? Blockers are not a treatment per se. They are the first part of a three-step process involving cross-sex hormones, then surgery. As one clinician notes: “It’s like evaluating the outcome of a knee operation just by studying the anaesthetic.”

Many ethical questions remain. How can you create a control group when those children on placebos would quickly know, since their puberty would begin? How can you disentangle the benefits of psychotherapy — which Cass has promised all patients — from those of a drug? How do you factor in that most patients have co-morbidities such as anorexia, autism or trauma from homophobic bullying or sexual abuse? Will a cohort of children feel under pressure from activists to be positive about these campaigned-for drugs? A key justification for blockers, especially among late-transitioning males, is they allow trans people to “pass” more easily as the opposite sex. But how can such cosmetic advantages be weighed against loss of physical capacity to have children?

Above all, how do you select child patients to test a drug when 85 per cent of dysphoria cases resolve themselves at puberty — but doctors can never predict which ones? And what if participants, whose bodies and lives are changed forever, have later regrets?

Maybe, say some clinicians, it would be better to study the huge new trans patient cohort that emerged only a decade ago: teenage girls. Or if a long-term view is required, compel adult gender clinics to release data on about 9,000 children who graduated into their care. (Six out of seven clinics have refused.) Yet there is one reason the NHS is compelled to launch a trial. If such an experiment were deemed too risky, why the hell was it being conducted at Gids since 2011?

It is time to throw puberty blockers into the pile of medical crazes, like lunchtime lobotomies and trepanning. End too the mad notion that demanding these terrible drugs is the metric of how much you care about gender-questioning young people. Are we really going to turn more children into lab rats because we haven’t yet convinced ideologues such as Creasy? Because the chances are no medical trial, no amount of scientific evidence, ever will.