Mick Hartley

Hannah Barnes in the New Statesman on the puberty blocker trial:

Patient information sheets given to parents and children who are considering participating in an NHS-backed puberty blocker trial do not provide a clear or accurate account of the balance of risks and benefits of puberty suppression, a group of healthcare professionals argue.

The Clinical Advisory Network on Sex and Gender (CAN-SG) – a coalition of more than 100 clinicians and medics committed to open discussion and evidence-based care in youth gender medicine – contend that without this information, parents cannot provide truly informed consent. Nor can children and young people assent to participation….

More than 380 clinicians, including some who specialise in evidence-based medicine and have helped write national clinical guidelines, have written to the Health Secretary Wes Streeting expressing their disagreement that the trial should take place in its current guise, or before other less invasive research avenues have been pursued first. The signatories, which include 220 doctors and surgeons, expressed “grave disquiet”.

Some are experts in trial design who are critical of this particular trial’s approach. Others believe no trial could be ethical, among them clinicians who worked with children at Tavistock’s Gender Identity Development Service (Gids), which closed in March 2024.

Now, some of these professionals are raising alarm over the patient information sheets given to parents and children. The sheets are meant to provide detailed information about the potential risks and benefits to participants in any medical trial.

Speaking in committee room 3 of the House of Lords on 15 January, Dr Louise Irvine, co-chair of CAN-SG, told gathered journalists: “Parents have not been told the true likelihood or the full scope of the harms involved.”

Nowhere are parents told of the possibility that their children might feel differently about their gender identity in the future, that there is no reliable predictor of which children might benefit from pubertal suppression, or that they could possibly regret medical steps taken when they were younger. Irvine argued that risks to bone health, sexual function, brain maturation, identity development and fertility were also not adequately reflected in the information sheets.

“The Pathways Patient Information Sheets treat puberty blockers as though they were a standalone, reversible pause,” Irvine argued. This characterisation was “misleading”, she added. “In reality, more than 90 per cent of children who start puberty blockers go on to cross sex hormones.” She urged the press to read them for themselves.

The whole thing, in other words, is deeply dishonest and unethical.

The trial information sheets say that puberty blockers may provide young people with gender incongruence “time to explore their gender identity without worrying about their body starting to change”. Parents and children are not told how speculative this hypothesis is, nor that it was rejected by the Cass Review. “Given that the vast majority of young people started on puberty blockers proceed from puberty blockers to masculinising [or] feminising hormones, there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual and gender identity development,” Cass wrote in the 2024 review.

One study, started by the Tavistock Gids and University College London Hospitals in 2011, found that 98 per cent (43 out of 44) of children aged 12-15 taking part progressed from puberty blockers to start cross-sex hormones (testosterone for females wishing to masculinise and oestrogen for males wanting to feminise). Gids staff working with gender-distressed children were presented with similar statistics in 2016. One, Dr Anna Hutchinson, described it as her “holy fuck” moment. And a wake-up call for many of her colleagues too.

Back then, clinicians saw that this data had profound implications for consent. It wasn’t just that families and young people needed to be told about blockers: they also needed more information on what transition might entail. “You couldn’t do it after you put them on the blockers,” Dr Natasha Prescott told me while I wrote Time to Think, “you had to do it before.” Because “once they’re on the blocker, they’ve started along a path”.

It was described as “transing away the gay”. And it’s simply a lie to say that this provides “a breathing space”. These are powerful irreversible drugs – which will now be supplied to young vulnerable children as a test – which will in the end tell us nothing.

It’s a disgrace.