This comes as the Executive Office reversed its decision to withhold the Ministerial paper that sought Executive approval for the indefinite ban on puberty blockers
UK Health Secretary Wes Streeting agreed to delay a UK-wide review into the ban on puberty blockers until October 2027 to avoid a clash with the scheduled Stormont Assembly election, it has been revealed.
This new information comes as the Executive Office reversed its decision to withhold the Ministerial paper that sought Executive approval for the indefinite ban on puberty blockers for new patients under 18 in Northern Ireland.
TEO initially refused to release the information in response to an FOI from Belfast Live, which asked for all the evidence considered by the Executive when making the decision to approve an indefinite ban on the use of puberty blockers in Northern Ireland.
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The Executive Office maintained that disclosure had the potential to damage the concept of collective responsibility and inhibit Ministers from expressing their views “freely, frankly and with candour.”
Within the released 18-page document, Health Minister Mike Nesbitt noted his engagement with the UK Secretary of State for Health, who intended to accept the CHM recommendations and replace existing temporary restrictions with an indefinite ban, subject to a review.
Minister Nesbitt confirmed to ministerial colleagues that he had an agreement with Wes Streeting that in the event that Executive agreed to an indefinite ban on the use of the drugs to treat gender dysphoria and gender incongruence, that the review would be delayed until October 2027 from initial proposal to review it in April 2027, so that it does not clash with the Assembly election which is scheduled for May 2027.
Mike Nesbitt also outlined how he and Wes Streeting had agreed that children and young people in Northern Ireland would have equitable access to planned NHS clinical trials and that the Knowing our Identity Services here (once restarted) would benefit from close working with the clinics in England in order to benefit from best practice learning and provision of peer support.
The Health Minister also informed the rest of the Executive that a decision would need to be taken “immediately” as he had been asked to sign the new legislation that same day to enable the indefinite ban to come into force on January 1, 2025, immediately following the expiration of the temporary order and that parliamentary convention dictates that any legislation must be laid 21 days before it comes into force.
The release of the main paper follows a partial disclosure earlier in the year. In July, TEO released a version of the minutes from the meeting which was entirely redacted apart from a list of attendees and an annex that had been publicly available since January 2025. This came weeks after the Information Commissioner’s Office launched an investigation into the initial handling of the FOI request.
TEO confirmed that, upon further consideration, they were now disclosing the Minister of Health’s Executive paper itself and stated that this paper, alongside the previously disclosed annex, constitutes the full evidence considered by the Executive when making the decision to approve the ban.
Crucially, TEO confirmed that certain sections of the Executive paper were still being withheld, citing the need to maintain the concept of collective responsibility and a “safe space” for Ministers to discuss issues robustly and openly, consistent with the public interest test articulated in the initial refusal.
The paper highlighted that the proposal followed careful consideration of the Commission on Human Medicines (CHM) report. The CHM report made several recommendations, including that the current prescribing pathway for these medicines presented an unacceptable safety risk for children and young people under 18 without significant additional safeguards.
The document states that an independent review of gender identity services in England (The Cass Review) found there is “not currently a reliable evidence base” upon which to make clinical decisions about the use of puberty blockers.
It also highlights how a July 2024 court judgment in England reinforced this, making “specific reference to the strength of the evidence in the Cass review” and stating that the findings about the “very substantial risks and very narrow benefits” amounted to “powerful scientific evidence in support of restrictions.”
The released document also highlights how the UK-wide consultation received 51 responses, with 59 per cent opposing an indefinite ban on the use of the drugs for patients with gender dysphoria or gender incongruence, 27 per cent supporting it, and 14 per cent neither for nor against.
Two out of three Northern Ireland-specific responses disagreed or strongly disagreed with making the arrangements permanent. This opposition came from local LGBTQIA+ community and voluntary organisations The Rainbow Project, Here NI, Cara-Friend, Mermaids NI, and the Belfast Trans Resource Centre.
Opponents argued the ban would have a “detrimental impact/consequences for mental health and wellbeing” and would not prevent access, but would simply push families into “more risky and underground routes to accessing care with less medical oversight”.
The Belfast Health and Social Care Trust Adult Services clinicians were the only NI-specific group that agreed with the proposal.
Responding to the latest development, Alexa Moore from The Rainbow Project said: “The Executive’s ban on puberty blockers has plunged a generation of trans young people into uncertainty and fear over their access to what is for many lifesaving healthcare. It created a cliff edge, wherein the vast majority of young people seeking this care have been given no pathway to do so, and those who were already accessing this care were left with very little additional support to cope with the detrimental impact that a withdrawal of care will have on their health and wellbeing.
“This, coupled with the refusal to release the evidence considered by the Executive in reaching this decision, has led to a colossal loss in confidence and trust within trans communities in the Executive.
“It is clear that recommendations made by the Commission on Human Medicines’ on providing clear pathways to support for those affected by this decision have been ignored or neglected. Young people and their best interests are falling by the wayside, while politicians are prioritising culture wars and dehumanising rhetoric against an already vulnerable and marginalised community.”
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