The NHS puberty-blockers trial is an unforgivable betrayal

On Tuesday, 283 MPs voted to proceed with a medical experiment that seeks to recruit some of the most vulnerable children in Britain, including those in care. They did so despite being repeatedly warned that injecting healthy children with puberty blockers could damage bone density, impair cognitive ability and lead to infertility.

Despite the best efforts of the Conservatives – who forced parliament to hold the vote – and campaigners such as detransitioner Keira Bell, the NHS-backed Pathways Trial will almost certainly now go ahead. This in itself is astonishing, considering that it was paused in February after the Medicines and Healthcare products Regulatory Agency raised concerns about the potential harm to the more than 200 children – some as young as 10 – who will be subjected to the trial. It is also pointless, given that NHS trusts continue to hold unpublished data that could answer many of the questions the trial is supposed to answer.

Conservative MP Caroline Johnson, a former consultant paediatrician, opened the debate. She asked Labour’s beleaguered and slightly confused-looking new health minister, James Murray, whether he ‘is aware of new evidence allowing clinicians to work out confidently which children will persist with the trans identity at 11 and which will not?’. She continued: ‘We need to think about the risk involved in the treatment, and whether it is worth the benefits that they will purportedly receive’.

Johnson drew attention to other serious concerns. Among them is the fact that 12-year-olds enrolled in the trial will be asked to complete questionnaires about whether they have engaged in oral sex during the previous year, ostensibly to assess their understanding of the impact that puberty blockers may have on future sexual function. They will also be paid for filling out the questionnaires. Murray opted not to address this point.

Throughout the debate, Murray hid behind the ermine-fringed authority of Baroness Hilary Cass, the paediatrician who recommended a trial as part of her review of gender-identity services for children, published in 2024. He solemnly informed the chamber that he had ‘struggled with the profound challenges this subject raises’. Yet when Conservative MP Rebecca Paul reminded him of the doubts he had professed about the trial only the day before the vote, his struggle appeared to be with remaining in the chamber, which he promptly left.

The authority on which ministers continue to rely has itself become increasingly controversial. Earlier this week, Cass defended the trial in an interview with the BBC, warning that 11-year-old girls are presenting to clinics having already taken testosterone, a claim repeated by Murray. One might have expected such a revelation to prompt calls for police action against those supplying these hormones to children. Instead, Cass argued that this was evidence that these children should be enrolled in a trial of puberty blockers. As Johnson explained to her colleagues in the House of Commons, ‘we would not give children cocaine on the basis that they wanted it and would get it illegally otherwise’.

Cass’s task of reviewing gender-identity services for children in the UK was an unenviable one. She stepped into no man’s land in search of evidence, with a target on her back and shots coming from all sides. But when the smoke cleared and the Cass Review landed, it was clear to anyone with eyes that the war was somewhat one-sided. She concluded that, ‘the evidence base underpinning medical and surgical interventions in this clinical area is remarkably weak’, and found ‘insufficient and / or inconsistent evidence’ regarding the effects of puberty suppression on psychological wellbeing, cognitive development and bone health.

To anyone whose brain has been spared the rot of trans ideology, this was no more surprising than discovering that Ozempic harms anorexic children. But it took someone of Cass’s stature to force the government to confront reality. Even those of us whose expectations of officialdom are calibrated somewhere between ‘low’ and ‘abysmal’ assumed no ethics board would approve a trial of puberty blockers. For her pains, Cass became public enemy No1 to trans activists, inside and outside parliament.

It is hard to escape the feeling that the paediatrician has been knobbled. Panicked by the prospect of children buying hormones online, she has backed a poorly designed and potentially dangerous experiment. Even trans-cheerleading rag PinkNews is supporting Cass on Pathways.

There is nothing more depressing than the politics of defeat, of managed decline. Giving distressed children puberty blockers because they might otherwise buy hormones from dodgy providers online is no different from giving girls who are being sexually exploited the pill to prevent pregnancy. What is happening is a crime, and yet, just as with the vulnerable children exploited by rape gangs, it is one the state is prepared to accommodate if the alternative is confronting its own prejudice.

The proper response to children obtaining powerful drugs illegally is not to provide those drugs under official supervision. It is to stop the people supplying them, protect the children involved and enforce the law. That ministers now present a clinical trial as the only realistic alternative is an admission not of compassion, but of failure.

Jo Bartosch is co-author of Pornocracy. Order it here.