Yes the UK should do a proper puberty blockers trial

The BBC reports:

Campaigner Keira Bell has told the BBC she believes the planned clinical trial of puberty blocking drugs for gender-questioning children is unethical and children “are essentially going to be harmed”.

The Pathways trial, run by King’s College London researchers, will look at how to improve care for children under 16 at NHS gender clinics.

The UK medicines’ regulator has approved the study to begin in January, and the research team says it has been designed “to meet rigorous scientific and ethics standards”.

Ms Bell and fellow campaigner, psychotherapist James Esses, have sent lawyers’ letters to Health Secretary Wes Streeting and medical research organisations arguing it should be stopped.

I disagree on this issue.

Medical “establishments” in multiple countries did fail to provide good care to young persons who are gender dysphoric or incongruent. There was a culture that any incongruence must mean they are trans, and should get puberty blockers. Shamefully staff who protested this were often silenced for forced out. It is quite possible a large number of girls who were merely lesbians, were convinced they were in fact trans as only one solution was put forward to their gender incongruence or dysphoria. It is quite legitimate to be very wary of what many of these medical groups did or said.

The Cass Review found that the evidence for the benefits and risks of puberty blockers was weak, and the (Labour) UK Government banned them as a result until there was better evidence. The NZ Government has taken a similar stance to the UK Government.

But one can condemn what happened in the past, but also be open to what a proper trial will find in terms of benefits and risks. Just because the evidence in the past was poor or weak, doesn’t mean we should say that there is no need to try and gain strong useful evidence.

My general position is that the younger the person is, the higher the barrier should be to assessing whether they should be able to consent to and receive drugs such as puberty blockers. An 8 year old is very different to a 14 year old, for instance. But I am very interested in the findings of a high quality trial, and then an informed debate on whether puberty blockers are appropriate for gender dysphoria – and if so at what age and under what conditions.

I quote Dr Hilary Cass:

Dr Hilary Cass said she was “really pleased” Prof Simonoff and the KCL team were undertaking the trial.

She said: “My review uncovered a very weak evidence base for benefits from the use of puberty blockers for children and young people with gender dysphoria. In fact, some children had more negative than positive effects.

“However, given that there are clinicians, children and families who believe passionately in the beneficial effects, a trial was the only way forward to make sense of this.”

She added: “Although a lot of media attention has focused on the trial, they have a much broader research programme. Following the outcomes for young people who do not elect for a medical pathway will be just as important as following those who do.”

I agree with Dr Cass.