Lords Chamber

Wednesday 24th June 2026

(began 1 month ago)

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None Portrait Oral questions: Legislation to introduce a close season for hares
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I beg leave to ask the question standing in my name on the Order Paper.
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Lord Davies of Brixton Portrait Lord Davies of Brixton (Labour)
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I thank the noble Lord Lord Alton for his important question. I know my friend, my noble friend. know my friend, my noble friend. The Minister is well aware of the nature of the appalling tragedy that's taking place in the Sudan, one of the factors which is fuelling the extent of that tragedy is the continued supply of modern weaponry, drones, training of mercenaries which are fuelling this ongoing tragedy. Did she agree with me that our government, our Labour government, should do all it can in order to prevent the supply of such equipment which is fuelling this disaster?

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Absolutely. This this conflict is there is no doubt it is being prolonged and it is being prolonged and it is being intensified because of the supply of drones and other high tech equipment to armed groups within equipment to armed groups within Sudan, not just SAF and the ISF, many others. And there are double many others. And there are double digits now of countries involving themselves in this conflict. They need to stop. That is the only way need to stop.

That is the only way that we see any kind of resolution. We need to get onto a ceasefire and some dialogue and a civilian led process. That is the only way forward here. The more arms are pumped into Ukraine, into Sudan, and the illicit gold flows and all the rest of it, it needs to stop because until it does, there will be no motivation for those warring parties to get round the table and resolve this.
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Baroness Chapman of Darlington Portrait Baroness Chapman of Darlington, Minister of State (Development) (Labour)
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Yes, I think that's a very good >> Yes, I think that's a very good suggestion. It's why we had an illicit gold conference very recently and well aware of the recently and well aware of the problem that he describes. And I think the idea of having a consumer facing campaign around this is excellent. And should that be something that should I mean, I would personally like to get involved in leading it. I think it's so destructive and it is without a doubt fuelling this conflict.

But I think I would very much welcome any moves to make consumers much, much more aware of the of where their gold comes from and the fact that it can can be used to, you know, support these absolutely devastating atrocities

**** Possible New Speaker ****

that we see in Sudan. Take the noble Lady, the Minister, back to the International Minister, back to the International Development Committee that I know she attended yesterday and has already been referred to, because the evidence given yesterday by Nathaniel Raymond, executive director of humanitarian research at School of Yale School of Public Health, he testified that the UK Parliament's international Parliament's international committee had failed to act on intelligence and genocide warnings in Sudan, and he specifically said that the there had been no political will or not enough political will, and it was blocked by the UK's unwillingness to confront the UAE.

The primary

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military enabler. As we know of the massacre In the El Fasher massacre in

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In the El Fasher massacre in 2025. Can she say what direct representations were made in response to the intelligence that response to the intelligence that was received in order to try to combat what was what was an impending genocide? Yeah.
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Baroness Cash Portrait Baroness Cash (Conservative)
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children as young as 11 risks becoming a medical scandal becoming a medical scandal unfolding in real time, gender incongruent children include some of the most vulnerable children in society, with disproportionate numbers of that cohort with autism, numbers of that cohort with autism, mental disorders and children in care. There is an unknown and inestimable correlation with social media as yet to be uncovered. The challenge for these children and for their families, and the difficulties that they face, are not to be underestimated, but gender incongruence and gender non-conforming behaviour are also often characteristics of children who grow up simply to be gay.

Surely the noble Baroness, the Minister, does not truly agree with the trial, which will place children who would otherwise simply have grown up to be healthy, gay, lesbian adults onto a pathway that may impair their fertility and their sexual development, the data shows. And the Cass Review accepted that the very large majority of children presenting with gender incongruence will resolve without medical intervention. I assume that the noble Baroness, the Minister, accepts this. And that being the case, this trial will be subjecting many physically healthy young children to completely unnecessary medical risks.

Let's be clear the medical risks inherent to taking puberty blockers at such a young age are truly life altering. They include possible lifelong consequences for brain development, including IQ, bone health, fertility and adult sexual function. Shockingly, 2000 children have already been treated with puberty blockers in this country. They were treated at the now closed Tavistock Clinic. More scandalously, they
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None Portrait Statement: PATHWAYS Clinical Trial Baroness Cash (Conservative)
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went on to adult clinics and we are entirely in the dark about how they entirely in the dark about how they are today. The data linkage study to analyse the information about those children has not yet been done. A shocking six out of seven of those adult clinics. They went of those adult clinics. They went on to have not released the data, despite Parliament legislating for despite Parliament legislating for it. So what are Ministers doing to require adult gender clinics receiving public money to provide that data? What is the current status of that process? And when the government still does not know what happened to the 2000 children already treated, why? And on what grounds is it exposing another cohort of healthy children to medical harm before that question has been answered? My Lords, it is no good to point to the fact that Baroness Cash Cass recommended a trial.

Government cannot and should not outsource such decisions, and it will be no defence to the litigation coming down the line as it already is in the US. That the noble Baroness told the government to do it. In any case, there are major issues about consent and particularly in the nature of the trial, as currently put together. I am deeply troubled by how the informed consent of children can possibly be obtained when they are too young to appreciate what they stand to lose as young as 11, and it's important to set out what they stand to lose.

Commencing puberty blockers at an early age may make fertility preservation for these children impossible. Studies show puberty blockers may affect brain development, including their IQ and memory function, as well as their bone density and organ development. There is currently no long term data sufficient to quantify those risks. And then, of course, there is a risk that normal adult sexual function and let's call a spade a spade. We're talking about the ability to ever experience sexual pleasure does not develop when puberty is interrupted at such an early stage.

In these circumstances, it is inexplicable that the government has rejected the MHRA recommendation that children under 14 should not be included in any trial. And yet this trial is for children from the age of 11. How does the noble Baroness, the Minister, justify that children under 14 are to be included in the trial? And how does the noble Baroness, the Minister, argue that any child can give informed consent to such risks? Please can the noble Baroness, the Minister, confirm that these risks and all others will be expressly communicated to the children and families concerned? Because if this trial does go ahead, it is inevitable that irreversible, unnecessary harm will be done to at least some of these children.

Finally, could the noble Baroness, the Minister, confirm that the government has carried out an assessment of the future liability coming down the tracks to the NHS and therefore to the taxpayer? Have the ongoing treatment costs, the treatment related harms and the future litigation risks being assessed? And what is the estimated cost to the NHS and the taxpayer of those, and how will that be funded? Polling in December 2025 shows almost 70% of the public is against giving puberty blockers to children, and 63% want this trial to be stopped.

My Lords, as the government considers a fresh start in other ways, I beg the noble Baroness, the Minister, to please think again and stop this trial here.
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Baroness Barker Portrait Baroness Barker (Liberal Democrat)
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My Lords, this statement. >> My Lords, this statement. >> Takes place in within a context. Of a relentless campaign by. Of a relentless campaign by. Against trans people, which started in the United States of America, in the right wing politicians there, but has been seized upon on that bandwagon, has been jumped upon by politicians in this country. That's the context for this. We on these benches have a policy towards trans people, which is based on our belief that trans people not only exist, but they have the right to exist, and they have the right to exist with the same dignity as the rest of us.

And that's part of that is having access to appropriate health care. I would want to ask the government, as they hope, that they seek to defend this test against the kind of political campaigning that we've we've just heard to bear in mind that the use of the use of puberty inhibitors is not the harmful, the harmful intervention that has just been characterised. It is something that a safe medical intervention that has been used for different, different conditions since the 1980s, on which there is already a lot of data.

But there is, as the noble Baroness Cass identified in her review, an absence or an insufficiency of data about their use in relation to people who have gender dysphoria. So that's why there's. This trial consists of 226 people, very, very highly regulated group period of activity was going to be going to go, has been allowed to go ahead in order to generate the data that she says that we need. It is true that last week, the independent MHRA approved an update to the to the basis on which this trial is going to happen, in order to make sure that the safeguards were increased, and it is not unusual for that to happen in a medical trial.

It is not unusual for trials to stop, to take notice of what has happened initially, and then to make revision to the basis on which they were. My Lords, we believe very strongly on these benches that medical treatment should be based on science and evidence, not on belief and ideology, and this trial has been under sustained, sustained attack from all political organisations, such as Sex Matters, who do not believe that trans people either should exist or should exist with the dignity that they currently do.

This trial is currently the only legal route for anybody to access puberty blockers. So in the interests not just of accurate scientific evidence, but also in the interests of children who need this treatment, will she ensure that the people undertaking this research are protected from the relentless political attacks against trans people.
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Baroness Merron Portrait Baroness Merron, The Parliamentary Under-Secretary for Health and Social Care (Labour)
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Who. >> Who. >> My Lords, I'm grateful to the noble Lady Baroness Barker and the noble Lady Baroness Barker and the noble Lady Baroness Cash for their contributions. And for me, listening to both contributions highlights very much why my right hon. Friend the Secretary of State led on this statement by saying this is a sensitive, emotive and difficult subject. But he also said, and it's to the point raised by both noble Baroness in coming at it from very different angles.

Our duty as a government, as any government, as indeed the last government accepted and acted on, is to protect the safety and the wellbeing of children, and also to act on expert clinical advice and use an evidence led approach. And we, like the previous government, will indeed be sticking to that. And the noble Lady Baroness Cash referred used the word outsourcing. I don't believe the last government outsourced responsibility when NHS England commissioned the most respected paediatrician who deals in this area, the noble Lady Baroness Cass, who we are fortunate to have with us now in the House.

I don't believe the last government outsourced. I think that they took a responsible, evidence led approach, and what the noble Lady Baroness Cass said. And it's worth reminding ourselves that the noble Lady Baroness Cass said this is an area of remarkably weak evidence, and indeed I would agree again. And it's also important to observe a very strong divergence of medical opinion. So actually, there is a choice we can either continue with. There's always a choice, and we can continue with uncertainty in an unsafe setting where there is that strong divergence of medical opinion.

Or we can seek the evidence. I, I can't predict what the evidence. And nobody in your Lordships House can predict because it doesn't exist yet. But I would also say to your Lordships House that, as I say, I think the last government had the right approach, which was also why we supported it in opposition, which was to accept the recommendations of the review by the noble Lady, Baroness Cass. And I again feel that is the. That is the responsible way forward.

I think it's worth reminding ourselves that the use of puberty suppressing hormones has been banned indefinitely for gender dysphoria outside of research settings. And so the trial that we're talking about today actually is being set up. This is the action we're setting it up to gather the evidence that the last government wanted, and that we are continuing. The trial was first approved by regulators in November 2025. And again, to remind ourselves, in February, March, I requested changes to the trial protocol to make it even safer.

This is quite normal in how these matters are dealt with. And to the noble Lady Baroness Cash, perhaps I can give her the clear assurance that the changes to make it safer, and that is absolutely the right thing to do. Were around the age of those included in the trial, monitoring a possible impact on bone density, as well as possible impact on future fertility and cognitive abilities, all to the points and concerns rightly raised by the noble Lady Baroness Cash, and indeed raised on a number of occasions in your Lordships House.

And I do want to emphasise it is absolute dialogue like this to take place during the trial. Reference to was made to safeguards and. And there are a number listed. But again, I would ask noble Lords to look at them, but I'll just mention some of them. They. That children can only participate with the consent of a parent or a guardian, and the child themselves must consent or assent. They can only participate again to the point raised by the noble Lady Baroness Cash, if they are not subject to any safeguarding concerns.

If there is sufficient understanding by the young person, but also by their parents or guardian, sufficient understanding of the nature of the treatment, potential advantages and disadvantages only if they have been deemed clinically appropriate by both their NHS care team and the national multidisciplinary team, and only if they're already accessing NHS gender services, including participating in a tailored package of psychological psycho psychosocial care. All of these build in very considerable. And the right, I believe, safety, preservation and ensuring the right people can.

I also say that there is no compulsion to take place in a trial and indeed, it is a very rigorous means to even get near to a trial. So I would like to emphasise that. And I can also say that because there are indeed ongoing legal proceedings, as the noble Lady Baroness Cash referred to, recruitment on trial will not begin immediately. We're currently in a set up period and we will set out in due course how we're going to be dealing with that.

The noble Lady Baroness Barker. Made reference to protecting researchers from relentless attacks. I hope the whole of your Lordships House would agree with that. Those who carry out research, those who lead reviews such as the noble Lady Baroness Cass and many others who we have indeed on our own benches, have been subject in many different areas to the most relentless attacks. Not always, by the way, in social media, but sometimes physical too. That is a violence is totally unacceptable.

We cannot move forward in any way. Yes, I can say to the noble Lady Baroness Cash that prospective participants will indeed have comprehensive information in a way that speaks to how they need that information on the advantages and the potential risks, and with regard to the minimum age, the minimum ages were agreed through detailed scientific discussions between the MHRA and the trial sponsor, and I think if I had to speak overall, it's all totally driven, as I say, by actually what is going to give the right evidence that we need for decisions, that it is clinically led.

And again, if I could refer back to the point about age, which I know does exercise noble Lords, and I think it's a very fair question, but it was recognised during discussions between the trial sponsor and the MHRA that the right balance had to be struck. It had to be struck between the maturity level of participants and also providing the treatment at the most clinically appropriate point in puberty, and that would, of course, be earlier for female birth registered females compared to birth registered males.

I would also like to make the point if the noble Lady herself doesn't make it, that. I am very grateful to the noble Lady Baroness Cass, who is ensuring that she will be available for a drop in discussion with anybody who would like to go into more detail, and I hope that noble Lords will avail themselves with that, and to some of the other points that were raised, the noble Lady, Baroness Cash, asked about whether the government had carried out an assessment of future liability and as always, all research trials are expected to have appropriate insurance, and indeed this one will and will take into account any potential risks in a financial setting.

The noble Lady refers to. And my final point that I will refer to, and I'm always happy to hear if noble Lords have other questions I can assist with. But the noble Lady, Baroness Cash cash, asked about six out of seven clinics not releasing data. Data is very important. That is why NHS England is really engaging with data sharing organisations and which the. Which the particular data study will be dependent. And it is separate, of course, to this trial.

But we absolutely expect all commissioned adult gender services to collaborate with the study to ensure its successful completion.
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