Puberty Blockers

Debate between Caroline Johnson and Jim Shannon

Tuesday 23rd June 2026 Commons Chamber

[Dr Johnson]

The hon. Gentleman is exactly right, and he expresses my point succinctly. Why is the Secretary of State going ahead with a trial—experimenting on more children unnecessarily—when he has the data to analyse already? Why has he chosen to fund this trial? Is he worried about the children who will be put on a medical pathway that may lead to cross-sex hormones and a lifetime of medicalisation when they would have got better by themselves anyway?

I want to talk about the age of these young people. The Medicines and Healthcare products Regulatory Agency warned in February that the youngest patients are at the greatest risk, and may end up on puberty blockers for a much longer period. They have a higher risk to fertility because sperm and eggs have not yet fully developed at Tanner stage 2, but this Government have chosen to include children of 11 or 12. Some will wonder why it is 11 for girls and 12 for boys—indeed, I was asked that question yesterday—but as a paediatrician I am aware that puberty starts earlier in girls than in boys. It is somewhat ironic that a trial based on the premise that girls could be boys recognises this biology, but I am glad that in this respect it does. However, that means some of the participants will be primary school-aged children with the merest form of puberty. How can they possibly meet the eligibility criteria, which includes

“sufficient understanding of the treatment advantages and disadvantages, including discussion of fertility preservation”?

How can a child of 11 understand what it means to lose sexual function, to be unable to have children when they are older, to have difficulties in thinking and to have weak bones? Remember that this Government think that 14-year-olds are not old enough to watch social media, but they think 11-year-olds are capable of understanding this.

[Jim Shannon (Strangford) (DUP)]

I just say this to the hon. Lady and, perhaps more importantly, to the Secretary of State, who is very genuine, personable and easy to speak to. In Northern Ireland, the Assembly and the Minister there have taken a decision not to pursue this. Would the hon. Lady agree that, when the Government pursue something here that may set a precedent for somewhere that has not agreed to it at the time, there could be an influence, with an adverse impact on the regional Administrations—the Northern Ireland Assembly where we are, and elsewhere—and it is important that the Government here do not take a decision that could influence areas they do not control?

[Dr Johnson]

I thank the hon. Gentleman for his intervention on devolution, and I am sure the Secretary of State was listening and considering what he has said.

To go back to the age of the young people, I am reminded of the judgment in Bell v. Tavistock, which says:

“We do not think that the answer to this case is simply to give the child more, and more detailed, information. The issue in our view is that in many cases, however much information the child is given as to long-term consequences, s/he will not be able to weigh up the implications of the treatment to a sufficient degree.”

I draw right hon. and hon. Members’ attention to the next part of the quote:

“There is no age appropriate way to explain to many of these children what losing their fertility or full sexual function may mean to them in later years.”

Yet, as Secretary of State confirmed yesterday, the children must consent or assent to being in this trial. Another question that he did not answer yesterday is why the Government did not heed the MHRA recommendation for a minimum of 14 years. Having established that the Government are going to put a group of physically healthy children with a self-resolving condition at a risk they may not fully understand, the remaining question is why they would they want to do this.

The trial itself has an interesting design. We are told that it is a randomised controlled trial—as a doctor, I am familiar with that term—but in this case it is a bit of a fudge. Yes, this Government-sponsored trial will randomise which children get the drugs now and which get them in a year’s time, but the comparison group that does not receive puberty blockers—300 children from the Horizon Intensive trial, with whom the trial will seek to compare—may not be considered a reliable comparison, because the group is a different group with different eligibility criteria. When the results of this trial are published, this fact is bound to be used by people who dispute or disagree with the findings. The Secretary of State said this trial will resolve the dispute over the issue, but that is one of the reasons why I think it will not.

I want to discuss sexual function, because yesterday the Secretary of State said that the trial would involve the completion of a number of questionnaires, and one of my hon. Friends raised the question about what happens to children’s sexual function in the long term. What is sexual function? It is desire, arousal and orgasm. The trial organisers are clearly concerned about this, because they put into the trial the ALSPAC—Avon longitudinal study of parents and children—romantic relationships questionnaire. I read the questionnaire on the Health Research Authority website, and children from the age of 12 and over will be asked these questions, one of which is:

“In the last year have you had oral sex with another person? (This is when they put their mouth or tongue on your penis/vagina or you put your mouth or tongue on their penis/vagina)”.

Let us be clear: if that is happening to a 12-year-old, that is sexual abuse and the police should be called. Is the Secretary of State content for the Government to be asking these questions of such young children? Can he believe that they will be paid £20 for completing their questionnaires, alongside £30 for completing the assessment of cognitive ability and £15 for completing physical and height assessments, in addition to travel expenses?

There will be lots of talk this week about the Prime Minister’s legacy. Putting children as young as 11 on puberty blockers, with irreversible life-changing consequences, would be the most disturbing final chapter in what has been a troubled book of leadership. Today, right hon. and hon. Members will be asked to vote to consider their approval or disapproval of the trial. I urge them to look at their conscience, read the trial protocol—it is online—and remember that these are vulnerable children who deserve the best care. One day, the children caught in the middle of this debate will be adults. It is our responsibility to ensure that when they look back on their one childhood, their one adolescence and their one chance to enjoy growing up, they must know that every decision was made with the utmost care, caution and respect for their future. The power to make that happen is in our hands today. I urge hon. Members to protect children’s futures.

“For Women Scotland” Court Ruling: First Anniversary

Debate between Caroline Johnson and Jim Shannon

Tuesday 14th April 2026 Westminster Hall

[Jim Shannon]

Whenever the hon. Lady refers to me as being “interesting”, I think that says that she and I have a different opinion on an issue. The Scottish courts have taken that legal decision. I am sure that the hon. Lady would always want to support the legal decisions in the land, whatever they may be and whether she likes them or not.

[Dr Caroline Johnson]

I wonder if the hon. Gentleman would reflect that there is a biological difference between an individual with a disorder of sexual differentiation, whom the hon. Member for Chelmsford (Marie Goldman) referred to as an intersex individual, and a biological male who feels that he prefers and is more comfortable living his life as though he were a woman.

[Jim Shannon]

I thank the hon. Lady for her clear message. She reiterates the position that I and many others in the Chamber hold.

Back home in Northern Ireland, Democratic Unionist party Ministers have appropriately taken decisive action, because the safety of our daughters—in my case, my granddaughters—in school changing rooms and the integrity of women’s sports cannot be put on hold. In the Department of Education in Northern Ireland, Minister Paul Givan—my colleague—has moved to scrap flawed, ideologically-driven guidance that ignores the legal opinion and pushes something completely out of order and wrong. The majority of people are convinced of that. We are ensuring that schools remain places of common sense, where toilets and sports are defined by biological sex. We will not allow a culture where teachers or pupils are forced to speak untruths or where biological males are permitted into female-only spaces.

It is deeply disappointing to see some, including the Equality Commission, trying to use the Windsor framework or complex legal roadblocks to delay the inevitable. Let us be clear: there is no Northern Ireland exception to biological reality. To suggest that a woman in Belfast is defined differently from a woman in Glasgow or London is not only absurd; it is legally incoherent. I remind everyone of the Glasgow legal opinion, which was very clear. If we are all adhering to the law of the land—I do not think that anybody in the Chamber would not want to support the law of the land—then we can all agree on that.

We are not interested in expensive court cases that seek to overcomplicate the obvious, as some would perhaps try to do. We are interested in protecting the hard-won rights of women and girls. We are interested in ensuring that, when a service is advertised as single sex, it means exactly that and nothing else, as the legal decision in Scotland indicated. We have the legislation in place. We need adherence now, and we look to the Minister to demand this of every publicly funded body. This is about dignity, privacy and, above all, the truth. The DUP, my party, will continue to lead from the front, ensuring that our laws and services reflect the common-sense values of the people we represent. The Government must follow suit as a matter of urgency.