Puberty Blockers

John Hayes Excerpts

Tuesday 23rd June 2026 Commons Chamber

[James Murray]

If a child is looked after under a care order, the local authority has parental responsibility, so it would need to be part of the consent process as the corporate parent.

I turn to the points raised by the right hon. Member for Salisbury (John Glen) about young people becoming involved in the trial and the checks that are in place to enable that to happen. As I set out earlier, as the trial involves children, it comes with a responsibility to interrogate and understand its design. As Health Secretary, I have sought the most detailed assurances possible from my clinical advisers as to how children taking part in the trial will be protected.

There are a number of important safeguards. As I have said, children can participate only with the consent of a parent or guardian, and the child themselves must consent or assent. They can participate only if they have had a diagnosis of gender incongruence for at least two years, have received psychosocial support through the NHS and are of stable physical and mental health. They can participate only if they are not subject to any safeguarding concerns and if they and their parents demonstrate sufficient understanding of the nature of the treatment, including its possible advantages and disadvantages. They can participate only if the treatment has been deemed clinically appropriate by both the NHS care team and the national multidisciplinary team and if they are already accessing NHS gender services. On eligibility, the bar is extremely high.

The number of young people who would expect to qualify for the trial will be low and the safeguards to ensure their safety and wellbeing will be rigorous. I have sought and had an assurance that, once they are involved in the trial, participants may be withdrawn at any point. We are not proceeding with the previous, now decommissioned, model of care overseen by the Conservatives when they were in government. We are proceeding cautiously, with rigorous safeguards in pursuit of the evidence, as Dr Cass recommended.

Last Thursday, the independent MHRA approved an updated protocol that significantly strengthened the objective criteria for withdrawing children from the trial, which is a change that I welcome. Signs of greater risk to participants will now trigger increased monitoring, clinical review or their automatic withdrawal from the trial. All participants will be monitored before, at the start of, every three months during, and after the trial. Before and during the trial, information will be collected about mental health, quality of life, self-harm and suicidality, body image, cognition, puberty stage, physical health and side effects.

I have been determined to ensure that the oversight of this trial is as rigorous and robust as it possibly can be, so I have requested monthly updates on its progress. That will include my being notified of any emerging risks.

This trial is rightly one of the most scrutinised UK clinical trials of recent times. We should expect nothing less when we are talking about the health and wellbeing of some of the most vulnerable children in our country. Yet, as Dr Cass has made clear, we have to build the evidence base to show whether the treatments are safe and whether they produce the positive outcomes that young people and clinicians want from them.

The Opposition’s motion would prevent us from following expert clinical advice, when proceeding with the trial is the most appropriate way forward. I say that not because I am suggesting that we should feel instinctively comfortable in doing so but because I have arrived at that conclusion after considering the clinical evidence and receiving robust assurances on the safeguards that are in place.

[Sir John Hayes (South Holland and The Deepings) (Con)]

I know that the Secretary of State has agonised over this matter—he made that clear in his statement to the House last night and again today—but what is not in doubt is the harm that these drugs do. It is an established medical fact. He is determined to be driven by the evidence. That is evidential. We know that the drugs have harmful effects, so in essence what he is saying is that we are prepared to wear those harmful effects on the off-chance that the drugs may have a beneficial set of effects, when there is no evidence to suggest up until now that they do.

[James Murray]

The MHRA has introduced additional safeguards. As a result of its dialogue with the trial sponsors, the amended protocol published last week increases the level of safeguards. That means that if the regular monitoring, which will happen at least every three months—it can be more regular during the trial—shows any sign of increased risk of harm, that will lead to increased monitoring, clinical review and, when considered against objective criteria, automatic withdrawal from the trial.

It is a question of monitoring this trial, possibly more closely than any trial before—the level of scrutiny is very great indeed—to ensure that at the first sign of any increased risk of harm, action will be taken. That is the assurance that I have sought in interrogating this matter carefully in recent days, and that is the basis on which I am talking to the right hon. Gentleman and others in the House today.

We must come to a fair and settled conclusion on this matter to move forward as a country, and I believe that we should follow clinical advice and establish the clinical evidence gathered in a highly scrutinised trial with all the safeguards in place that I have described. Only that approach will give us the confidence about where we settle on this matter in the future. On that basis, the Government oppose this motion.

--- Later in debate ---

[Sir John Hayes (South Holland and The Deepings) (Con)]

The journey from childhood to adulthood is challenging for many, difficult for some, and tortuous for a few. Through that journey, the support of older people, who are often parents, loved ones, people who care, is critically important. For those who suffer from gender dysphoria, that journey is all the more challenging. Many people—perhaps all of us in this Chamber—will have struggled with the emerging sexuality that is part of the journey to adulthood, but most people who suffer from dysphoria cope with it as they go through puberty. Indeed, the evidence—and there has been much talk of evidence in this debate—shows that medical intervention in those cases would not only be unnecessary but profoundly damaging.

Yet at the Tavistock clinic, the horrors of which I first highlighted in 2019, thousands of children were prescribed life-altering drugs. Indeed, it is more shocking still: more than 70 children aged three and four were sent to that clinic, and 382 children aged six and under were referred. The Government are fond, now, of speaking about the Cass review commissioned by. the previous Government, but the review was not welcomed by the Minister and the trans lobby. When it was commissioned, it was regarded with horror by those who presumably now support this trial.

The Cass review found that doctors must be extremely cautious about giving trans drugs to under-18s—not 11, 12 or 13-year-olds, but people under 18. It found that doctors must be able to

“refer to the longer-term benefits and risks”

of treatment options; that young children should have therapy before they are allowed to socially transition; that many parents expressed concern about their child being socially transitioned and affirmed in their expressed gender without parental involvement; that too many decisions about changing gender have been rushed, with too little consideration given to whether children might regret their actions later in life; and that childhood trauma, neglect and abuse feature heavily in the cohort of patients seeking gender change.

As many as two thirds of those referred had suffered neglect or abuse, with high levels of parental mental illness, substance abuse and exposure to domestic violence. Those are the vulnerable children who went to the Tavistock clinic, which was closed after pressure from those who understood the horrors that took place there. When it was opened, of course—

[Dr Arthur]

Will the right hon. Gentleman give way?

[Sir John Hayes]

I will in a moment, when I have made an attack on the liberal bourgeoisie, which the hon. Gentleman might want to hear. When the Tavistock clinic was opened, it was seen as an emblem of progress by the liberal bourgeoisie. Now, of course, we know that it was the embodiment of wickedness. On that note, I give way to him.

[Dr Arthur]

I am part of the liberal working class. This debate is not about the Tavistock clinic. The right hon. Gentleman has just quoted Baroness Cass, but one thing he has not said is that she recommended that the clinical trial go ahead. She said recently that she supports the trial because she thinks there will be real benefits to it. Rather than talking about Tavistock, will he address what Baroness Cass, who he quotes extensively, thinks about this trial that we are debating?

[Sir John Hayes]

Baroness Cass certainly wanted to gather more evidence. The evidence we have shows the damage that puberty blockers can do. We know that the substantial science suggests that they affect bone maturation, cerebral capacity and, of course, fertility. It is certain that there is no compelling evidence that puberty blockers have a beneficial effect. That is why she sought more evidence, as she concluded that there was no compelling evidence that they have a beneficial effect.

[Christine Jardine]

As another member of the liberal working class, I wonder whether the right hon. Member has the experience that many of us in this place have of talking to constituents, friends and family who have children who have struggled with their gender identity and have benefited from puberty blockers. While he says that there is no evidence, many of us have direct experience of seeing the benefits in action.

[Sir John Hayes]

That experience clearly contradicts the Cass review’s findings, but it is for the hon. Lady to have that debate, no doubt, with Dr Cass.

What is certain is that we have no indication from the Government about what success in the trial will look like. When challenged on that subject, answer came there none. How will we gauge whether the trial is a success or a failure? Are these children really guinea pigs to be used to provide the evidence that the hon. Lady says is already freely available in her anecdotal experience of communicating with her constituents and others?

We know that there is certainly evidence from other countries. Have the Government looked to draw on that, rather than engaging in this dangerous trial? We know that there is evidence too from the 2,000 or more children who went through Tavistock. Some have suggested that we should look at the data already available rather than putting any more children at risk. Yet despite the Secretary of State’s agonised decision—I do not intend that to be sarcastic or pejorative; I appreciate that the Secretary of State was completely straightforward about how difficult it was to make the decision—the trial goes ahead. I accept that there are additional safeguards—this is not Tavistock; it is something different—but none the less it brings immense risk alongside the determination to try to gain facts. Instead, let us look at Finland and Denmark and at other countries that have already gathered evidence. Let us look at what we know of those who have already been through this process.

G. K. Chesterton said:

“children are innocent and love justice”.

I fear that this trial will steal their innocence and deny them justice. I hope that even at this late stage the Government, recognising that, will abandon this awful trial and save innocent children from that fate.

[Madam Deputy Speaker (Ms Nusrat Ghani)]

We come to the wind-ups; I invite the shadow Secretary of State.

--- Later in debate ---

[Stephen Kinnock]

This is a debate about hormones for suppressing puberty, and is related to the matter that the hon. Lady raises, but it is important that we get the sequencing right. Let us look at the trial and the evidence. That is part of the process of understanding the milestones and the forks in the road faced by children who are experiencing gender incongruence. Let us do this one step at a time.

We are proceeding carefully, cautiously and under the mantra that the safety and wellbeing of children are non-negotiable, and with clarity that a robustly scrutinised trial with rigorous safeguards is the only way of establishing a robust evidence base for puberty-suppressing hormones.

Many hon. Members have asked about safeguards, so let me remind the House what they are. A child can participate only with the consent of a parent or guardian and the child’s own consent or assent, and only if they have had a diagnosis of gender incongruence for at least two years; if they are of stable physical and mental health; if they are not subject to any safeguarding concerns; if they and their parents demonstrate sufficient understanding of the nature of the treatment, including its potential advantages and disadvantages; if they have been deemed clinically appropriate by both their NHS care team and the national multidisciplinary team; and if they are already accessing NHS gender services, including participation in a tailored package of psychosocial care.

[Sir John Hayes]

Will the Minister at least commit to looking again at the experience of Finland and Denmark, whose evidence has led them to now emphasise counselling rather than medical intervention?

[Stephen Kinnock]

A little later, I will go through all the different work that is going on. This is absolutely not happening in isolation; we are taking into account a range of other studies.

Some colleagues have raised the work of the MHRA in strengthening the safeguards for young people involved in the trial. The MHRA has been engaged in a scientific dialogue with the trial sponsors, and it was the outcome of that process that led the MHRA, as an independent body, to publish the updated protocol last week. We welcome the changes, because they show that the MHRA is taking its job seriously and that the system is working as intended. We cannot cut corners when it comes to the safety and wellbeing of children, and the safeguards are now in place to guarantee greater monitoring and clinical reassessment, including objective criteria for withdrawing children and young people from the trial entirely. I remind colleagues that the bar to qualify for the trial is extremely high, with only a small number of young people expected to meet the strict criteria.

Some other colleagues—I turn now to the point made by the right hon. Member for South Holland and The Deepings (Sir John Hayes)—have queried the need to have a clinical trial when a number of children have already taken puberty blockers and information is already available. However, Dr Cass concluded that there is not enough evidence about the risks and benefits of those medications. That is why she was so clear in recommending a trial to find that clinical evidence, because that is the basis on which we can take those decisions.

The information in the data linkage study is much more limited than the detailed information that the research team will be able to collect about the relative benefits and risks of puberty-suppressing hormones. NHS England is, however, committed to delivering the data linkage study and has taken time to ensure that the data is shared by relevant organisations.