Puberty Blockers

Nusrat Ghani Excerpts

Tuesday 23rd June 2026 Commons Chamber

[Esther McVey (Tatton) (Con)]

I thank the hon. Lady for giving way; I am listening to her very intently. Does she know what a measure of success would be in this puberty blocker trial? If 80% of the children on it were happy with the outcome, would that be a success? What are the ultimate measurements of success?

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. The hon. Member for Luton North (Sarah Owen) is making an important speech, but before she gets back to her feet, I must tell her that I need to get 12 more Members in to speak.

[Sarah Owen]

I know that further details will be coming from the Secretary of State as to what a marker of success is, but I think we have to ask ourselves what a marker of success is for the individuals and families. For some, staying in their sex from birth may look like success. For others, that will not be the case. This is very much on the individual.

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[Rebecca Paul (Reigate) (Con)]

I frankly cannot believe that we are here again. When the Pathways clinical trial was paused earlier this year, I felt that there had finally been—[Interruption.]

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Forgive me—there is a five-minute time limit, which is the only way that I can incorporate all the Back Benchers who wish to contribute.

[Rebecca Paul]

Yesterday, even the Secretary of State for Health and Social Care conceded—the second one to do so—that he is “uneasy” and even “uncomfortable”. I suggest that his discomfort is nothing next to the lifelong damage that the trial will potentially do to an extremely vulnerable cohort of children, whom we should be protecting. That funny feeling in his stomach—[Interruption.] Oh, he has left. That feeling is his good judgment trying to be heard—he will not hear this if he has left—and it is not too late for him to listen to it. I agree with what one of my hon. Friends said yesterday: he is a good man who is being placed under intolerable pressure on this issue. But he needs to find his courage.

The number of children and young people presenting to the NHS with gender distress increased dramatically in the years after 2009, with an exponential rise from around 2014. What is behind the increase among Gen Z is unclear, but the reasons are likely to be multifaceted. It is speculated that the factors may include 24/7 internet access, the increased acceptance of trans identities, or even peer social and cultural influences. Over the past 20 years, groups such as Stonewall and Mermaids have called for better access to treatment and more rights for trans people. Large corporates have gone big on diversity and inclusion to boost their brands.

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[Rebecca Paul]

I thank the hon. Member for that excellent question. I obviously always respect and listen to different clinicians, but what is happening with this debate is that one set of clinicians with one view is being listened to. Let me remind everyone about lobotomies. Lots of very respected people came out for lobotomies; in fact, the person behind the idea won a Nobel prize. I think we would all agree that those clinicians got that wrong, so it is incumbent upon us in this House to always question. It is absolutely right that we listen to clinicians, but unfortunately we are seeing only one set of clinicians with one set of opinions being listened to here.

A Finnish study was published in April that looked at more than 2,000 adolescents and young adults who had been referred to gender services. It found that medical interventions did not reduce psychiatric problems and may even be associated with worsening mental health. How many times have we heard it said that puberty blockers offer a pathway towards improved mental health and reduced psychiatric distress for those struggling with gender identity? I have lost count. But there is hard evidence that not only says different; it says the opposite. I would be keen to understand from the Minister and the Secretary of State whether that study was taken into account before deciding to go ahead with the trial.

I want to point out that children and young people who grow up to be same-sex attracted are over-represented in this cohort, and that is something we need to think about. If we look at the case of Keira Bell, she was a lesbian struggling with her sexuality, and instead of people saying, “It’s okay to find other women attractive—there’s nothing wrong with that. You do not need to change your body,” they said, “Ah! You’ve got gender dysphoria.” They put her on puberty blockers, and then she went on to testosterone shots. She then had her breasts removed in a double mastectomy, and then she detransitioned. This is a deeply homophobic approach to healthcare. Those on the other side of the argument think they have the progressive position. I am sorry, but you are repeating mistakes that have been made historically—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. Obviously, I have not said anything, so I am not repeating anything. No “yous” and “yours”.

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[Olivia Blake (Sheffield Hallam) (Lab)]

It is a pleasure to follow the hon. Member for Edinburgh West (Christine Jardine), and I agree wholeheartedly with her comments about homophobia.

I remind the House that I am a former biomedical scientist, and I have probably read lots more medical publications than many in this Chamber. I have also volunteered many times for medical research, either as a healthy patient in my younger years or as a patient now in my slightly older years, so I know the process from both sides. I think it is really important that we recognise that the UK has some of the highest standards for medical research, especially when it involves patients. There is talk about why there is no placebo, but sometimes it is not ethical to do a placebo-based trial. If we are withholding a form of medical intervention from someone just to prove that the next best thing will be the next best thing, that is not ethically right, because we are withholding medical care when someone needs it. That is very different from a healthy patient model, in which we are treating healthy patients to see if there is a biological change that would be harmful to all patients.

All too often, healthcare for the trans community is marked by lengthy wait lists, inconsistent treatment and discrimination—we have heard some of that stigma today—and there needs to be a concerted effort to change that. We have heard a lot about safeguarding children, and I think everyone in the Chamber agrees that that must be paramount, but I fear we are dividing trans children from other children when it comes to their medical needs and what support should be in place.

I am pleased that my right hon. Friend the Secretary of State for Health and Social Care confirmed yesterday that the Pathways trial will go ahead. We have heard many Members mention that young people getting better is a way through this, but that is very stigmatising for those who do hold on to their trans identity into adulthood. In fact, very many—the majority—of young trans people will go on to be trans adults, and we also know that those who detransition do in some instances retransition, because they detransitioned for the social reasons of not having a supportive family and other social pressures. This is not as static as some may think, and in fact young people often raise that fluidity with me.

Young trans people need this trial to move forward. For many, this represents the only legal route to access puberty suppressants at the moment. A pathway can be profoundly impactful, and we have heard people describe it as lifesaving. This has not fallen from the sky. There are well-established scientific and clinical precedents for the use of puberty-suppressing hormones, supported by decades of research and medical practice, and for a variety of different conditions. Even fertility clinics use these drugs in some of their regimes with certain patients. As I have mentioned, placebos are not the solution to making this a safer trial.

Puberty-suppressing hormones are not new and they are not experimental. They have been used safely since the 1980s, and we have decades of clinical experience of supporting their use in controlled settings. But instead of engaging seriously with the potential benefits of such a trial, the Opposition have framed the issue as part of a broader culture war that is trying to erase trans children’s identities. By removing healthcare, we are not going to remove trans children; they will look for alternative access to treatments, including, as we have heard, starving themselves to prevent puberty starting. That is horrific to hear—as someone who has been very active on eating disorders, that is really quite terrifying.

We should be focused on ensuring that the voices of those people who will be most impacted—the young people and their families—are part of the discussion. The way in which the trial has been put together is of course not perfect—no medical trial is perfect—but it is really, really important, and the risk of harm from not going ahead with the trial has to outweigh the risk of harm from doing the trial. We need the data and the understanding, so we can make the right decisions when designing the clinical interventions and services that should be available to young people. Anyone who is denying that should think again about why they are making that argument. This issue is not about whether trans young people exist; it is about whether we choose to respond with the real—

[Madam Deputy Speaker (Ms Nusrat Ghani)]

Order. I call Carla Lockhart.

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[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.