Puberty Blockers

Stephen Kinnock Excerpts

Tuesday 23rd June 2026 Commons Chamber

[The Minister for Care (Stephen Kinnock)]

I would like to start by declaring an interest, because my son Milo, of whom I am extremely proud, is a trans man.

I have listened to colleagues very carefully over the course of our proceedings. There have been some truly heartfelt speeches, and this strength of feeling is certainly warranted wherever children are concerned. The Government welcome this scrutiny, and I want to thank Members from all sides of the House for the constructive tone and substance of this debate.

I am not the Minister who is responsible for leading on this policy in the Department for Health and Social Care. Nevertheless, I feel a great deal of responsibility for the health and wellbeing of children in our country. As the Minister of State for Care, I am, for example, responsible for making sure children at end of life are receiving the right palliative and end-of-life care. And tooth decay, for example, has an appalling effect on children’s wellbeing. When it comes to gender incongruence, I cannot help but think of those children suffering in great distress, who may even be watching our proceedings this evening, and I want them to know that all of us in this Chamber want what is best for them. We might disagree about how we get there, but I do not doubt the sincerity of anyone who has spoken today.

Fundamentally, our approach on this side of the House is to be led by the evidence, and on this I pay tribute to Dr Hilary Cass, who has taken on one of the most sensitive and polarising issues of our times with such courage and professionalism.

The shadow Minister, the hon. Member for Sleaford and North Hykeham (Dr Johnson)—I hugely respect her expertise as a paediatrician—has said that our decisions could be motivated by “fear and hostility”, but that is not a charge that anyone could level at Dr Cass, who has shown the utmost courage and professionalism from the moment that she was appointed. It was on the strength of her independence and integrity that the previous Conservative Government, of which the hon. Lady was of course a member, accepted her recommendations. One of those recommendations was for a regulated, robustly safeguarded trial. Yesterday, Dr Cass said that she is

“absolutely convinced that more children will be harmed if we don’t do the trial than if we do.”

[Alex Sobel (Leeds Central and Headingley) (Lab/Co-op)]

I commend the Minister on an excellent and brave speech. When the Cass report came out, I was criticised for not accepting it in full, and now the very same people who said that to me are not accepting the Cass report in full. Does he agree that that is hypocrisy, and that those people should stick to their word?

[Stephen Kinnock]

I know that feelings on these matters are strong and heartfelt. If the Conservative party has changed its position and is putting forward its arguments with sincerity and honour, that is a perfectly acceptable position to take, but I simply remind the House of the journey that the party has been on.

[Rebecca Paul]

The Cass review also suggested a clinical trial for cross-sex hormones. On that basis, will the Government launch a clinical trial on cross-sex hormones as well?

--- 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.

[Esther McVey]

I have been listening to the debate and have not yet heard what the Government will deem to be a measure of success of this puberty blocker trial before it goes ahead. What are the criteria, the measurements, the percentages and the numbers, and what are the timelines over which they will be measured? Can the Minister explain what those are? If someone is unhappy, can they sue the Government?

[Stephen Kinnock]

As the right hon. Lady will know, a lot of this is about the distress and the tremendous mental health pressure that young people going through gender incongruence feel. Clearly, one of the outcomes that we will look for from the trials is an alleviation and an amelioration of those significant mental health issues and distress. Those are the kind of outcomes we want to see to help some of those young people who often end up in awful situations, leading to self-harm and other terrible situations.

Some colleagues have asked about the wider support we are providing for children and young people with gender dysphoria and incongruence. I am pleased that the Pathways study is just one part of the wider work being done to ensure that the support is there. For example, Pathways Horizon is an observational study of all children and young people attending NHS children and young people’s specialist gender services. Pathways Connect is a brain imaging study, Pathways Voices will interview young people, and Horizon Intensive is about ensuring that there is a comparison group of 300 participants who are expressing gender incongruence.

Furthermore, NHS England has opened three new children and young people’s gender services in the north-west, London and Bristol, with a fourth planned for the east of England this year. I can confirm that the Government aim to have a service in every region of England in the coming years. These services use a different model with multidisciplinary teams, including mental health support and paediatrics, within specialist children’s hospitals to provide holistic care. The new services will increase clinical capacity and reduce waiting times so patients can be seen sooner and closer to home.

I can update the House that waiting lists for children and young people’s gender services have come down since this Government took office. As of April, nearly 3,000 fewer children and young people were on the waiting list compared with September 2024.

This Government stand by the principle that we will always be led by clinical advice and clinical evidence, but that does not mean we take these decisions lightly, and it does not mean that we are abdicating our responsibilities either. My right hon. Friend the Secretary of State has requested monthly updates on the progress of the trial, including any emerging risks. Throughout this process, he has immersed himself in the detail, scrutinised the issue and sought the strongest assurances from his most senior clinical advisers. We have received those assurances and are proceeding on the basis of evidence, not ideology.

I end with regret that it appears that the cross-party consensus on Dr Cass’s expert review has been lost, but also with hope that colleagues can get behind Dr Cass’s work again. We will move forward on the basis of taking decisions based on the expertise of clinical and medical professionals, and acting within clearly defined safeguards and robust oversight, including in this House, to provide the best quality of healthcare and support for all children and young people to access what they need.

On one level, this is a specific debate about a specific issue, but when we zoom out, we see that it goes to the heart of what our NHS is about, which is how best to do the greatest possible good for the greatest possible number of people. When we look at this through that basic ethical prism, there can be no doubt that this Government’s position is the right one. A small cohort of vulnerable children are struggling, and it is our job to help them—it really is as simple as that. I therefore urge colleagues to oppose the Opposition’s motion.

Question put.