Streeting defends puberty blocker trial amid calls to halt study

Health Secretary Wes Streeting defended proceeding with the PATHWAYS trial of puberty-blocking drugs for gender-questioning children, saying his decision was guided by clinical advice even as he acknowledged personal discomfort with the treatment. The trial, due to start in January, will involve about 226 young people aged 10 to almost 16 who are being seen at gender clinics in England, with close monitoring of physical and mental health and a careful consent process involving both children and their parents.

Blockers that delay puberty are not routinely prescribed on the NHS for gender dysphoria outside clinical trials; their use remains tightly regulated with the consent of devolved governments across the UK. The PATHWAYS study comes after the Cass Review concluded that existing research claiming benefits from puberty blockers in youngsters with gender dysphoria was of poor quality and recommended more robust investigation. Streeting has repeatedly said he would rather see rigorous evidence than rely on uncertain data, while insisting patient safety and informed consent are paramount.

The health secretary’s stance drew sharp pushback from Conservative MPs and some clinicians. Dr Caroline Johnson, a Conservative shadow health minister and consultant paediatrician, described the trial as Streeting's trial and told MPs that the majority of children in the study are being unnecessarily subjected to risky medications under his leadership. She questioned why the government would fund experiments on physically healthy children when Streeting has said he is uncomfortable about the drugs’ use in this population. Streeting, in reply, said he was guided by clinical advice and his duty to follow expert guidance, adding that his discomfort did not override the responsibility to advance care in line with expert recommendations.

Support for the trial also came from other quarters. Labour MPs argued that meeting the health needs of young trans people requires evidence-based care, with some saying clinical trials are the safest way to manage potential risks. Danny Beales, a Labour MP, noted that young people seek care and may turn to unregulated providers if care is inaccessible, stressing that a clinical trial represents the best path to ensure safety and oversight. Preet Kaur Gill, another Labour member and former children's services manager, urged Streeting to engage more directly with clinicians and researchers amid safeguarding concerns voiced by colleagues and families alike. Streeting later told MPs that he was absolutely open to receiving representations and evidence from clinicians involved in the care of children and young people, including critics of the plan, and he reiterated that no child would participate without parental consent.

Streeting has described the decision as one he wrestles with daily. In parliamentary appearances, he has emphasized that the trial's design includes close monitoring of bone density and brain development, with a careful consent process that involves both children and their parents. He has also noted that the plan adheres to the Cass Review's recommendations, which he said were commissioned by his Conservative predecessor, Sir Sajid Javid. The broader policy debate continues in Parliament, where supporters say clinics should be able to gather robust evidence on treatments used for gender dysphoria in youth, and opponents warn of potential harms to developing brains and fertility and question whether children can truly consent to such interventions.