Summary
The Puberty Blocker Trial - despite regulatory hurdles, political controversy, and a government ban, the "Pathways" puberty blocker trial has been approved to proceed amidst a fierce culture-war debate over the clinical evidence of benefits versus harms for transgender youth.
The Puberty Blocker Trial – also known as Pathways – Children Being Used in the Culture War Against Trans People
The puberty blocker trial, known as Pathways, was given the go-ahead last week following belated attempts by the Medicines and Healthcare Products Regulatory Agency (MHRA) to put a halt to the trial.
The concerns raised by the Agency followed the appointment of Professor Jacob George as its Chief Medical and Scientific Officer. He was subsequently forced to step back from the trial due to reported suggestions of potential bias against trans people.
In a highly unusual move, the government banned the prescription of puberty blockers for trans young people who had previously been prescribed their use in order to pause pubertal development, despite objections from the British Medical Association (BMA), the Royal College of GPs and the Royal College of Psychiatrists. They remain available to young children experiencing precocious puberty, whose access to this medication has not attracted political interference or ideological commentary.
The Pathways Trial is the outcome of the recommendations of the Cass Review, which found that the evidence on the efficacy of puberty blockers for trans young people was limited. Recently, the BMA reported on its independently commissioned review of the Cass findings, concluding that, “there was limited evidence of harm of treatment”.
Moreover, the BMA raised serious concerns about the failure to assess the potential harm of withdrawing puberty blocker treatment from trans young people. It found that while some of the statements contained within the Cass Review were substantiated by the cited literature, other statements were not substantiated or were only partly substantiated.
The BMA concluded that:
“There was a tendency for statements to simplify complex findings or to emphasise potential risk without equivalent contextualisation of potential benefits”.
Importantly, the BMA also reports that the use of ‘off-licence’ drugs is common in medical practice and that “a considerable proportion of paediatric medicine is outside of the licensed indication”.
So, there was little evidence of any harm caused by puberty blockers prescribed ‘off licence’, and there was no assessment of the potential harms to children that could be caused by their withdrawal. Despite this, some political parties have sought to demand the halt of the Pathways Trial for reasons that bear no relationship to clinical evidence or protocols.
They have sought to incite the public to condemn the trial without any concern being expressed for those young people who may suffer considerably as a result. These children are being weaponised in a culture war that cares little for their developmental needs and even less for their well-being. It leaves them at the mercy of ideologically driven interference rather than evidence-based intervention.
“We have raised some concerns related to the well-being of participants, and scientific dialogue will now follow with the trial sponsor,” they added.
TransLucent supports the trial, which will once and for all establish the safety of puberty blockers together with their effectiveness for trans youth.
