Blocking the Puberty Blocker Study
The Director of Genspect UK on campaigning to stop the NHS puberty blocker study
When I first set about writing the puberty blocker report, I was advised not to bother – apparently, it would never get past an ethical review. However, having spent significant time analysing unregulated or ethically questionable studies in gender medicine, I wasn’t convinced.
The field is littered with questionable studies inappropriately granted ethical approval. One such example is the first study of puberty blockers from the Netherlands, where one child died as a consequence of vaginoplasty. Following blocked puberty during adolescence, the participant did not have sufficient tissue for a conventional vaginoplasty and subsequently developed post-surgery necrosis. A 2023 update on the first puberty blocker study reported that:
“Out of 30 patients potentially eligible to participate in a 17-year follow-up study, four had declined to participate, two had detransitioned, one who had not detransitioned expressed serious regrets about vaginoplasty, and two had ‘passed away.’ Only at the end of the presentation did the researchers admit that the two patients who had ‘passed away’ had in fact died by suicide.”
The failure of ethical review boards to prevent such unethical studies underscores the necessity of independent scrutiny, so I set about examining the NHS-proposed study. I distinctly remember feeling a sense of alarm when I realised that the study was uncapped and that several thousand young people were expected to participate. My alarm turned to panic as it became clear that the study would not exclude individuals with co-morbidities such as ASD or ADHD, the cohort most likely to experience regret and discontinue treatment. The study raised serious ethical and methodological problems. In fact, on closer examination, it looked like a handy loophole introduced to circumvent the UK’s ban on puberty blockers.
Genspect UK’s Campaign Against the Study
Genspect UK released our report on the puberty blocker study in early December and launched our campaign to stop it with a letter to the Health Secretary and a call to action. We conducted extensive advocacy efforts, briefing policy makers and engaging with the public to give people the confidence to challenge this proposed study. Determined to halt it, we worked diligently to expose its flaws.
Genspect’s position is clear: there is already sufficient research to show that this is a failed medical intervention. Further studies are unnecessary.
As Carl Sagan succinctly put it, “Extraordinary claims require extraordinary evidence.” The burden of proof does not lie with those questioning these interventions; rather, it is the responsibility of the clinicians advocating for medicalisation to produce compelling evidence of its necessity and efficacy. Bertrand Russell famously argued that if someone were to claim that a china teapot orbits the Sun between Earth and Mars but is too small to detect, the burden of proof would remain on the claimant, not on others to disprove it:
“If I were to suggest that between the Earth and Mars there is a china teapot revolving about the sun in an elliptical orbit, nobody would be able to disprove my assertion provided I were careful to add that the teapot is too small to be revealed even by our most powerful telescopes. But if I were to go on to say that, since my assertion cannot be disproved, it is intolerable presumption on the part of human reason to doubt it, I should rightly be thought to be talking nonsense.”
Likewise, it is nonsense for promoters of the medicalisation of children’s identities to suggest that there is any good reason to block an adolescent’s sexual development. It is time to stop looking for Russell’s intergalactic teapot. Conducting additional studies on this failed medical intervention serves only to legitimise these treatments.
Suppressing adolescent sexual development raises such profound ethical concerns that it could only be justified in the case of life-threatening illness. This criterion does not apply to a diagnosis of gender dysphoria. Contrary to the disinformation spread by Mermaids and GIDS, the risk of suicide among gender-dysphoric young people is not disproportionately high compared to other vulnerable youth. Thus, there was never a legitimate justification for initiating trials on puberty blockers in the first place.
With all that in mind, Genspect held a webinar about the puberty blocker study in late January featuring Professor Michael Biggs, whose work was instrumental in exposing GIDS at the Tavistock; Sue Evans, the first whistleblower at GIDS; and Dr Louise Irvine, chair of Can-SG. We facilitated a detailed discussion, highlighting the ethical concerns surrounding puberty suppression in adolescents.
Legal Challenge Launched
We welcome the legal challenge initiated by Keira Bell and James Esses to prevent this flawed study. We are also honoured that our work has contributed significantly to this case. Our puberty blocker report stated that:
“In particular, the data linkage study, which aims to track long-term outcomes of patients who have transitioned from child to adult services, may yield results that mitigate against a further study into puberty blockers.”
This argument was cited in the legal letter before action:
“We note the data linkage study recommended by the Cass Review may yield results that mitigate against a further study into puberty blockers.”
Our report also highlighted how Cass (2024, p.153) noted:
“There was no indication across the studies of adverse or negative effects.”
Additionally, we observed that:
“A comfortable majority of the studies reviewed by the University of York found ‘significant improvements’ from psychological and psychosocial treatments.”
The legal letter similarly states:
“The systematic reviews conducted by the University of York show that less invasive, psychotherapeutic interventions are associated with no negative side effects and with improvements in mental health in a comfortable majority of gender-distressed patients.”
We further emphasised in our report that:
“Non-medicalised interventions represent the safest and most promising area of research for treatment of gender-related distress.”
The legal letter reinforced this position, stating:
“The evidence suggests that psychological interventions are the safest and most promising avenue for future research.”
Our report also stated:
“It [the puberty blocker trial] must explain how it will recruit an adequate number of participants, given that puberty blocker treatment would be contraindicated for the majority of patients on the current waiting list.”
The legal letter concurred:
“A sufficient number of participants would be required to power sufficiently the study, yet puberty blocker treatment is likely to be contraindicated for the majority of patients on the current waiting list.”
Finally, our report concluded that:
“Only male patients at Tanner Stage 3 or below, with a documented history of early-childhood-onset gender dysphoria, and who are capable of giving informed consent to the possibility of future surgical complications, should be eligible to participate in the puberty blocker study.”
The legal letter echoed this requirement:
“We consider that in order to have any chance of being compliant with the findings of the Cass Review, the study would have to be restricted to male patients at Tanner Stage 3 or below with a documented history of early-childhood-onset gender dysphoria.”
Fighting Medical Harm
As a movement, we are increasingly effective in collaborating, employing forensic analysis and rigorous research to challenge harmful medical interventions imposed on children and vulnerable adults.
Genspect maintains that the burden of proof lies with those advocating for medical interventions for gender distress. Ethical healthcare must prioritise evidence-based, non-invasive approaches over unproven and potentially harmful treatments.