Puberty Blocker ban: “Risk NHSE will violate human rights”

NHS Lanyard, with two vials of Triptorelin a gonadotropin-releasing hormone (GnRH) agonists (Puberty Blocker), with a syringe and needle
Triptorelin a gonadotropin-releasing hormone (GnRH) agonist (Puberty Blocker)

The Women and Equalities heard evidence for the use of puberty blockers and it’s crystal clear, a generation is being needlessly harmed.

On the 22nd of January, The Women and Equalities Committee had a session on the “Evidence of the safety and efficiency of Puberty Blockers”. During which, Bioethics Professor Simona Giordano, WPATH Ethics Committee member, discredited arguments of potential medical and ethical concerns that drove the internationally rejected Cass Review, and the people who abused it, to shape the climate of gender-affirming care for children and young people into the abhorrent state of neglect the UK is currently experiencing.

With the help of committee members equipped with questions reflecting their commitment to understanding the details of trans healthcare and methods to better the treatment of young people. Giordano made glaringly apparent, that it is unprecedented to ban a medication not based on medical effect, but application in only one cohort especially when no new evidence of harm has been released, alongside tearing down any potential “justification” of the upcoming clinical trial on the use of puberty blockers.
Exposing the causal factors as not being backed by any evidential or medical reasoning, and in doing so, the ideological and discriminatory foundation of the “gender critical” attack on gender-affirming care.

The Unethical Clinical Trial

LibDem MP Christine Jardine asked if there are “any safety or ethical considerations in only allowing access to a medication in a research trial after it has previously been available?” a question that was likely to come up but given the current environment of institutional transphobia, it contained an element of surprise. Professor Giordano stated there are “numerous ethical issues in providing medication only within a research trial” and that in doing so “there is a risk NHSE will violate the principles contained in virtually all declarations and conventions in human rights as they apply to participation in research.”

The Helsinki Declaration was cited to state it is “the duty of the clinician to take equal care of those that participate and those who do not”. The restriction of healthcare access behind the trial “may” violate this principle. Particularly in the consideration that the “voluntary consent of the person of whatever age” has to be protected by law. In the upcoming trial however, only parental consent is required even at the age of 16 meaning healthcare access can “exclude children in care or children without supportive parents”, which risks “skewing the sample” regardless of how small this group may be. This is a situation Giordano “has not come across before”, she explained how the solution to these ethical violations, and in her tonal professionality, “peculiarities” is as simple as “providing treatment to all patients for whom the benefits are similarly favourable” and participation in the trial “on a voluntary basis.” It does not get more clear-cut than that.

In October 2024 a Council of Europe report “Right to the highest attainable standard of healthcare for LGBTI people in Europe” stated the total withdrawal of access to healthcare outside of this research trial may breach “the fundamental ethical principles of governing research.” This trial however was tarnished from the start with a blatant declaration of bias, as the deputy chief investigator is Dr Micheal Absoud who gave a conference on “Autism spectrum disorders and gender dysphoria in adolescents” at the SEGM conference in Athens last year, a declared anti-LGBTQ+ hate group that shares funding streams with Alliance Defending Freedom.

Side effects? Only if you are trans

Alongside Giordano were NHS clinicians, former Tavistock clinical lead Professor Gary Butler of Child and Adolescent Health and Professor Ashley Grossman of Endocrinology. Being NHS gender specialists it was expected to hear some misinformation fuelled speculation, with Grossman astonishingly rejecting the Endocrine Society’s guidance in claiming gender dysphoria as being “subjective”. Despite Grossman’s best efforts at projecting his fallacious understanding of gender incongruence, the pair had no choice but to reflect the evidential reality. Puberty blockers do not have any harmful or differing medical effects “when prescribed to trans people of any age.” Grossman’s primary concerns, some of which shared by Butler, boil down to therapy being required to confirm the persistence of “the transgender state” (as Grossman grossly called it). At which point the updated service specification for the new Children and Young People’s Gender Services, based on the Cass Reviews conclusions, centres “exploratory therapy”, which many have argued is a repackaged form of conversion therapy, rendering the ban on puberty blockers unjustified by their own attempt at “justifying” it. This is of course putting aside the fact that Giordano discredited those concerns.

Regarding the aforementioned lack of side effects, the Cass review and again those who abuse it, rely on a select few potential harms which for whatever reason they have decided this week only affect trans people. One of the focal arguments used to “justify” the ban on puberty blockers is the claimed potential impact on bone density. Sarah Owens ensured the room knew that this is the same as with many other medications,confirmed by all three witnesses. She followed up, asking if “steps to mitigate these concerns have been successful”, Butler firmly said there is “ no overall loss of the calcium in the bone” and that this is “all part of the routine monitoring process in children and young people services.” Butler also mentioned that as reflected in a study from Amsterdam and a soon-to-be-published UK study even in the rare cases bones are affected “bone and calcium content recovers once sex hormones are started” to which Labour MP Samantha Niblett asked, “As research is still being done does that mean we don’t know how to mitigate that risk or is there treatment we can give alongside that addresses calcium in the bones?” The response? ”Appropriate nutrition, vitamin D, and exercise.” Hardly cause for fearful concern, least of all to the point of using it as grounds for banning a medication.

Another primary argument used to support the ban on GnRH analogues is the “potential effects on the brain”. Giordano shut that argument down, “The scientists who have looked into this matter found no difference in cognitive function, executive function or IQ scores of trans young people treated with puberty blockers compared to cisgender cohorts”. Hannah Barnes seems to believe the “truth is scientists haven’t looked into it at all” and in a last-ditch effort to salvage medical basis for her ludicrous claim referenced a Sallie Baxendale review. Baxendale has worked with Transgender Trend, spoke at the 2023 SEGM conference and is published on the Clinical Advisory Network on Sex and Gender (CAN-SG)

Rosie Duffield, who according to Hannah Barnes “spent her career advocating for the marginalised” proved her knowledge extends only as far as Terf talking points and not far enough to understand a longitudinal study. She asked Butler why he continued to prescribe blockers after the release of the early interventions study, which was weaponised to suggest there are “no clear benefits” to outweigh claimed risks with the prescription of puberty blockers. Despite its conclusion, “Overall patient experience of changes on GnRHa treatment was positive.” Unsurprising it was simply Butler following the NHS service specification. Giordano illustrated the ideological motivations behind the questioning of the University of York review, as “from a clinical perspective” mental stability in patients is a positive outcome. This is something the trans community, medical professionals, academics and advocates alike have preached for years, removing healthcare access for one group when there are simply no negative or differing effects is abhorrent medical discrimination which breaches the human rights of those affected.

“Transing away the gay” or the “conveyor belt” are incredibly damaging narratives used as foundational support for hate groups like SEGM, politicians and self-proclaimed journalists to “justify” the destruction of gender-affirming care access for a generation of children and young people. The supposed “rushing” of an individual who would “otherwise have been a cisgender gay person”. Which of course appeared in Duffield’s final desperation at providing the press with rhetoric. It makes perfect sense that Hannah Barnes would omit this from her article. Professor Grossman compared it to anorexia and you could hear a faint “I was going to do that” from Duffield when Sarah Owens saw through her attempt and ensured the entire panel spoke. This naturally meant the line of questioning would quickly be suppressed as unsurprising, “The core relation between puberty blocker prescription and later transition is not causation.”

“Gender-Critical” unconscious bias

When you can’t win against facts and evidence, the last course of action for the ideologically captured journalist is to discredit those who delivered them and the reasons for why they were delivered in the first place. Amongst the most successful of journalistic tactics to achieve this is the withholding or manipulation of both information and the voices of those being reported on. The reporting on the session is the most recent reflection, the committee had the intent to “examine the medical evidence for an indefinite ban and how a research trial on puberty blockers should be set up in order for it to be safe and produce robust results.” or as Hannah Barnes put it: “Trying to undermine the Cass Review”.

The session “Seemed strange” to Hannah Barnes “given the recent four-year review into youth gender services that looked at that very question”. It is hard to overstate the damage caused by a pseudoscientific politically motivated review that has been widely discredited. Even though the likes of Duffield and Barnes sat through over two hours of expert witnesses explaining the reality of GnRH analogues and the generation being harmed by an unprecedented ban with the withholding of treatment behind an unethical clinical trial, the unconscious bias of those who dedicate their motivations to a patriarchy enforcing movement closely aligned with fascism is so intense that even the simplest of points is lost at comprehension.

It is beyond my comprehension however, that Barnes would say “All it went to show is how so many politicians have failed to engage in the detail of the debate on how best to care for gender-distressed young people and how far we are, still, from settling it”. when the reality of the situation is that is what the committee sought to do and with the help of an expert witness dedicated to the betterment of medical ethics, the very thing it achieved.

Upon reflection unconscious bias is too generous a term, the session made clear that a generation of young people are actively being harmed with the excuse of non-existent threats, and those who are facilitating this grotesque environment of hesitation and disregard are actively aware of their actions, hypocrisies, and ideological motivations. Given the international condemnation of the NHS’ “potential” ethical and human rights violations, Professor Simona Giordano was the perfect choice to clarify any uncertainties. However, as this choice ensured a voice of reason, the likes of SexMatters Maya Forstater have resorted to claiming the “WEC have no mandate” to have held the session, which as a result of the evidential destruction of her “charity’s” frequent claims, just had to be “biased and partial”. We must have been watching a different meeting, or more likely, only one side of this debate cares about medical ethics.