On 28 April 2025, several hate groups—including Sex Matters, LGB Alliance, Transgender Trend, and Genspect—sent a joint letter to Sir James Mackey, CEO of NHS England, demanding the cancellation of the upcoming puberty blocker trial. Disguised as a concern for ethics and legality, the letter is in fact a calculated attempt to obstruct medically necessary care for transgender youth.
The letter grossly misrepresents the recent Supreme Court judgment in For Women Scotland v Scottish Ministers. While the Court stated that, in some legal contexts, the term “sex” in the Equality Act 2010 refers to biological sex, it did not mandate the exclusion of transgender people from single-sex services. Despite this, the Equality and Human Rights Commission (EHRC) issued interim guidance that encourages a requires the exclusion of transgender individuals from such spaces, an approach which significantly oversteps the legal ruling and is not backed by any statutory change to the Equality Act.
The Equality Act 2010 remains in force and unamended. It still provides protections for transgender individuals under the characteristic of gender reassignment. Trans people can legally access single-sex spaces where it is proportionate and justified, based on actual context, not blanket policies. The EHRC’s interim guidance seeks to undermine this balance, creating a chilling effect on trans inclusion through guidance that misrepresents existing legal standards.
The letter then asserts that gender-affirming care for trans youth, specifically puberty blockers, is now “untenable,” claiming that if trans individuals cannot access single-sex spaces, then there is no justification for medical intervention. This is both legally and ethically flawed. Puberty blockers are not administered to guarantee social access but to mitigate clinically significant distress caused by gender dysphoria. Their purpose is to provide young people with time and space to understand their identity without the irreversible physical changes of puberty.
The scientific consensus on this matter is clear. Studies have consistently shown that puberty blockers can improve mental health outcomes. A 2020 study published in Paediatrics found that access to puberty blockers was associated with significantly reduced rates of suicidal ideation. A 2023 study in The Lancet Child & Adolescent Health reported improvements in psychological functioning for young people undergoing treatment. These are not fringe findings, they reflect the current understanding of best practice in paediatric transgender healthcare.
What is most concerning is that these organisations are not neutral observers of medical ethics. They are lobbying groups with openly hostile positions towards trans rights. Sex Matters has repeatedly pushed for legal definitions and policies that erase transgender identities. The LGB Alliance has focused substantial energy on undermining trans equality under the guise of protecting same-sex attraction. Transgender Trend and Genspect have both distributed misinformation, including to schools and media outlets, aimed at discrediting gender-affirming care.
Allowing these organisations to influence NHS policy is a dereliction of public duty. Their agenda is incompatible with the NHS’s commitment to evidence-based, inclusive healthcare. Moreover, their actions may place the UK in breach of international human rights obligations. Article 24 of the UN Convention on the Rights of the Child guarantees the right to the highest attainable standard of health. The World Health Organisation and the Council of Europe have repeatedly affirmed the rights of transgender individuals to appropriate medical care and legal recognition.
The letter’s final call—to halt the puberty blocker trial altogether—is not an ethical position. It is a transphobic demand to remove life-saving care from a vulnerable group of young people. These organisations are attempting to use the judiciary and regulatory bodies to override both medical consensus and the lived realities of trans youth.
This is not safeguarding. It is not rights-based advocacy. It is a deliberate campaign to undermine the autonomy, dignity, and health of transgender children in the UK.
Trans young people deserve evidence-based care. They deserve protection from ideologically motivated interference. NHS England must proceed with the puberty blocker trial, guided by science, law, and compassion, not the manufactured moral panic of lobby groups seeking to erase trans lives under the banner of charity.