Keira Bell argues that she was harmed by puberty blockers as a teenager
LUCY YOUNG FOR THE TIMES
The field of gender medicine, bogged in controversy over recent years, is one where high emotion and vociferous assertions dictated terms for far too long. Frequently, they silenced vital questions about potential harms from recklessly prescribed treatments.
Medical interventions such as puberty-blockers were promoted on the basis that they pressed a “pause button” in sexual development while unhappy children decided their future. In reality, their prescription signalled a virtual certainty that a child would go on to take cross-sex hormones, as the overwhelming majority of young people who started on them did.
Often — though not exclusively — the young people expressing the strongest wish to change gender have been same-sex attracted, autistic, or with a troubled family history. Parents have found themselves navigating a nightmarish path through a Wild West of treatments with their children.
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In one family court case reported recently by The Times, a father described his distress when his 15-year-old daughter was prescribed a dangerously high dose of testosterone by the online service GenderGP, which an independent expert, an endocrinologist, said had placed the child at risk of sudden death. His daughter, who had autism and previous anorexia, is now estranged from him: in the last update he was allowed to receive, it appeared she was scheduled for surgery.
It was on such troubled territory that Baroness Cass, a distinguished paediatrician, led a courageous review which resulted in the NHS banning the use of puberty blockers last year. Her findings in April 2024 demolished much of the case for what had become widespread practice.
A form of global consensus had sprung up, she said, based on a single Dutch study which suggested improved psychological health for a narrowly defined group of children on the drugs. This had led some practitioners to abandon the “normal clinical approaches”, such as counselling, which would usually apply to children in psychological distress. In fact, the report said, gender medicine was an area “of remarkably weak evidence”.
Dr Cass later said puberty blockers were “powerful drugs with unproven benefits and significant risks”. Among those risks are dangers for bone density, neurodevelopment and — when they lead on to cross-sex hormones — fertility.
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On the strength of her statement, it is difficult to understand the logic of her parallel recommendation for further trials on puberty blockers. Yet one is now scheduled to begin next month in King’s College London, and will recruit about 226 children over three years: the youngest participants could be 10 to 11 for girls and 11 to 12 for boys.
Campaigners argue that it is impossible to run such a clinical trial ethically and have begun a legal process to have it suspended. One campaigner, Keira Bell, compellingly argues that she was harmed by puberty blockers as a teenager, and asks a pertinent question: “Why aren’t we doing follow-ups with people like me?”
In fact the Cass Review had tried to do just that, seeking to follow up with about 9,000 people who had been referred to the youth gender clinic. But the majority of NHS adult gender services refused to co-operate with the necessary data sharing.
Today’s children should not be put at fresh risk to provide an evidence base which could, and should, have been achieved by other means. It is time to halt this confused and indefensible trial.