Wes Streeting pushes ahead with NHS puberty blockers clinical trial as high court rules ban lawful

The Labour health secretary has said the NHS will push forward with a clinical trial to establish evidence on puberty blockers, after the High Court ruled an emergency ban on them was lawful.

On Monday, Mrs Justice Lang dismissed the challenges, which had argued that an emergency ban on puberty blockers made by the previous Conservative government was unlawful.

Campaign group TransActual, and a young person who cannot be named for legal reasons, made a bid to challenge the decision of then-health secretary Victoria Atkins on the medicines, which suppress the natural production of sex hormones to delay puberty.

Health and social care secretary Wes Streeting welcomed the ruling, adding “children’s healthcare must be evidence led”.

He continued: “Dr Cass’s review found there was insufficient evidence that puberty blockers are safe and effective for children with gender dysphoria and gender incongruence.

“We must therefore act cautiously and with care when it comes to this vulnerable group of young people.

“I am working with NHS England to improve children’s gender identity services, and to setting up a clinical trial to establish the evidence on puberty blockers.

“I want trans people in our country to feel safe, accepted, and able to live with freedom and dignity.”

open image in gallery

The Cass Review, commissioned by NHS England and published in April, concluded that gender care is currently an area of “remarkably weak evidence” and young people have been caught up in a “stormy social discourse”.

Research by the University of York, carried out alongside the report, found evidence to be severely lacking on the impact of puberty blockers and hormone treatments, while the majority of clinical guidelines were found not to have followed international standards.

In her 62-page ruling, Mrs Justice Lang wrote: “This decision required a complex and multi-factored predictive assessment, involving the application of clinical judgment and the weighing of competing risks and dangers, with which the court should be slow to interfere.”

She added: “In my judgment, the Cass Review’s findings about the very substantial risks and very narrow benefits associated with the use of puberty blockers, and the recommendation that in future the NHS prescribing of puberty blockers to children and young people should only take place in a clinical trial, and not routinely, amounted to powerful scientific evidence in support of restrictions on the supply of puberty blockers on the grounds that they were potentially harmful.

“Although the Cass Review did not state in terms that puberty blockers cause ‘a serious danger to health’, that was not the question that the Cass Review was asked to consider.

“That was a matter for the defendants to determine on all the evidence before them. It would have been premature to do so before the final report had been published.”

open image in gallery

At a hearing on 12 July, the High Court in London heard the secondary legislation prevents the prescription of the medication by European or private prescribers and restricts NHS provision to their use within clinical trials.

Lawyers for the group and young person had argued that the order made by the previous government on 29 May was unlawful.

The Department of Health and Social Care (DHSC) and the Department of Health in Northern Ireland defended the claim.

The emergency ban was set to last from 3 June to 3 September 2024, according to the previous Conservative government. The court heard that it might be made permanent by Labour ministers.

The ban currently applies to gonadotropin-releasing hormone analogues - medicines that consist of, or contain, buserelin, gonadorelin, goserelin, leuprorelin acetate, nafarelin or triptorelin.

TransActual’s director for healthcare, Chay Brown, said after the decision: “This is a disappointing result. Defence evidence makes clear that they decided on an emergency ban first and sought ways to justify it second.”

He continued: “We are seriously concerned about the safety and welfare of young trans people in the UK.

“Over the last few years, they have come to view the UK medical establishment as paying lip service to their needs; and all too happy to weaponise their very existence in pursuit of a now discredited culture war.

“It is essential that NHS England and the Department of Health and Social Care now take urgent steps to reverse this perception.”