UK Clinical Trials to Investigate Puberty Blockers' Impact on Young People with Gender Incongruence
The UK's National Health Service (NHS) has announced two clinical trials aimed at assessing the impact of puberty blockers on young people experiencing gender incongruence. The studies, part of a broader "Pathways" programme, will investigate the effects of these medications in children and adolescents.
Two distinct trials are currently underway. The first trial, Pathways Trial, is expected to recruit 226 participants over three years, with the youngest participants aged between 10-11 for biological females and 11-12 for biological males. Participants will be randomized into two groups: one that starts puberty blockers immediately, while the other group waits a year before beginning treatment.
The trials' objectives include monitoring participants' health, wellbeing, and development over 24 months, as well as examining their ongoing care needs. Results from these studies will be compared to those of young people with gender incongruence who do not receive puberty blockers.
Concerns have been raised about the ethics of these trials by advocacy groups, including TransActual. Chay Brown described them as "coercive in nature," stating that some participants may experience distressing pubertal changes while waiting for treatment. Emily Simonoff, a professor of child and adolescent psychiatry at King's College London, acknowledged that new medications often become available only through clinical trials, but noted the importance of conducting such studies.
The UK's 2024 Cass review of NHS gender identity services found insufficient evidence on the effects of puberty suppression on psychological wellbeing, cognitive development, and fertility. In response, NHS England announced in 2023 that children with gender dysphoria would no longer receive puberty blockers as routine practice, limiting their use to research settings.
The long-term implications of these trials remain uncertain, but they are expected to provide valuable insights into the impact of puberty blockers on young people's lives.
The UK's National Health Service (NHS) has announced two clinical trials aimed at assessing the impact of puberty blockers on young people experiencing gender incongruence. The studies, part of a broader "Pathways" programme, will investigate the effects of these medications in children and adolescents.
Two distinct trials are currently underway. The first trial, Pathways Trial, is expected to recruit 226 participants over three years, with the youngest participants aged between 10-11 for biological females and 11-12 for biological males. Participants will be randomized into two groups: one that starts puberty blockers immediately, while the other group waits a year before beginning treatment.
The trials' objectives include monitoring participants' health, wellbeing, and development over 24 months, as well as examining their ongoing care needs. Results from these studies will be compared to those of young people with gender incongruence who do not receive puberty blockers.
Concerns have been raised about the ethics of these trials by advocacy groups, including TransActual. Chay Brown described them as "coercive in nature," stating that some participants may experience distressing pubertal changes while waiting for treatment. Emily Simonoff, a professor of child and adolescent psychiatry at King's College London, acknowledged that new medications often become available only through clinical trials, but noted the importance of conducting such studies.
The UK's 2024 Cass review of NHS gender identity services found insufficient evidence on the effects of puberty suppression on psychological wellbeing, cognitive development, and fertility. In response, NHS England announced in 2023 that children with gender dysphoria would no longer receive puberty blockers as routine practice, limiting their use to research settings.
The long-term implications of these trials remain uncertain, but they are expected to provide valuable insights into the impact of puberty blockers on young people's lives.
just another layer added to this complex issue... these kids already feeling lost and unsure about themselves, now they gotta wait a whole year to get some treatment that might help? 
it's like putting off the inevitable... i'm all for doing more research, but shouldn't we be trying to find ways to support them sooner?
. It's crazy how fast this field is evolving and, honestly, I feel kinda uneasy about these trials... Not because I think they're a bad idea, but 'cause I worry that some of the young folks taking part won't fully understand what they're getting into. Like, have they been properly informed about the potential risks and benefits? 
The Cass review highlighted some pretty significant gaps in our understanding - like how these blockers might affect fertility or cognitive development long-term. We need more research to get it right 
I mean, can't we just listen to their stories and provide them with the care they need? These trials are basically saying that if you're trans or non-binary, you gotta go through this awkward phase of puberty blockers and then we'll see how it turns out... 
I'm so worried about those kids going through this, you know? Being told to wait a year before getting help just feels like so much pain and uncertainty 
It's like, we gotta make sure those kids are safe and supported throughout this whole process 
. And what about the long-term effects we don't know about yet? It's like we're taking two steps forward and one step back 
And what's with the two-year wait period before they even start treatment? That seems like a pretty big gamble. I mean, I get that we need more research, but don't we want to make sure these meds are safe first? 
. Like, what if they experience some super distressing stuff during puberty and have no meds to help them through it? Its not like its a guarantee that the trial will be good for them 
. And I feel bad for the parents who are gonna have to deal with their kid's feelings and emotions throughout this whole process 
. And what about the emotional toll of waiting for treatment? Chay Brown's point about distressing pubertal changes is a big one 
It feels like we need to be thinking about the bigger picture here, not just the science 
.
. Maybe these trials will give us some much-needed answers 
.
And then there's this whole "coercive in nature" thing... what about all the kids who just wanna try puberty blockers already? They're already stressing out 'cause their bodies are literally telling them they don't fit in. Do we really need to make 'em wait a year or more for treatment? 
It's like, we should be supporting these kids on their journey, not putting 'em through puberty-induced anxiety. 
. They're basically putting kids through puberty without being 100% sure if it's even helping them in the long run... like what's the rush? we should be prioritizing their well-being and safety over trying to "investigate" new meds 
The NHS is trying to do good, but sometimes I worry they're playing catch-up instead of thinking things through 
. And those concerns from TransActual... yeah, that does sound a bit coercive 
From my perspective as a neutral observer 
. It's not easy to navigate the world when you feel like you don't quite fit in 
.
. It's all about finding that balance between helping people feel safe and respecting their autonomy 
and consider new perspectives 
and what doesn't 
for young people struggling with gender incongruence 
!