New Puberty Blocker trial important but unlikely to provide the answers we need
By Dr Aidan Kelly
News about the NHS allocating £10m in funding for a Puberty Blocker trial is welcome and long overdue. However, it's hard to see how any of the evidence produced from this study will directly address many of the concerns that were raised in the Cass Review.
The section on the PATHWAYS Trial contains no mention of a control group and in effect sounds similar in content to the Carmichael research carried out in 2021, albeit on a bigger scale. PATHWAYS Horizon sounds similar to the preexisting LOGIC study, currently being conducted by the Tavistock and Portman Clinic. This is a prospective study of those who were and (mostly) were not able to access medical care.
To my mind, the interesting thing here is that, despite the time taken to carry out the Cass Review and the subsequent time spent on developing this research initiative, the same problems continue to exist.
The most eminent minds in their respective research fields - although notably nobody with a track record of research in transgender healthcare - are unable to provide a solution to the reality that this is an area of healthcare that is highly complex and in which it is difficult to conduct research and indeed to work.
As the saying goes, beware of false prophets. This study will not (and can not) address the real issue in this field, which is whether we as a society can accept that trans identities are an ordinary part of the human condition and that some transgender young people will benefit from accessing treatments to change their bodies to be more in line with their gender identity.
It goes without saying that we need to exercise caution and care when thinking about ANY medical treatments for young people, but that decision is best left to the treating clinicians, the young person in question and their parents.
There is already enough practice-based evidence for experts in the field to know that most youth, appropriately assessed, can benefit from this treatment pathway.
