Puberty Suppressants
3. What discussions he has had with King’s College London on the compliance of the PATHWAYS puberty blocker trial with the Medicines for Human Use (Clinical Trials) Regulations 2004.
The PATHWAYS trial has undergone a thorough independent review and has received all the regulatory and ethical approvals. The sponsors of the study, King’s College London and South London and Maudsley NHS foundation trust, are working to ensure that it is conducted in compliance with the relevant regulations.
The United States Department of Health and Human Services’ peer-reviewed report found that harms from paediatric medical transition are significant, long term and too often ignored and inadequately tracked, as testified by Keira Bell, who is here in Parliament today. What is the Government’s rationale behind medicalising yet more vulnerable children, given that we have no evidence of any benefit to this approach and, in fact, plenty of evidence of harm?
As the hon. Lady knows, the Government are acting on the recommendations of the excellent report from Hilary Cass, which I think she would agree is world-leading evidence, and moving the model away from medical intervention towards a more holistic approach to care. The Government will continue to be guided by that evidence, as the whole House will appreciate. The hon. Lady referenced Keira Bell, and I know that my hon. Friend the Member for Birmingham Edgbaston (Preet Kaur Gill) has asked the Secretary of State to meet clinicians and others who disagree with the trial. That meeting is being arranged, and we will continue to work under the guidelines for clinical evidence.
I remind the House that puberty blockers are still prescribed to young people who are not trans; I do not see some of my colleagues who are so exercised when puberty blockers are given to young trans people expressing the same concerns for their cisgender peers. Even Dr Cass herself acknowledged that puberty blockers are effective for some young trans people and recommended against a blanket ban. While the trial is ongoing, can the Minister outline what steps the Department is taking to increase funding and capacity for children and young people’s gender services to address the unacceptably long waiting times, which continue to cause enormous harm?
We need to be very careful about our language, in line with Dr Cass’s report. We are talking about children who are presenting with gender dysphoria and in gender distress. The Government support moving away from the medical intervention model towards a holistic approach to care based on the evidence, and that has cross-party support more generally, although I am not entirely sure of the position of the Liberal Democrats on supporting it. That is the model with which we are progressing. On the wider issues with regard to support for children and young people, particularly as they present across the board, this Government are investing much more than anyone else has indicated that they would in support for all services.
Part of the trial is to ask the child participants the Avon longitudinal study of parents and carers romantic relationships questionnaire. Is the Minister as concerned as I am that children under the age of 13 will be asked sexually explicit questions?
I think all Members across the House are concerned about the distress with which young people are coming forward for all of these services, and the need to support them and their families. Again, it is important that all parts of this trial follow clear ethical and clinical guidelines.
The Government were right to bring in the indefinite ban on puberty blockers due to concerns over the past 15 years about the gender services treatment that was being given. Over that time, 2,000 children who were questioning their gender identity have been given puberty blockers, so could the Minister explain why we are not following up on their long-term outcomes before we administer these powerful drugs to 200 more children?
I thank my hon. Friend for his question and his constructive work in this area on behalf of young people. I think there is a further question on this topic on the Order Paper. The Government are looking at how we can best use the data linkage study from that previous work. As I think hon. Members understand, that data was collected for different purposes—it is not of the quality that might be needed for this review—but we will continue to use all the evidence that is available, both in this country and in others, in line with the best clinical practice and under the guidance that Dr Hilary Cass prescribed in her review.
I call the shadow Minister.
The Secretary of State has previously said that he accepts all the recommendations in the Cass review. One such recommendation is that the Secretary of State mandate the release of data for the data linkage study. Can the Minister tell us what specific steps have been taken to mandate the release of that data?
We absolutely stand by that work, and we are working with NHS England to make sure it is mandated to do exactly that.