← Back to House of Commons Debates
Puberty-suppressing Hormones
11 December 2024
Lead MP
Wes Streeting
Debate Type
Ministerial Statement
Tags
NHSTaxation
Other Contributors: 28
At a Glance
Wes Streeting raised concerns about puberty-suppressing hormones in the House of Commons. A government minister responded. Other MPs also contributed.
How the Debate Unfolded
MPs spoke in turn to share their views and ask questions. Here's what each person said:
Government Statement
The Minister stated the Government’s approach to puberty blockers for treating gender incongruence in children is based on evidence-led practices, ensuring safety and equality. He acknowledged the Cass review's findings that lack sufficient long-term evidence on puberty blockers' effects, leading to a temporary ban extended by emergency order until further evaluation. The Commission on Human Medicines concluded these medicines represent an 'unacceptable safety risk'. Consequently, Minister Streeting has issued an indefinite banning order for private UK and international prescribers to supply puberty blockers to under-18s.
The statement also announced the establishment of a clinical trial by NHS England and NIHR to better understand the effects of puberty-suppressing hormones on young people. The National Institute for Health and Care Research is working towards recruiting the first patients by spring 2024. Additionally, he updated progress made in transforming gender identity services per Dr Cass's recommendations, including opening three new regional NHS children and young people’s gender services with a fourth expected to open by spring. This initiative aims to improve holistic care tailored to individual needs.
Minister Streeting emphasised the Government's commitment to protecting vulnerable young trans individuals from harmful public statements, acknowledging their mental health struggles and the need for continued support. He vowed to work collaboratively with the community to ensure free, equal, and dignified healthcare.
Grahame Morris
Lab
Easington
Question
As many young people face long waiting lists to access necessary services, what measures are being taken to ensure they receive prompt and appropriate care?
Minister reply
The Government is working on establishing new regional gender identity services as per Dr Cass’s recommendations. This includes opening three centres already and aiming for full coverage by 2026. Additionally, NHS England is exploring the establishment of a follow-through service for young adults aged 17 to 25 years old who are currently on waiting lists.
Kerry McCarthy
Lab
Bristol East
Question
The Minister mentioned the need for an evidence base. What steps will be taken in the meantime to support children and young people experiencing gender incongruence?
Minister reply
Until robust evidence is established, the Government will continue to rely on expert advice from bodies like the Commission on Human Medicines. Holistic care models are being implemented across newly opened regional services, providing multidisciplinary treatment tailored to individual needs.
James Davies
Cons
Conwy
Question
How does the indefinite ban affect access to necessary healthcare for those who require puberty blockers immediately?
Minister reply
The indefinite ban prioritises safety, and clinical trials are underway to develop a robust evidence base. In cases of urgent need without adequate research, care is provided through established channels ensuring children’s wellbeing remains paramount.
Nia Griffith
Lab
Llanelli
Question
What steps will be taken to address the mental health needs of young people questioning their gender identity?
Minister reply
The Government is committed to improving mental health support through a comprehensive care model that includes timely appointments with paediatricians and mental health professionals before referrals to specialist services. This approach aims to provide holistic care addressing both physical and psychological aspects.
Edward Argar
Con
Melton and Syston
Question
Welcomes the Health Secretary's statement but has questions about the timeline for opening additional regional centres, the effectiveness of closing online loopholes in regulations, and progress on further research into patient care.
Minister reply
The Minister commits to full implementation of Dr Hilary Cass’s review recommendations. The north-west London and Bristol services are now open, with a fourth planned for spring 2025, aiming for specialist gender service coverage by 2026. He is working closely with the devolved Governments, ensuring UK-wide measures, and will keep observing loopholes to prevent any potential breaches.
Tonia Antoniazzi
Lab
Gower
Question
Welcomes the Government's approach but asks for assurances regarding robust safeguards in an upcoming trial on puberty-supressing hormones.
Minister reply
The Minister assures that the study will be established robustly, ethically and appropriately, going through all usual review stages including peer reviews, funding committee considerations, and ethical approval processes before recruitment begins in spring 2025.
Helen Morgan
LibDem
North Shropshire
Question
I thank the Secretary of State for her statement and urge rapid establishment of regional centres. I ask about steps being taken to implement these centres and request a timeline. Concerning evidence, will he publish all supporting data, including consultation results?
Minister reply
We aim to have all regional centres operational by 2026. The current waiting list stands at over 6,237 children and young people for gender services. We are working on implementing recommendations from the follow-through service for those aged 17-25, ensuring a transitional rather than an extension of children's services approach. Regarding puberty blockers, we restrict their use due to insufficient evidence and safety concerns, as per the Commission on Human Medicines.
Alex Sobel
Lab/Co-op
Leeds Central
Question
Will the order applying restrictions on puberty blockers for under-18s be universal or specific to those with gender dysphoria?
Minister reply
The restriction applies specifically to use among children and young people with gender dysphoria, where there is an unacceptable safety risk. Puberty blockers are safe for other conditions but not for this purpose due to a lack of evidence.
Rebecca Paul
Con
Reigate
Question
Welcoming the statement on prioritising child safety and addressing the medical scandal surrounding puberty blocker use, does he agree that no professional should tell a child they were born in the wrong body?
Minister reply
Clinicians must ask comprehensive questions to provide holistic and evidence-based care for children experiencing gender dysphoria, aiming for healthier outcomes.
Kate Osborne
Lab
Jarrow
Question
Concerning a Council of Europe report on the withdrawal of healthcare access outside trials for minors with gender dysphoria, does he agree to meet me as a UK delegate to discuss this?
Minister reply
While open to meetings, I base decisions on clinical evidence. The Commission on Human Medicines highlights unacceptable safety risks and insufficient long-term effects data, thus supporting current restrictions.
Siân Berry
Green
Brighton Pavilion
Question
Regarding the reliance on purpose for which drugs are prescribed in decision-making, is this discriminatory?
Minister reply
A range of medicines can be unsafe or inappropriate for certain conditions. Listening to clinicians over politicians ensures appropriate use.
Nadia Whittome
Lab
Nottingham East
Question
I share the deep disappointment that many young trans people and their families will feel about the Health Secretary’s decision today. I know that they have communicated to the Health Secretary and his Department the huge concerns that they have about their wellbeing in the face of these restrictions. Too many young trans people are already in, or at high risk of, mental health crisis. What consideration has he given to the impact of this decision on their mental health?
Minister reply
Very heavy consideration—of all the considerations, it is the one that has weighed most heavily. As I said in my statement, trans people too often find themselves at the wrong end of the statistics on mental ill health, self-harm and suicide. I take those issues very seriously indeed.
Julian Lewis
Con
New Forest East
Question
I do not think anyone who has listened to the Secretary of State today could be in the slightest doubt about the responsibility that he has borne and the personal empathy that he has injected into his handling of this very difficult question. I personally thank him for it. What about surgical procedures? One hears about irrevocable steps such as so-called top surgery—the removal of healthy breast tissue from young females. Where does the law stand on that issue at the current time?
Minister reply
The only thing worse than a Member not knowing the answer to their own question is the Minister not knowing the answer. Happily, in this case, I can say that surgical intervention for trans people does not apply to children and young people.
Peter Swallow
Lab
Bracknell
Question
I welcome the spirit in which the Health Secretary has made today’s statement and his commitment to improving healthcare for all trans people, but I want to press him a bit on continuity of care. This summer, I had a real struggle working with parents of young trans kids who were supporting their children in their journey and had accessed puberty blockers through overseas prescribers. They had done so after much heartfelt indecision, because they thought they were supporting what was best for their children and, frankly, because better healthcare options were not available to them under the previous Government. I welcome the moves taken to speed up the trial, but can my right hon. Friend assure me that while we wait for that trial to be set up, nobody currently receiving treatment with puberty blockers—however they may have accessed them in the past—will face a discontinuity in their care?
Minister reply
Any young person in Great Britain and Northern Ireland who had a valid prescription for these medicines in the six months prior to 3 June and 27 August respectively can seek continuation of their prescription from a UK-registered clinician. Guidance has been issued to general practitioners setting out prescribing scenarios.
Christine Jardine
Lib Dem
Edinburgh West
Question
I, too, thank the Secretary of State for the empathetic and reassuring approach he has taken today, because this has been a very toxic and, in many ways, very damaging debate for everyone involved. Further to the question about continued care, what reassurances can he give to people who have embarked on a course of treatment that they might now fear will be halted, and to the very many young people and their families in this country who are going through a very difficult time? Desperate situations make people do desperate things. What steps is the Secretary of State taking to ensure that the availability of these drugs is not driven underground—that they are not made available through means that none of us would like to see?
Minister reply
As I say, any young person in Great Britain and Northern Ireland who had a valid prescription for these medicines in the six months prior to 3 June and 27 August respectively can seek continuation of their prescription from a UK-registered clinician. More broadly, it is my intention to ensure we start bringing down those waiting lists.
Stella Creasy
Lab Co-op
Walthamstow
Question
The Health Secretary is right when he says that young trans men and young trans women in this country need us all to do better on their behalf, particularly in the debate and how we move forward—there must be more light, not heat. He is also right when he says that time is of the essence. However, can he give us more clarity, and give those who will be listening to this statement in fear a sense of where this is going? He has talked about an indefinite ban until 2027—not a rolling ban, but an indefinite ban—and he has talked about recruiting participants to a study that might begin its recruitment in 2025.
Minister reply
I am grateful to my hon. Friend for her question. We are trying to proceed at pace with the clinical trial. I share the urgency that she brings to her question.
Carla Lockhart
DUP
Upper Bann
Question
I am sure the Secretary of State will welcome the Northern Ireland ban as well, making this a UK-wide ban. Going through puberty is a biological and natural way for a boy or girl to develop. Anything that interferes with this process in such an extreme way is going against the natural process. Therefore, I agree with the sentiments about its being a scandal that medicine was being given to vulnerable young people without proof of its being safe or effective. Will the Secretary of State therefore outline what support is available for children and young people who have taken these drugs and bear the scars of these drugs?
Minister reply
I thank the hon. Member for her question. On the cases of young people who have been on a gender identity pathway and later regret those interventions, whatever those interventions may have been, they are small in number, but they are addressed in the Cass review.
Jonathan Davies
Lab
Mid Derbyshire
Question
The MP thanks the Secretary of State for his nuanced approach, questioning how a lack of evidence-based practice led to inappropriate use of puberty blockers and asks if there are lessons to be learned from this situation.
Minister reply
The Minister acknowledges the dilemma faced by both clinical leaders and political leaders regarding the prescription of puberty blockers without adequate evidence. He highlights that while some individuals have found these medications affirming, others may not benefit appropriately, leading to a need for an evidence-based approach to protect patients from harm and maintain trust in healthcare.
Joy Morrissey
Con
Beaconsfield
Question
The MP thanks the Secretary of State for his stance on protecting young people, praising his nuanced approach towards trans individuals transitioning as adults.
Minister reply
The Minister appreciates the kind words but reminds that politics often involves disagreement. He emphasises the importance of consensus and creating a safe environment for all children in the country.
Emily Darlington
Lab
Milton Keynes Central
Question
Concerned about potential self-medication by trans individuals due to restricted access, she asks about commitments to ensure timely healthcare services.
Minister reply
The Minister assures that the Government aims to improve service delivery for trans people and ensures continued prescription availability for those already using puberty blockers.
Jim Shannon
DUP
Strangford
Question
Acknowledging the Cass report, he inquires whether a permanent ban on puberty blockers should be considered.
Minister reply
The Minister stresses the importance of building an evidence base regarding the safety and efficacy of puberty blockers before making decisions that prioritise children's welfare.
Rachel Taylor
Lab
North Warwickshire and Bedworth
Question
She expresses concern about media portrayal impacting trans young people negatively, detailing a constituent’s experience with delayed access to specialist services.
Minister reply
The Minister agrees that long waits are unacceptable and highlights the need for improved care quality. He also calls for responsible communication in the media regarding trans individuals.
John Hayes
Con
South Holland and The Deepings
Question
I associate myself with the remarks of my hon. Friend the Member for Beaconsfield about both the tone and content of the Secretary of State’s remarks. I first raised my concerns about the Tavistock clinic back in 2019, when a number of professionals resigned because they were so concerned about what was happening with regard to prescribing. He will know that anyone who raised those issues—I think of Kathleen Stock, for example—has been treated very poorly, and with spite, by some of the militant activists in that field. Although I entirely recognise the tone that the Secretary of State adopts—he is a thoughtful and sensitive man—I must ask him this. He has been clear that the prescribing practice was inappropriate, that people were not given time to give their full and informed consent, and that it was an unacceptable safety risk. Who oversaw that? When were those decisions made? Who made them, and how will they be held to account? Many young lives have been severely damaged.
Minister reply
As the report into the failures of the Tavistock clinic shows, a whole range of individuals and organisations did not discharge their duty of care appropriately to an extremely vulnerable group of children and young people. I pay tribute to the whistleblowers of the Tavistock and Portman who laid their careers on the line. They were subjected to the worst kinds of attempts to silence whistleblowers, and in some cases to bully them out of the organisation or vilify them.
Vikki Slade
Lib Dem
Mid Dorset and North Poole
Question
While I am deeply disappointed, on behalf of our trans children, by the Secretary of State’s statement, I thank him for speaking directly to those children. I know that they will appreciate his sentiments. Trans young people in Mid Dorset and North Poole already rely increasingly heavily on their GPs, their schools and CAMHS, with many leaving education entirely, doing serious harm to themselves and losing their lives while on the waiting list. The former director of Tavistock told me that no data was collected on incidents of assisted suicide and deaths of children who were on the waiting list. Data was collected only of children and young people who had already started treatment. As a result, we have no information about the harms that young people and their families are going through in those years leading up to treatment. What assurance can the Secretary of State give me that those already under the care of CAMHS and paediatricians will be treated urgently? Can he update me on progress on how long those already on the list might expect to wait? Will he commit to collecting data from families on the waiting list, so that we can truly understand their experiences?
Minister reply
The hon. Member points back to the waiting list, which currently has 6,237 people on it. I do not think it is too much to expect the NHS to have a relationship with each of those young people and to make sure that they are receiving some support and care while they are waiting. I have been given assurances that support is offered to young people on the waiting list.
Jim Allister
TUV
North Antrim
Question
I certainly welcome the Secretary of State’s extension of the ban on the prescription of puberty blockers. I want to ask him whether he has more information for us on the criteria that will apply for entry into the clinical trials. Will there, for example, be a minimum age? Will parental consent be required? Both those things seem to be important, so may I have assurance on those two points?
Minister reply
The details of the trial are still being worked through. They will be and are subject to a robust ethical approvals process. Only once final ethical approval is granted is the final study design set in stone. As such, I cannot comment on the finer details at this time, but I just reassure the hon. and learned Member that the issues he raises are very much under consideration in the design of the trial.
Carla Denyer
Green
Bristol Central
Question
I share the concerns expressed by experts at the Council of Europe that removing access to puberty blockers except through clinical trials may breach the fundamental ethical principles governing research, amounting to coercion and therefore a breach of young people’s human rights. Exactly how harmful that decision is, however, hinges on how easy or hard it is to get on the clinical trial. How many places will there be on the trial? If he cannot at this stage, can he please reassure me that he will take careful consideration of the fact that if the trial is limited in size, that will cause harm to more trans and gender-questioning young people.
Minister reply
The trial will be uncapped, and I reassure the hon. Member and the House that all NIHR-commissioned research must go through robust scientific and ethical approval processes, both of which can influence final study design.
Robin Swann
UUP
South Antrim
Question
I thank the Secretary of State for his statement, which I welcome, both in its tone and the approach taken. I welcome that this indefinite ban will include Northern Ireland. I thank the Secretary of State and his predecessor for the collaborative approach they have taken with the Minister of Health in Northern Ireland. It is important for the House to note that the ban in Northern Ireland was supported by all the Northern Ireland Executive parties. In his statement, the Secretary of State talks about being able ‘to restrict the sale or supply of puberty blockers…through a prescription issued by…a prescriber registered outside the United Kingdom.’ What steps will he take to close all those loopholes and avenues that would allow these drugs to be prescribed, recommended or supplied by online suppliers for under-18s?
Minister reply
The challenge that the hon. Member mentions relates not just to these drugs, but goes more generally, too, and it is something we are looking at closely.
Shadow Comment
Edward Argar
Shadow Comment
The Shadow Minister supported the Secretary of State's actions, emphasising their commitment to protecting children. He acknowledged the Cass review’s recommendations and NHS England's decision to halt routine prescriptions of puberty blockers for gender dysphoria due to insufficient evidence on long-term impacts. Argar highlighted his predecessor’s use of emergency powers to extend the ban to private clinics and praised the current measures aimed at improving healthcare services based on comprehensive research.
He expressed interest in more details regarding regional centre deliveries, ensuring UK-wide implementation, further research progress, closing online loopholes, and commitments for ongoing updates. Argar pledged constructive cooperation with the Government to provide compassionate care led by evidence.
▸
Assessment & feedback
Summary accuracy
About House of Commons Debates
House of Commons debates take place in the main chamber of the House of Commons. These debates cover a wide range of topics including government policy, legislation, and current affairs. MPs from all parties can participate, question ministers, and hold the government accountable for its decisions.