A CLINICAL trial into the benefits and risks of puberty blockers in teenagers is set to proceed after a legal challenge over the trial was thrown out by a High Court judge.
The trial, known as Pathways, is set to see around 220 children with persistent gender incongruence receive puberty suppressing hormones, half of whom would begin the treatment straight away while half would start it a year later.
It follows a review published in April 2024 by Dr Hilary Cass, who found that there was not enough evidence on the use of puberty blockers for clinicians and families to make informed decisions.
Following the publication of the review, puberty blocker prescriptions were "paused" for under-18s in Scotland, before prescription was subsequently banned altogether across the UK.
A campaign group and two individuals sought to bring legal action against the Health Research Authority (HRA) and the Department of Health and Social Care over the proposed trial, but this was dismissed by a judge on Friday.
The claimants in the legal action were Bayswater Support Group – made up of parents and guardians of children and young adults who identify as trans or non-binary – as well as psychotherapist and gender critical campaigner James Esses and Keira Bell, who began taking puberty blockers when she was 16 before later “de-transitioning” and who has spoken of the long-term effects such treatments had on her.
Their lawyers told a hearing in London earlier this week that the group had concerns about the long-term physical and mental side effects on children participating in the trial, claiming that proper safeguards were not put in place and that the ethical approval process was flawed.
They asked a judge to allow the legal challenge to proceed, and to make an injunction delaying the start of the trial until the claim was determined.
The HRA and the UK Government opposed the bid to continue the legal action.
In a ruling on Friday, Justice Chamberlain threw out the claim.
Reading a summary of his judgment, he said: “The trial was commissioned by NHS England and designed by its co-sponsors with conspicuous care, in consultation with other expert bodies.
“The participants will be children with persistent gender incongruence who are receiving treatment from specialist gender services.
“Each child will have been assessed over many months by specialist doctors. In each case, the treating team will have formed the opinion that the child has a reasonable prospect of receiving a clinical benefit from the treatment.
“There is a detailed process to ensure that the child assents, and a parent consents, to the treatment, having been fully informed of what it involves and of its potential outcomes.”
The judge continued that none of the grounds of challenge was “arguable with a realistic prospect of success”, and that the decision to approve the “pragmatic” trial was “quintessentially a question of judgment” for public health bodies.
Responding to the legal challenge being thrown out, Good Law Project solicitor Zoe Johannes said it "is a significant win for young trans people".
She said: "The arguments made by the claimants weren't really rooted in concerns about ethics, safety of efficacy.
"This is an ideological attack on healthcare for young trans people. But decisions about healthcare should be made by young trans people and their clinicians – not by anti-trans campaigners."
