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NHS puberty-blocker ruling will save lives

'It is staggering to realise just how flimsy the evidence in favour of all this was.' Credit: Getty

March 13, 2024 - 7:00am

Halting the development of children who wish to be the opposite sex is insane. It’s so insane that you could be forgiven for thinking there’s something about it you must have missed. Do bodies and time no longer function in the way that you, and billions of other humans, have always known them to? Are panic-stricken nine-year-olds world experts on gender as a social construct?

When you think back to your schooldays, were your peers dropping like flies due to the absence of life-saving gender affirming care? It’s either that, or the entire concept of puberty suppression — one that has been supported by countless adults and institutions that ought to know better — is ludicrous.

NHS England has just announced it will no longer be prescribing puberty blockers to children with gender dysphoria (a fancy term for distress at being the sex you are, which explains precisely nothing). There is, it turns out, “not enough evidence to support the safety or clinical effectiveness” of this form of treatment. Other countries, such as the Netherlands, home of “the Dutch protocol”, are now acting with greater caution. It seems as though the doubters — those of us “radicalised” into believing what everyone else believed until six or seven years ago — were right all along.

Even so, I didn’t expect us to be quite so right. For a while, my own position on puberty blockers was rather like my pre-referendum position on Brexit. I trusted my ignorance was making a terrible idea look worse than it actually was. To advocate for something so extreme, those on the other side had to know something I didn’t. While the moral implications of supporting children in their flight from the body seemed devastating, I was prepared to accept that maybe one could “press pause” — not socially, but at least in some cold, hard physical sense.

As I’d often be reminded when I raised objections, I’m not an endocrinologist, or a psychologist, or a queer theorist, or a porn-addled New York writer, or a four-year-old child speaking in gendered tongues. It is hard to pinpoint precisely which field makes you an expert on whether puberty blockers are a good idea, because for so long the only acceptable qualification has been insisting that they are a good idea.

As Hannah Barnes documented in Time to Think, experienced clinicians at London’s Tavistock clinic ceased to be considered experts the moment they no longer toed the line. Whistleblowers such as David Bell and Sonia Appleby were sidelined and vilified. The painstaking work of campaigners such as Stephanie Davies-Arai was wholly dismissed. Anyone who did not approve of blockers was at best a bigot, at worst someone who wanted trans children dead.

It is staggering to realise just how flimsy the evidence in favour of all this was. Experiments have been conducted on the bodies of children due to the political cowardice of adults. Humans cannot change sex. We cannot go through any other puberty than the one our body is destined to go through. This is what makes us adults. It is obscene that so many have lied to children, and by doing so put them at risk of so much long-term damage.

Right now, social media is awash with ideologues insisting that children will die because of this decision. On the contrary: lives will be saved, and it will be due to the work of campaigners who kept naming the madness even when told they had no right to speak.

They will not be thanked for it; far more likely is that they will be blamed for stoking a culture war which made due diligence impossible. Anyone who lies to children about their own bodies will have no difficulty lying about the part they played in this scandal. Still, some part of them will know: it was always insane.


Victoria Smith is a writer and creator of the Glosswitch newsletter.

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Stephen Walsh
Stephen Walsh
9 months ago

This is not just clinicians. A sizeable number of parents are renaming their children -often very young children – giving them chest binders and puberty blockers, demanding their schools and everyone else accept their new identity – thereby trapping the child on a path they can’t easily reverse – and, for example, putting their female children into male changing rooms and other facilities when playing sport. They do this perhaps because they are confused themselves, perhaps because they don’t want their children to be gay, perhaps because gender non-conforming is fashionable and exciting, or perhaps because they want to avoid considering whether their child’s unhappiness is anything to do with their own behaviour. But the tide will only turn when parents cease to receive social validation and cachet from this behaviour.

Lindsay S
Lindsay S
9 months ago
Reply to  Stephen Walsh

There does appear to be a spreading insanity, a god complex where people believe they have the right to mold others to their will. To have themselves or their offspring viewed as special. This denial of reality needs to be nipped in the bud.

David Morley
David Morley
9 months ago
Reply to  Lindsay S

Yes – this is the common denominator, a pervasive change in our culture. Expecting to be able to genuinely change sex is just more extreme. Interesting that this is all happening as various forms of trans humanism are about to become possible.

Adrian Smith
Adrian Smith
9 months ago
Reply to  Stephen Walsh

Parents and teachers have been as badly misinformed as children. Hopefully this marks the beginning of the return to sanity. However I have made a number of posts likening this to a cult and there will be some people who never leave the cult. They will fade into the background over time and ultimately they will be the ones ridiculed and seen as cranks. The good news is they won’t be able to pump their kids full of dangerous synthetic hormones on the NHS. I would expect private practice will follow suit as they will struggle to get indemnity insurance operating outside of established NHS policy that has been unequivocal in declaring there is insufficient evidence to justify the treatments.

UnHerd Reader
UnHerd Reader
9 months ago
Reply to  Adrian Smith

Just wait until these kids suffer from the side effects from taking puberty blockers like Lupron. Girls who took it for precocious puberty and young women who took it to treat endometriosis are now losing their teeth and hair, suffering from osteoporosis, in wheelchairs because of sever joint pain and brain fog so severe they can’t work. A Swedish documentary (Trans Train on YouTube) follows a young trans boy, who at the age of 15, lives with agonizing joint pain and osteopenia. There’s going to be hell to pay.

Adrian Smith
Adrian Smith
9 months ago
Reply to  UnHerd Reader

It should never have taken so long for this ban to happen. The people most responsible are the trans activists who got anything they did not like removed and hounded anyone trying to do proper research. That is the reason the evidence is so weak in both directions.
There should be no more experiments with these things until every ounce of research benefit has been gained from the tens of thousands of kids worldwide who have already been experimented upon.

Diane T
Diane T
9 months ago
Reply to  Adrian Smith

Your comment ‘ The people most responsible are the trans activists who got anything they did not like removed and hounded anyone trying to do proper research’ avoids the culpability of those who are officially charged with ensuring the ‘public good’ who became eager facilitators of an almost cult-like movement. I think it’s fairly obvious to us all, unhappily, that the outcome of such ‘official negligence’ will be that many children and young people will have been permanently harmed as a result.

Diane T
Diane T
9 months ago
Reply to  Adrian Smith

I’m sorry, but saying ‘Parents and teachers have been as badly ‘misinformed as children’ avoids acknowledging serious parental and state failures. There’s plenty of evidence available, (which the vast majority of mankind supports) on the biological facts of gender. There has been mounting evidence available, to those who should take the trouble to research it, of the negative outcomes that can arise from medically meddling against a vast body of evidence that says ‘Do not go there! Yes, some parents have been jointly gullible and in thrall to ‘medical advice’ from, at best, misguided ‘believers’, at worst, ‘charlatans’ who would peddle fantasy over fact. Supporting the fantasy, state institutions wanting to be seen as ‘relevant’ were captured and parents looked on as men in drag read (?) to their young children in state libraries.

Adrian Smith
Adrian Smith
9 months ago
Reply to  Diane T

Yes there has been as widespread delusion about this, it is part of a general delusion collectively titled woke. It has its roots in the wolf of Marxism but hides in the sheep’s clothing of #bekind. It has many of the characteristics of a cult and it is wrong to blame those who got sucked in by the cult as they are victims too.

Diane T
Diane T
9 months ago
Reply to  Adrian Smith

Absolutely agree it’s a ‘woke’ delusion that well meaning parents may mindlessly (and perhaps fashionably) follow but state institutions? I can’t bring myself to acknowledge their ‘victimhood’ ….

John Chapman
John Chapman
9 months ago
Reply to  Adrian Smith

‘The return to sanity’? That would be comforting. But we have here a dire spiritual sickness that greater honesty alone won’t cure.

Hugh Bryant
Hugh Bryant
9 months ago
Reply to  Stephen Walsh

But the tide will only turn when parents cease to receive social validation and cachet from this behaviour.

Or when some of the kids so abused grow up and sue their parents as well as the doctors and drug companies who have promoted this abuse. It can’t happen soon enough.

carl taylor
carl taylor
9 months ago
Reply to  Stephen Walsh

Apologies if the term is not new to you, but what you describe is cynically known as transhausen-by-proxy. (Incidentally, I wonder if the timing of NHS England’s announcement was prompted at all by the release of the WPATH files?)

Adrian Smith
Adrian Smith
9 months ago
Reply to  carl taylor

No complete coincidence. The NHS England consultation process (the finalised new policy announced is just one part of a bigger process, which will release further items when ready) the WPATH files have taken a lot longer than originally promised to be released.

Charlotte Revely
Charlotte Revely
9 months ago
Reply to  Stephen Walsh

In the past, if a child was being harmed by the actions of the parents, neighbours, teachers and doctors would raise the alarm, social services, the police and the courts would step in. Now every single one of those institutions is captured by gender ideology and the person raising the alarm is the one most likely to be visited by police or shunned in polite society.
The parents who were concerned and didn’t want their children on this path were told their child would kill themselves, that they were bigots and nazis if they didn’t immediately affirm. You might discover your child was already going by a new name and pronouns at school, that Mermaids or Lush had provided them with breast binders behind your back.
It’s akin to having a child with anorexia and being punished for making them eat. Some parents definitely used this for their own attention seeking ends – the Transhausens by Proxy crowd – but many were as lost and confused as their children in the face of this global societal insanity. Many people should be prosecuted and imprisoned for this scandal, but much like the Post Office, I doubt it will happen.

2 plus 2 equals 4
2 plus 2 equals 4
9 months ago

There should be a public enquiry and those clinicians who failed in their sworn duty to “first do no harm” held to account.

I would also like to see a “rogues gallery” of cheerleading celebrities who put their own perceived entitlement to progressive acclaim above the proper care of sick and distressed children.

carl taylor
carl taylor
9 months ago

Don’t worry on that score, the internet is forever, and they won’t be allowed to forget it. Hopefully it will haunt their future days and undermine any other faddish bandwagon they jump on.

Adrian Smith
Adrian Smith
9 months ago

All the info on the new policy is here and the results and analysis of the consultation.
https://www.england.nhs.uk/publication/clinical-policy-puberty-suppressing-hormones/#:~:text=Puberty%20suppressing%20hormones%20(PSH)%20are,have%20gender%20incongruence%20%2F%20gender%20dysphoria.
I am pleased the loop hole on “exceptional circumstances” has been closed. I doubt the trial will go ahead particularly quickly. But I really do not see the need for it, until after all the evidence we can already gather from the 10,000s around the world who have already been put on these experimental drugs outside of an experimental framework has been analysed (there are studies underway by the Cass review which are looking at all 9000 GIDS patients and global experiences).
The interim proposal which was consulted upon ducked the issue of those who were already on them saying a consultant endocrinologist needed to decide whether or not to continue (worst person to decide in my view). From my quick look I could not see what happened to that part in the new policy.

Lang Cleg
Lang Cleg
9 months ago

We need a public inquiry.
We can have court cases in which adults (women, safeguarders, etc) win their rights back and are thus able to freely express their views on these horrors without losing their jobs or being harassed.
But we can’t sort out the collapse of safeguarding frameworks within all the country’s important institutions this way. It must be a public inquiry.

R Wright
R Wright
9 months ago

Not long now until the first medical negligence claims.

Hugh Bryant
Hugh Bryant
9 months ago
Reply to  R Wright

Inevitably the cost of those claims will be met by the taxpayer (as usual) whilst those who are personally liable, criminally in my view, will go completely unpunished.

Adrian Smith
Adrian Smith
9 months ago

The pendulum is now swinging back against this particular bit of woke insanity. It is a bit too early, but won’t be all that long, before the real wolves in social justice sheep’s clothing realise trans is a liability to the revolution and they discard it from the cause (a bit like they have discarded radical feminist and gay men).
I do fear for ordinary trans people, as the back lash could be quite horrible for them, but it will be the trans activists that caused it and it will be the trans activists who just disappear into the wood work.
There is lots of talk about how as a society we have got so wrapped up in rights we have lost sight of human values. One of the most important aspects / values of humanity is compassion – the woke have exploited it in #bekind, but we must not abandon real compassion or the Marxist ideologies behind woke will claim many more millions of lives..

Lindsay S
Lindsay S
9 months ago
Reply to  Adrian Smith

Ahh #bekind, made famous by a woman whose suicide overshadowed the fact that she was anything but. She was a domestic abuser but she was also physically attractive and moderately famous so will instead be remembered as “struggling with her mental health and a victim over over zealous policing and cruel media”

Ian Barton
Ian Barton
9 months ago

I look forward to the day of reckoning for those people who mutilated autistic children.

Andrew Buckley
Andrew Buckley
9 months ago
Reply to  Ian Barton

and Gay children.

Adrian Smith
Adrian Smith
9 months ago
Reply to  Ian Barton

Nice dream, but if there is anything at all, it will be a whitewash just like Covid.
Just rejoice that for the kids in UK (Canadian and kids unlucky enough to live in democrat states have longer to wait) the nightmare is coming to an end. There are those stoking up the suicide trope. If there are any suicides at all it will be on those who stoked it up not on those who had the courage to speak out eventually leading to this decision.

William Brand
William Brand
9 months ago

Woke politics kills children. Girls are hyper susceptible to fads. You can’ turn a p***s inside out until you grow a big d**k after puberty. Most males are mortally insulted if they discover they have had sex with a trans woman so they might as well stay with the gays. Girls follow fads and remove breasts and womb and then grow up and want their girl parts again. Adding a functional p***s doesn’t work so they might as well stay lesbians until one is developed. It will probably be a d***o with Bluetooth attachment to one of Musk’s brain chips. Note that rich Moslem women will buy it to correct the FGM their parents did to them.

William Brand
William Brand
9 months ago

Some immigrant parents are culturally required to get a son and so they decide to turn their girl children into boys. Afghan do it culturally with girls dressing and living as boys then changing back at puberty. Immigrants are likely to use blockers and western techniques to attempt to change a child’s sex.

Stephanie Surface
Stephanie Surface
9 months ago
Reply to  William Brand

I doubt this. Many Asian cultures are more likely to decide to have an abortion, if the fetus turns out to be female, than to go through complicated reassignment procedures. I am told, that many doctors and nurses are therefore very reluctant to reveal the sex to these pregnant women at their first ultrasounds.

William Brand
William Brand
9 months ago

It’s another case of luxury opinions of elite people. They mouth socially approved opinions that they would never do themselves. These opinions are executed upon the lesser classes and taught in schools as fact. One hopes that these false elite opinions do not corrupt innocent AI who will soon rule medicine etc.

Hugh Bryant
Hugh Bryant
9 months ago
Reply to  William Brand

One hopes that these false elite opinions do not corrupt innocent AI who will soon rule medicine etc.

Too late, I’m afraid.

Adrian Smith
Adrian Smith
9 months ago

Anyone interested in such things, the consultation report is here:
https://www.england.nhs.uk/wp-content/uploads/2024/03/tonic-psh-consultation-analysis-report.pdf
The weight of opinion expressed by those who responded is against the new policy ie in favour of continuing. The majority on both sides of the argument felt not enough evidence had been taken into account – eg pet studies that had been excluded for being so bad. There does appear to be overall agreement though that the quality of evidence either way is poor. One side sees this as an excuse to continue, the other a reason to stop.
It is a good job consultations are not a vote. For mainstream use of potentially harmful drugs there must be overwhelming evidence that the benefits outweigh the risks – you will suffer from cancer treatment but leaving it untreated will kill you.
The activist organisations on both sides clearly sent out a number of standard answers for individuals to submit.

Kate Fulcher
Kate Fulcher
9 months ago

Brilliant as always Victoria, and a lot of great comments here. Insane is the right word.

Adoptive Loiner
Adoptive Loiner
9 months ago

A huge thank you to the whistleblowers and campaigners, some of whom are named in the article, who have put in the really hard miles to bring this madness to public attention in the face of abuse and intimidation.

Without them the Tavistock would likely still be operating, and this decision by NHS England may never have been made.

John 0
John 0
9 months ago

I’m I the only one who thinks the NHS position change is not really about noticing the evidence base (which has been there for ages) but simply the number of lawsuits they are facing from detransitioners?

Adrian Smith
Adrian Smith
9 months ago
Reply to  John 0

Other than the attempt to bring a class action against GIDS, which has not filed yet, I am unaware of any other such UK cases but please provide links if there are some.
Whilst the outcome of court cases can produce very rapid change, the threat of court cases or even filing and awaiting the outcome often drives a determination not to change before the verdict as such a change will be seen as an admission of guilt.
In this case I see this as the UK system grinding far too slowly but eventually working. I take a small degree of pride that whilst UK cannot claim to be leading the charge we are at least in the leading cohort for once.

Dougie Undersub
Dougie Undersub
9 months ago

Oh Victoria, why do you have to drag Brexit into everything?

Lancashire Lad
Lancashire Lad
9 months ago

Yes, a very unwelcome intrusion into a debate that’s too important for such political opinionation.

Adrian Smith
Adrian Smith
9 months ago
Reply to  Lancashire Lad

It proves she is just as susceptible to BS from the elite as anyone else. Maybe this issue is her stopped clock moment?

David Morley
David Morley
9 months ago

This is good news – this is the most serious aspect of the whole trans issue – way beyond the issue of gender neutral toilets and the rest.

If we could wave a magic wand and turn men into real women, women into real men, and back again no harm done – well why not. But we can’t. All we can do is create a simulacrum with enormous downsides.

David Morley
David Morley
9 months ago

As a society, we are not keen on being simply “stuck with” things and making the best of it. Breasts too small, enlarge, lips not plump, Botox, overweight, rail against western beauty standards, don’t like innate differences between men and women, deny. It’s something we seem to have picked up from America – reality as a domain of consumerism – malleable to our will and our wallet. And now some take the sex they are born with as similarly malleable. But it’s simply not, and never will be.

The alternative? Find ways to help people deal with the curved balls life has thrown them and live happy lives in spite of it.

David Morley
David Morley
9 months ago

What we need now is to wind back on the gender nonsense which may well have facilitated both this and the mental health crisis being suffered by the young. It’s time to let boys be boys, and girls be girls (in the most positive way they can), and stop trying to reform them according to feminist ideology. Opening doors to girls (and boys) was a good thing, trying to modify them to fit a utopian view of how they should be was not. We need to stop before more harm is done.

Charlie Two
Charlie Two
9 months ago

this is what happens when you normalise male fetishists’ inner desires. you allow horrific psycopathies to walk in public unchallenged. there is a reason these fetishes were always done in private: because letting them loose is worse than letting a hungry wolf into a nursery.

David Morley
David Morley
9 months ago
Reply to  Charlie Two

You’re ignoring the fact that more girls are now identifying as trans than boys. And you are trying to shift blame onto men. It’s a societal problem, the causes of which are not completely clear. That feminist ideology has been pushed in schools, and by some parents, and has pretty much become orthodoxy, surely cannot be unrelated. Is it just a coincidence that gender uncertainty follows years of attempts to deconstruct gender roles, and change children’s behaviour to align with feminist preferences – prosecuted through the education system to children too young to challenge it.

Andrea Vickers
Andrea Vickers
9 months ago

I hope the next ban will be on the surgeons that perform these ghastly ‘gender reassignment’ surgeries; the double mastectomies on young girls, often leaving them without nipples; the hideous phalloplasty, with sausage-like appendages made from forearm or thigh skin; the breast augmented men with paraphilias, and the smelly, suppurating, often hairy holes that have to be dilated several times a day, which will never pass as a vagina.

Whatever happened to “first, do no harm”?