Clinical Advisory Network on Sex and Gender
BMA critique vindicates Cass review but questions government “overreach” – what the BMA got right and what they are still getting wrong On 6th May 2026, the BMJ published a news article about the BMA critique of the Cass Review with the title, ‘Puberty blockers: BMA critique vindicates Cass review but questions government “overreach”’ (1). Journalist […]
The National Institute of Health and Care Research (NIHR) is funding the PATHWAYS trial on puberty blockers for children with gender incongruence, pending ethical approval. CAN-SG opposes the trial, citing serious ethical concerns, including unclear benefits and potential harms such as injury to fertility and cognitive development. The UK regulations mandate a trial only if its benefits outweigh its risks and emphasize the protection of vulnerable groups. CAN-SG argues that more research is needed on psychosocial interventions before considering puberty blockers, aligning with recommendations from the Cass Review. CAN-SG has written to the trialists, the oversight board and the regulators to express concerns, seeking proper ethical oversight.
This article by Dr David Bell and Dr Sinead Helyar examines concerns regarding a proposed clinical trial of puberty blockers (PBs) for children with gender dysphoria. It argues that a PB trial would pose unacceptable risks and contravene ethical standards. The authors advocate alternative avenues for research and safer treatment methods for this vulnerable group of children.
In July, the British Medical Association (BMA) Council voted to oppose the Cass Review recommendations on transgender healthcare for children and young people, prompting an open letter signed by over 1000 members criticising this decision. The BMA reversed its decision in September, adopting a position of “neutrality”.
The recent decision by NHS England to ban routine use of puberty blockers is a positive step to protect children. Concerns remain about private providers, cross-sex hormones for 16-18 year olds, lack of research, and care for detransitioners. We hope the Cass final report will provide further clarity, but regardless of what is in the final review, the principle of evidence-based care for gender questioning youth has been established by Cass.
Professor Sallie Baxendale’s article in Unherd discusses her challenges in publishing a paper on puberty blockers’ impact on cognitive function. Despite facing rejection from three journals, her paper has now been published in a well-respected peer reviewed journal, shedding light on the minimal evidence and concerns about the impact of puberty blockers. Prof Baxendale’s Unherd article sheds light on issues in the peer review process.
The review of the literature found that no well-designed studies have ever been conducted to properly assess the impact of puberty blockers on cognitive function.
Our current understanding of the importance of puberty in the development of cognitive function, animal studies and very limited data from human studies do not support the notion that puberty blockers have no impact on cognitive development or that any effects are reversible.
Indeed, the evidence to date points in the other direction.
CAN-SG’s submission to NHS England’s consultation on interim clinical policy on use of puberty suppressing hormones for children and young people with gender dysphoria/gender incongruence CAN -SG has submitted its response to the NHS England consultation. The consultation closes on 1 November. Anyone who has an interest in this policy can contribute to the consultation. […]
The Clinical Advisory Network on Sex and Gender has submitted its response to NHS England’s consultation on its interim clinical policy for puberty suppressing hormones. We welcome the proposal to end the routine prescription of puberty suppressing hormones (PSH) to children and young people with gender dysphoria or gender incongruence and to focus on psychosocial […]