Embargoed until 0001, 22 November 2025
Following the announcement that two new research studies PATHWAYS TRIAL and PATHWAYS CONNECT have received the necessary regulatory and ethics approval to proceed as part of an evaluation of puberty blockers for young trans people, Chay Brown, Health Director for TransActual responded:
“It breaks my heart when I think of the young people affected.
“This research is not about the safety of these medications which have been used for this very purpose since 1989. It is the result of an ideological view at the very top of the NHS that being trans is a ‘less desirable outcome.’
So, the very clear plan is to delay, obstruct and obfuscate transition related care while, elsewhere, the NHS is dishing out untested weight loss drugs like sweeties, to even younger people.
“It is unconscionable to coerce young people into participating and, for half of the cohort, delay the care they’ve been assessed as needing. It is and will be for a long time to come the only means that young people have of accessing puberty blockers through the NHS, and it is strictly capped at 226 regardless of how many would benefit from the care.
“This goes against every assurance made previously. I am surprised that this trial received ethical approval. Hard questions will one day be asked of those who have given this trial the fig leaf of ethical approval.
“While we are glad that some young people will be able to access the care they need without being criminalised, we fear that this is overall bad news for young trans people in the UK.”
– ENDS –
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For further information, please contact jane fae via press@transactual.org.uk.
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Further commentary from TransActual
People – including young people – have a right to autonomy over their body. There was never any evidence of harm to justify the discriminatory criminalisation of the provision of puberty blockers to trans young people but not cis young people by the last two Secretaries of State for Health and Social Care. There were only fears that it would encourage and enable more young people to be trans who might otherwise be ‘dissuaded.’
This study is a continuation of that flawed assumption, and the deeply biased approach taken by policy makers and institutions towards trans people. It is unambiguously a violation of medical ethics to coerce young people into this study as the only legal way to access the medications they need and want, to gatekeep which specific young people are accepted, and even worse to choose via lottery which of them will receive a sub-par version of the treatment.
Young people who experience consistent suicidal thoughts or who self-harm will be excluded from the trial – to do this in the full knowledge that this medication may improve their mental health is abject cruelty.
The potential for bias in this study is increased by its choice of senior personnel. Of particular concern are the links between Deputy Chief Investigator Dr Michael Absoud’s links and the anti-trans group known as SEGM. This is an SPLC-designated anti-LGBTQ+ hate group which promotes pseudo-scientific theories about trans people, acts as a lobby group for the restriction of access to care for trans people across the US, has connections to the anti-vaccine Trump-aligned Department of Health and Human Services led by RFK Jr, and is a hub for many people and organisations who actively promote conversion abuse.
SEGM was recently disavowed by Dr Gordon Guyatt, the “godfather of evidence-based medicine” and developer of the GRADE system, which the NHS uses for assessing the evidence base for different medical interventions. Dr Guyatt accused SEGM members of “misrepresenting and misinterpreting” his work to justify “denying care such as puberty blockers and hormone replacement therapy.”
Unfortunately, we fear this study is designed from the outset to arrive at a specific conclusion, and so will not generate good scientific evidence. Indeed, it cannot while it operates in such a coercive manner, inducing desperate trans people to perform whichever version of trans-ness a panel of doctors will accept. Like the Cass Review before it, the trial is in all likelihood an elaborate pantomime to generate a false sense of scientific legitimacy for what is purely a moral panic about gender related healthcare – with the enthusiastic collaboration of most of the UK’s politicians and news outlets.
The disregard of DHSC and NHS England for the lives and safety of young trans people and their families is underlined by their attacks on the healthcare and patient privacy of those served by the WellBN clinic. This has been threatened with closure in an investigation which appears to have violated the patient’s rights to privacy. This investigation had led to the pausing of – legal – prescriptions, and has been described by parents as causing “immediate and extreme harm to our children”. These adolescents whose access to medication has been taken away, will not be eligible for the trial because of their previous use of HRT.
Much more evidence and testimonials relating to the widespread practice of anti-trans conversion therapy by NHS practitioners is available in the book “Transitions”, published by Trans Media UK, and available from TransActual.
Until those who openly associate with anti-trans organisations like SEGM and Genspect are entirely removed from positions of power over trans healthcare, there cannot be trust between the trans community and the DHSC or NHS. Nor can any other marginalised group in the UK trust the DHSC or NHS to act in an unbiased or evidence-based way.
None of this was necessary, and the UK continues to do great harm globally through its institutional support for questioning whether being transgender is a ‘medically acceptable outcome’. We hope that eventually the principles of evidence-based medicine, patient freedom and autonomy, and basic human decency will eventually win out, and this trial will be consigned to being a cautionary tale in future medical textbooks.