Health Secretary Wes Streeting is defending the ban on the prescription of puberty blockers to young trans people that was put in place by his predecessor, Victoria Atkins, on 29 May, just before the parliamentary session ended. Parents of those affected, who looked to Labour for help, have been left in despair – but is the ban even lawful?
Passed using an emergency order and without MPs getting the chance to vote on it, the ban is scheduled to remain in place until 3 September, but Streeting has hinted that he wishes to make it permanent.
Life-saving treatment unlawfully rescinded?
A challenge to the legislation, led by the Good Law Project and TransActual, called on the court to quash the ban on grounds that the legislation is unlawful. Atkins does not appear to have consulted with medical experts first, which is normally a statutory requirement, nor to have identified the serious danger to health which is necessary in order for that requirement to be ignored.
“It is clear that this ban is having a devastating – and harmful – impact on young trans people”, said TransActual’s director for healthcare, Chay Brown. “Having reviewed the case, and the arguments put forward by the secretary of state, we continue to be of the opinion that this ban was not properly introduced.”
Concerns around puberty blockers relate primarily to the risk of bone demineralisation. For this reason, they have only ever been used for short periods of time, with careful supervision and testing. Bone demineralisation can be caused by a number of other medicines, smoking, heavy drinking, pregnancy, and menopause, but bones can recover over time if people are physically active and eat a balanced diet. There are also a number of drugs available to help with this.
Much more dangerous drugs are used in childhood to treat a variety of conditions in circumstances where doctors believe that the risks of non-intervention are higher. Critics of the ban argue that Atkins and Streeting have underestimated the risks of failing to treat gender dysphoria, and that, furthermore, such assessments need to be made on a case-by-case basis.
MPs raise concerns about the ban
Parliamentary support for the ban is limited. The Liberal Democrats oppose it, and several of Streeting’s Labour colleagues have spoken out. Clive Lewis MP drew on his experience of meeting people who had been helped by puberty blockers and said “Careful, clinical provision is the way forward, not this politicisation”.
“Trans people need to be able to exist safely as themselves with respect & dignity, and with equal access to adequately funded healthcare”, said Apsana Begum MP, describing the treatment as “a life-saving measure”. Zarah Sultana MP said, “Labour’s manifesto promised to ‘remove indignities for trans people who deserve recognition & acceptance’. That entails ending the Tories’ ban on puberty blockers”.
“Only a small number of young people are prescribed puberty blockers”, Nadia Whittome MP pointed out. “Those who are often describe them as lifesaving. I know the distress the puberty blockers ban is causing them. No matter what happens in court, I will continue fighting for the government to scrap it.”
The health secretary has been encouraged to meet with trans people who have experience of going through puberty without blockers, and with parents who are worried about the safety of their children in the absence of treatment. Some parents are already considering moving abroad if it is the only way to get their children help.
Evidence base and expertise called into question
Defending his decision, Streeting said “I know there’s lots of fear and anxiety. I am determined to improve the quality of, and access to, care for trans people”, arguing that he wanted to establish a firmer evidence base for treatment. Citing the Cass review (which former business secretary Kemi Badenoch said was only made possible by the positioning of ideologically motivated individuals in government, and which has been widely criticised by experts in the field), he expressed concern that not enough is known about the long-term effects of using puberty blockers to treat trans children, though he acknowledged that they have been used to treat precocious puberty for many years.
“The decisions I am taking will always be based on evidence, rather than politics or political pressure” he concluded. Yet Streeting has no medical qualifications or scientific expertise related to this area. The Cass review itself did not call for such a ban, and it is widely agreed by doctors that stopping any form of hormone-related medication abruptly can have damaging side effects.
Expressing concern for the young people affected by the ban on treatment, whom he considers to be at high risk of suicide, Good Law Project’s Jolyon Maugham has called on Streeting to explain why he believes that he is better qualified to weigh up the risks and make decisions about their treatment than their doctors.
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