UK high court upholds puberty blockers ban due to ‘substantial risks’ for minors

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CNA Staff, Jul 29, 2024 / 13:57 pm (CNA).

A United Kingdom high court judge upheld the British government’s emergency ban on puberty blockers for minors on Monday, finding the blockers carry “very substantial risks and very narrow benefit.” 

Advocacy group TransActual challenged the U.K.’s ban along with a 15-year-old who remains unnamed due to a court order.

Justice Beverly Lang cited England’s National Health Service (NHS) study that preceded the restrictions, calling it “powerful scientific evidence in support of restrictions on the supply of puberty blockers on the grounds that they were potentially harmful” in her decision.

The 2022 restrictions, based on a study known as the Cass Review, prevent the prescription and supply of gonadotropin-releasing hormone analogues known as “puberty blockers” for minors except when used in clinical trials.

While the emergency ban on prescribing puberty blockers is set to expire in September, the U.K. government has set “indefinite restrictions” on puberty blocker prescriptions within England, in line with NHS guidelines.

TransActual condemned the court decision in a July 29 statement, saying that the study was led by “anti-trans” academics.

“We are seriously concerned about the safety and welfare of young trans people in the U.K.,” said TransActual director for health care Chay Brown. “Over the last few years, they have come to view the U.K. medical establishment as paying lip service to their needs, and all too happy to weaponize their very existence in pursuit of a now discredited culture war.”

Advocates for puberty blockers argue that the drugs help young people buy “time to think,” according to court documents.

The drugs block a child’s natural development during puberty, preventing the production of hormones, such as testosterone and estrogen. Puberty blockers also stunt growth in height, a girl’s breast development, and a boy’s facial hair growth, among other things.

The final report of the Cass Review, cited frequently by the judge, found that “there is no evidence that puberty blockers buy time to think, and some concern that they may change the trajectory of psychosexual gender identity development.”

The Cass Review was an in-depth study based on input from clinicians and professionals experienced in gender services, as well as parents and organizations working with LGBTQ+ children.

“The professionals who participated in the study were often conflicted because they recognized the distress of young people and felt the urge to treat them, but at the same time, most had doubts because of the lack of information on long-term physical and psychological outcomes,” the Cass Review final report read, as cited in the court decision.

Many professionals and parents feel pressured to take the puberty blocker route for children out of a fear of increased suicidality in transgender individuals, the report noted. While the suicide rate for transgender individuals is disproportionately high, the study found no evidence to suggest that hormone treatment reduced the risk of dying by suicide and noted that the suicide risk of people with gender dysphoria “remained comparable to other young people with a similar range of mental health and psychosocial challenges.” 

In a 2022 letter cited by the court, Dr. Hilary Cass, who chaired the study, recommended “an established research tragedy and infrastructure” to address outstanding questions about the treatment of gender dysphoria.

Without it, she said, “the evidence gap will continue to be filled with polarized opinion and conjecture, which does little to help the children and young people, and their families and carers, who need support and information on which to make decisions.”

The Cass Review is one of many studies looking more closely at treatment of gender dysphoria. A recent Mayo Clinic study found that puberty blockers may cause “irreversible damage” to young boys, while a 2022 study gained national attention after it found that putting children on puberty blockers can harm bone density.

“We cannot encourage or give support to reconstructive or drug-based medical intervention that harms the body, nor can we legitimize or uphold a way of living that is not respectful of the truth and vocation of each man and each woman, called to live according to the divine plan,” the Catholic bishops of England and Wales wrote in an April 25 statement on gender identity. 

“You are still our brothers and sisters,” the bishops said in a statement directed toward “transgendered” individuals. “We cannot be indifferent to your struggle and the path you may have chosen. The doors of the Church are open to you, and you should find, from all members of the Church, a welcome that is compassionate, sensitive, and respectful.”