The Secretary of State will currently be receiving many representations to stop what is being tagged #StreetingTrial. He has publicly registered his discomfort with medically interfering with natural puberty and also appealed for cross-party consensus “to take the heat and the ideology” out of the debate. However, aside from the ubiquitous heat and ideology in the context of current debate on “gender”, there is no real possibility of clinical and professional consensus on allowing a clinical trial of puberty blockers to go ahead on children reaching and going through puberty. Many clinicians would say that a serious medical intervention which impacts the body and brain of a developing child is unjustifiable where it is seeking to address what are fundamentally psychological matters of feelings: wishes, desires and dislikes. But many clinicians who would say that have been silenced over the last decade by anxieties for their jobs and reputations. They may have hoped for the universities and research journals to have promoted enquiry and discussion and their professional bodies to have supported ethical and cautious individualised psychological practice. Until now that enquiry and caution has not been forthcoming and they have seen that the heat and ideology of transgenderism has resoundingly captured the floor.
The Cass report, the closure of Tavistock GIDS and the banning of puberty blockers seemingly opened a door for more widespread and welcome reflection and review. A hoped-for follow up of the many young people who were given puberty blockers in the UK, however, has never been undertaken and the prospect of using this medication on more children in the context of a “clinical trial” now looms. This is a turning point for many silent and silenced clinicians and they are protesting.
We publish here a letter to Wes Streeting that sets out the objections of clinical psychologists whose professional training and expertise means that they cannot, in conscience, agree that such a trial is justifiable.
The Rt Hon Wes Streeting
Secretary of State
Department of Health and Social Care
14 December 2025
Dear Secretary of State,
Plea to halt the Pathways Puberty Blocker Trial
We, the undersigned 20 clinical psychologists, have personally noted and experienced the censorship of open debate in academia, educational and health service settings and in the media. Clinicians and other professionals have been silenced and feared for their jobs and reputations. It is only now that more of us feel able to speak out, and we are doing so to ask that the Pathways Puberty Blocker trial be halted.
There are many possible psychological, familial, cultural and social reasons why some children show signs of feeling unhappy with the sex they were conceived with and born as. This distress is not the same as suffering an inborn constitutional condition or a serious life-threatening illness such as cancer, hence the ethics and the cost-benefit weighing of the medical risks of clinical trials is completely different. It is neither ethical nor is it possible to conduct a legitimate randomised controlled trial on puberty blocking for psychologically based distress. The actual purpose of the Pathways Puberty Blockers trial is ill-defined, and its methodology cannot answer questions beyond “what happens if we do this to one group and do it a bit later to another?”. With such an unsound rationale it is clear that the medical and developmental risks are not justifiable.
It seems only political intervention at this stage can pause the trial so that the many serious questions can now be raised by clinicians. There is not a current professional or clinical consensus in this area of practice and many clinical experts have grave reservations. We are concerned, as you are, about the sociopolitical context that has influenced previous decision making and we strongly question the assumptions that underpin the rationale for this trial. Our concerns include ideological agendas and vested interests. Past research in this area has been heavily scrutinised and weaknesses, bias, suppressed and inadequate research exposed. The current trial risks repeating and replicating these issues again in its flawed research design.
Key psychological and clinical considerations are central to our grave concerns. Young children do not understand the essential nature of their birth sex until they are older, or the nature and fluidity of the concept of their identity which is still forming. At the age at which it is being proposed they receive puberty blockers they cannot validly consent to risk their fertility, their ability to experience sexual pleasure and other aspects of adult sexuality. Parents cannot validly consent on their behalf as this is not the same as their sanctioning risky treatment for potentially life-threatening diseases.
Politicians on all sides of the House would support you to act with courage and responsibility. Halting the Pathways Puberty Blocker trial will allow these seriously problematic issues to be fully and more widely considered before more children are subjected to medical interventions that we already know interfere with normal maturational processes and which are likely to result in serious lifelong changes to their bodily functions and their brains.
We welcome your openness where you acknowledged that you have concerns with, and deep discomfort about, medications that interfere with puberty. As clinicians we share that discomfort. Leaving behind the heated ideology which to date has interfered with debate, the reality is that previously suppressed profound lack of consensus remains within the clinical community and that the trial should therefore not proceed. We are happy to engage in further discussion or assistance.
Yours sincerely,
Ms Patricia Harvey Consultant Clinical Psychologist (rtd) on behalf of
Dr Lucy Johnstone Consultant Clinical Psychologist
Dr Gill l’Anson Consultant Clinical Psychologist
Dr Celia Sadie Consultant Clinical Psychologist
Dr Libby Barnardo Clinical Psychologist
Dr C Thompson Consultant Clinical Psychologist
Dr John Higgon Consultant Clinical Psychologist (rtd)
Prof David Pilgrim Chartered Clinical Psychologist
Dr Peter Harvey Consultant Clinical Psychologist (rtd)
and 11 named Consultant Clinical Psychologists/Clinical Psychologists.
psychology UNREDACTED 