England's halt of routine puberty blockers 'important news,' say two U.S. experts

By Gina Christian, OSV News

(OSV News) -- England's decision to halt routine prescriptions of puberty blockers following a review is "absolutely very important news" -- and shows that research is a "game-changer" in the debate over gender transitioning for children, two U.S.-based experts told OSV News.

NHS (National Health Service) England announced March 12 it would no longer automatically prescribe puberty suppressing hormones to child patients at its gender identity clinics, joining a growing list of countries that includes Denmark, Finland, France, Norway and Sweden to limit such usage.

The move follows an interim report by Dr. Hilary Cass, a former president of the Royal College of Pediatrics and Child Health, whom NHS appointed in 2020 to conduct an independent review of its gender identity services.

Cass and her team found that there were "gaps in the evidence base" for puberty blockers, which arrest the onset of puberty by inhibiting sex hormones.

The drugs -- which in the U.S. are approved by the Food and Drug Administration for precocious, or premature, puberty -- have in recent years been prescribed in an off-label capacity to children expressing confusion about their gender.

However, a number of clinicians and researchers have raised concerns that administering the blockers to children who are not experiencing premature puberty can have negative, long-term effects on brain and bone development, as well as metabolism.

Those risks are real, said Dr. Patrick Lappert, a retired board-certified plastic surgeon and deacon at Annunciation of the Lord Parish in Decatur, Alabama.

Deacon Lappert, who has spoken nationally about the risks of puberty blockers, told OSV News that the sex hormones acted on by these drugs "are responsible for the massive process of regulation of the developing child -- including their skeletal growth, the development of muscle mass, the development of coordination, coordinated movement, as well as the development of higher executive functioning of the brain, their ability to make decisions, (and) their ability to recognize and logically sort through problems."

Puberty blockers "utterly shut that (process) down," he said, adding they leave a child's "affective development (and) ... subjective emotional life development that is part of their future adult sexuality ... arrested completely."

While proponents of puberty blockers say the regimen is evidence-based, "there's no science in there," with clinical studies of "the lowest quality," said Deacon Lappert. "There is no scientific basis for doing this to children at all. It's (based on) anecdotal reports unsubstantiated by long-term data."

Yet the "emergence of research, particularly substantive evidence reviews, assessing the risks and benefits of treatments for 'gender confusion' ... has been a game-changer not only in health care settings but also for the cultural conversation," said Mary Rice Hasson, Kate O'Beirne Senior Fellow at the Ethics and Public Policy Center in Washington, where she co-founded and directs the Person and Identity Project.

Hasson told OSV News the "small, poorly done studies that were largely unchallenged" over the past 20 years supported the view that "puberty suppression (was) 'fully reversible.'"

"But as the number of identity-distressed young people spiked, some publicly regretted 'transitioning' and began to speak out," Hasson said.

One of the most prominent voices is that of Keira Bell, who legally challenged the Tavistock and Portman NHS Foundation Trust, which operated the NHS gender identity clinic where Bell had sought her transition. Although a British appeals court later overturned her legal win, Bell has maintained she was "treated like an experiment," and continues to warn that many children and teens actually seek transitioning to address mental health and other disorders.

Hasson said the outcry has put medical professionals on notice.

"Clinicians in Sweden, the U.K. and Finland began scrutinizing the outcome data and found appallingly little evidence of benefit, but clear evidence of harm," she said.

Hasson cited a February 2024 study by Sallie Baxendale, professor of clinical neuropsychology at University College London, which found "no evidence" that the cognitive effects of puberty suppressing-drugs "are fully reversible following discontinuation of treatment."

On the contrary, "there is some evidence of a detrimental impact of pubertal suppression on IQ in children," wrote Baxdendale.

"We know that research is making a difference, because six European countries, including the U.K., already have reversed course, based on substantive evidence reviews showing lack of benefit and high risk of harm," Hasson said. "They now limit or oppose medicalized interventions for identity-distressed minors."

At the same time, she added, "the U.S. is a tougher environment," since "ideology sets the narratives."

Deacon Lappert agreed, saying that "all of the language that is offered in support of doing this to children is ... political, ideological language."

"Major medical associations generally align with progressive agendas and follow the lead of the activist-led World Professional Association for Transgender Health, which promotes 'standards' written by gender clinicians themselves," Hasson said.

In addition, she said, "gender clinicians and hospitals with gender clinics have a profit motive in offering medicalized interventions in minors," who enter the system "with healthy bodies, but wounded minds."

Hasson said the harm experienced "at the hands of gender docs" makes them "become medical consumers for life, dependent on successive, expensive medical interventions in their pursuit of something they can never have: the body of the opposite sex."

She called for "severe financial penalties" against medical providers and clinics that engage in "these horrendous practices" in order to end them.

Rather than puberty blockers and surgical procedures, Hasson pointed to what she said "has always worked" in addressing gender confusion for children: seeking individual and family therapy, developing deeper relationships with family and friends, cultivating healthy interests and skills, and limiting harmful influences, particularly from social media.

"The decision by the National Health Service in England is a very welcome sign," Deacon Lappert said. "And it joins a large chorus of voices that are basically crying out to stop doing this to children."