No minimum age for children in ‘biggest ever’ study on trans treatment

A new study on children identifying as ‘transgender’ has no minimum age limit and is expected to have 3,000 participants.

The Pathways Horizon project, run by King’s College London, is an observational study monitoring children receiving treatment in NHS gender clinics, due to start this autumn. It was revealed that children as young as three have been seen at these clinics. The study aims to add good quality evidence for the treatment of children for gender dysphoria, and will contain ten times as many child participants as any previous research.

Last year, Dr Hilary Cass’s review concluded that care for children experiencing gender dysphoria is “an area of remarkably weak evidence” and criticised the Tavistock gender clinic for not collecting data on the children it treated. It recommended further research into the topic.

Gender-related distress

Chief Investigator of the Pathways Horizon study, Professor Emily Simonoff from King’s College London, said: “PATHWAYS HORIZON will closely follow the quality of life, physical and mental health of young people accessing the NHS Children’s and Young People Gender Services throughout the study.

“In future, we hope to get new funding to follow these young people into late adolescence and into early adult life.”

Her colleague Dr Michael Absoud, a consultant in Paediatric Neurodisability and Deputy Chief Investigator of the project explained: “this study will help, in the future, to understand how neurodivergence intersects and overlaps with gender-related distress, and whether different types of support are needed to meet the unique needs of these young people presenting to our services”.

Professor Richard Emsley, who is the statistician for the project, said: “It will help us to identify whether certain kinds of treatment packages seem to be more linked with good outcomes than others.

“That will allow us to develop further research in the future to pit interventions against each other or develop them in more detail.”

Mixed reception

The study has been met with mixed reactions, with many showing relief that there will be substantial, quality research into the topic: “The Tavistock and other captured clinics actively sabotaged any efforts to research the consequences of their ‘care’. Thank goodness that is now being addressed head on.”

However, others have raised concerns, with one person stating: “So they’re going to basically trap these kids in their delusions by allowing social transition, which Cass says does just that, and giving them plenty of attention for pretending. When will this stop!”

Another person criticised the length of the study. “Five years? So still children at the end of the study? Not having to deal with adult life with sterility and lack of sexual response? Not time for long-term impacts to kick in? Or moving on from childhood dreams?”

A further comment noted: “no one appears to have asked ‘Isn’t it rather shocking that we’ve given kids medication with life-changing impacts for a decade without a clue what we’re doing?’”

Lack of caution

In July, a High Court ruled that a private gender clinic run by former Tavistock staff could continue to prescribe cross-sex hormones to children.

The clinic prescribes the drugs to 16 and 17-year olds without conditions, despite the Cass Review urging “extreme caution” and stating that there must be a “clear clinical rationale for providing hormones at this stage rather than waiting until an individual reaches 18”.

Susie Evans, alongside a mother who remained anonymous, brought the legal challenge against the Care Quality Commission (CQC) for registering the clinic. She called them “irrational and highly risky” and said she was “extremely disappointed” in the judgment.

Evan’s Lawyer, James Gardner, partner at Conrathe Gardner LLP, commented that the CQC “chose to disregard the ideological activism of key members of the GenderPlus team, and it is shocking that the High Court was unwilling to intervene.”