[The Weeping Angel]

Of course people are outraged by the decision to ban puberty blockers.

[Malcolm Armsteen]

They talk of nothing else in our pub.

[RedSparrows]

It's a minority issue but since when did that make it irrelevant? It's strikingly heavy handed from what I understand.

[Malcolm Armsteen]

Please explain.

[Tubby Isaacs]

Please explain.

Puberty blockers have already been effectively banned by NICE. There wasn't really any need for Victoria Atkins to ban them. Streeting says he'll carry on the ban if it's lawful.

I appreciate that this was a political trap, and that it doesn't make any practical difference, but I think better to uphold the principle that the Secretary of State doesn't ban medical treatments.

[Malcolm Armsteen]

Doesn't the SoS follow and enforce NICE guidance?

[Tubby Isaacs]

There's a legal case at the moment about whether Victoria Atkins had the right to do this.

[Malcolm Armsteen]

This is Streeting's reasoning, as expressed on Twitter today:

Children’s healthcare must always be led by evidence. 

Medicine given to children must always be proven safe and effective first.

I know there’s lots of fear and anxiety. 

Let me explain why this decision was taken.

[The] Cass Review found there is not enough evidence about the long-term impact of puberty blockers for gender incongruence to know whether they are safe or not, nor which children might benefit from them.

The evidence should have been established before they were ever prescribed.

The NHS took the decision to stop the routine use of puberty blockers for gender incongruence/dysphoria in children. 

They are establishing a clinical trial with NIHR to ensure the effects of puberty blockers can be safely monitored and provide the evidence we need.

The former Health Secretary issued an emergency order to extend the restriction on prescription to the private sector, which I am defending.

Puberty blockers have been used to delay puberty in children and young people who start puberty much too early.

Use in those cases has been extensively tested (a very different indication from use in gender dysphoria) and has met strict safety requirements.

This is because the puberty blockers are suppressing hormone levels that are abnormally high for the age of the child.

This is different to stopping the normal surge of hormones that occur in puberty. This affects children’s psychological and brain development.
We don’t yet know the risks of stopping pubertal hormones at this critical life stage.

That is the basis upon which I am making decisions.

I am treading cautiously in this area because the safety of children must come first.

Some of the public statements being made are highly irresponsible and could put vulnerable young people at risk.

I know there’s lots of fear and anxiety. I am determined to improve the quality of, and access to, care for trans people.

I hope this thread provides some context for the caution and care I am taking when it comes to this vulnerable group of young people.

The decisions I am taking will always be based on evidence, rather than politics or political pressure.

It has, of course, provoked the usual storm of splenetic comments.

Plus complaints that he has caved in to JK Rowling and Badenoch, and that he is 'out of his lane' and has no authority in this area, and that this action is permanent...

Personally I can see no 'heavy handedness' in this, it seems to me to be a cautious approach to be hoped for in a Secretary of State for Health.

[Tubby Isaacs]

I agree that lots of highly irresponsible comments have been made by his opponents. But Cass didn't want puberty blockers banned, as far as I know. She could very easily have done that, and there is presumably a reason why she didn't.

[Tubby Isaacs]

Yeah, I'm sure the Muslim Vote endorsed candidate would be much liberal on this stuff.

[Malcolm Armsteen]

I agree that lots of highly irresponsible comments have been made by his opponents. But Cass didn't want puberty blockers banned, as far as I know. She could very easily have done that, and there is presumably a reason why she didn't.

The reason she didn't is that she was writing a report to government, and it's then their decision. Her views were pretty unambiguous, though.

I am still waiting for example of what she got so wroing it has provoked 'international condemnation' as some have stated.

[Tubby Isaacs]

She recommended all sorts of stuff. Why wouldn't she hae recommended a ban if she'd wanted one?

But I agree that what she says about puberty blockers (or at least this use of them) was pretty strong and a ban isn't a huge leap from them.

[Tubby Isaacs]

Labour's war on food production. And the countryside. Because presumably it can all go on "car park roofs" or something.

[Malcolm Armsteen]

She recommended all sorts of stuff. Why wouldn't she hae recommended a ban if she'd wanted one?

But I agree that what she says about puberty blockers (or at least this use of them) was pretty strong and a ban isn't a huge leap from them.

Because that isn't the business of an enquiry.

That is the job of the responsible party. And as you say, she made her views pretty clear, so I don't get why you are stressing over this point.

[Tubby Isaacs]

An inquiry can't call for something to be banned? The Government would have to ban it, but nothing to stop anybody calling for a ban.

[Malcolm Armsteen]

The clue is in the name. It can make strong recommendations. Which may lead to a ban. But generally it uses positive language - must, rather than must not. It's in the framing.

For example:

Children/ young people referred to NHS gender services must receive a holistic assessment of their needs to inform an individualised care plan. This should include screening for neurodevelopmental conditions, including autism spectrum disorder, and a mental health assessment.

[Tubby Isaacs]

You can't make a strong recommendation of ban?

[Malcolm Armsteen]

Would that be the same as a ban?

I really don't get why you're so wound up about this.

[Tubby Isaacs]

I'm not wound up any more than you are.

[Malcolm Armsteen]

Good.