PATHWAYS Study: Puberty Suppression

Baroness Thornhill Excerpts

Wednesday 24th June 2026 Lords Chamber

[Baroness Merron (Lab)]

I agree with the noble Baroness and I thank her for the offer of the briefing, which I mentioned earlier, and for her observations. I associate myself with what she said about the complexity of the matter, which is why I take it so seriously. The fact is that this situation exists. I am exercised about those who are accessing puberty blockers in an unregulated fashion. It is extremely concerning, which is another reason for this trial, as well as the services being set up. That is why we indefinitely banned the sale and supply of puberty blockers via private prescriptions, taking effect from January 2025. If offences are committed then those involved will be brought to justice, and rightly so.

[Baroness Thornhill (LD)]

My Lords, in my pre-political life I was a senior teacher at a very large comprehensive school, and responsible for child protection and what used to be called pastoral care. I dealt with lots of children who were confused about their sexuality, their place in the world and many other issues. I am afraid that I too would have asked the questions that the noble Baroness, Lady Cash, asked, based on that real experience. My question is aligned to my past experience. Studies show that a disproportionate number of children and adolescents with gender distress have neurodivergent conditions, such as autism. These are protected under the Equality Act. Could the Minister explain how neurodivergence was taken into account when designing the PATHWAYS trial, in particular the consent process—that is what troubles me the most, if I am honest—and any equality impact assessment?

[Baroness Merron (Lab)]

The noble Baroness gives me the chance to reiterate that all the questions are valid. We are dealing with a complex, sensitive and difficult issue. What matters is that we get to the right place. As the noble Baroness, Lady Cass, said, I know we are all agreed on protecting children and young people. That is our motivation.

The noble Baroness asked about consent. As I said, children can participate only with the consent of a parent or a guardian, and the children themselves must consent or assent. The individual circumstances and nature of a child will be closely considered as part of the consideration. That is absolutely crucial. Children and young people may participate only if they are not subject to any safeguarding concerns. I am happy to speak in greater detail to the noble Baroness. All of this will be extremely rigorous, and rightly so. When we talk about the trial, we are talking about volunteers—that is crucial. They can participate only if they have been deemed clinically appropriate by both the NHS care team and the national multidisciplinary team. There is, correctly, the opportunity at every level to consider every child or young person as an individual, which is so important.