Transgender People: Provision of Healthcare

Caroline Johnson Excerpts

Tuesday 16th December 2025 Westminster Hall

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con)]

It is a pleasure to serve under your chairmanship, Mr Turner. I congratulate the hon. Member for North Warwickshire and Bedworth (Rachel Taylor) on securing this important debate. I declare an interest: I am an NHS consultant paediatrician and I have cared for those with gender dysphoria in the past, and am likely to do so in the future. As we discuss a fairly heated topic, we need to remember that there are people experiencing significant challenges, and they deserve the very best healthcare based on need and the best evidence.

One challenge is that name and sex records are sometimes different from how people are referred to in a ward. The previous Conservative Government launched the Sullivan review, which found that a failure of NHS bodies to record biological sex meant that some people were not invited to sex-specific screening. It recommended that we should not combine questions on sex and gender, and that putting politics before patients threatens clinical care. When will the Government formally respond to the Sullivan report? When does the Minister expect to implement its important recommendations? How will the Government ensure that intimate care is provided by someone of the same biological sex where possible?

I would also like to raise the issue of phalloplasty, which is a major surgery on healthy bodies, creating a penis. According to the NHS website, it causes urinary incontinence, loss of sexual function, and in 3% of cases, necrosis and loss of the penis. Is the Minister confident that the NHS is doing the right thing with this surgery?

I want to move on to talk about children with trans identity. We have been talking about the puberty blockers trial. Why is that trial occurring? Drugs are, unusually, being given to children with physically healthy bodies. Despite telling Members of this House that he was comfortable with the trial, the Secretary of State said on Friday to the media that he was “uncomfortable”. Why is it being considered before the completion of the data linkage study recommended in the Cass report?

Some 9,000 children went through the Tavistock gender identity and development services. Many regretted irreversible damage to their bodies. Why have the Government chosen to experiment on a new batch of children before the data linkage study recommended by the Cass report is complete? What steps is the Minister taking to secure that data? What steps is she taking to hold to account the people who are obstructing the data linkage study? What assessment has she made of the motivation of those obstructing a study that, at its heart, is designed to protect children?

What of the trial itself? Some 226 children will receive puberty blockers—is that a limit? Will there be no more by law? They will be randomised into treatment now or treatment after 12 months, and analysed after just two years. When someone receives the drug for only a year, they will still be a child. What meaningful results can be obtained over that period?

The true control group of those not receiving the drugs is not randomised, but chosen or matched from a different trial—the Horizon Intensive trial. Is the Minister concerned that that may introduce a bias? The criteria for getting puberty blockers under the trial require that one parent consents, not necessarily both—one might disagree—and the clinician must think it will benefit the child, but on what specific criteria will the clinician make that decision? Is the Minister concerned to ensure that ideology does not affect judgment?

The Cass review said that the majority of children with gender dysphoria will recover from their distress without any medication, and that it is not currently possible to predict which children they would be. Does the Minister accept that the vast majority of children in this, the Streeting trial, are physically healthy children whose distress would get better without puberty blockers, and that this Labour Government are choosing to give potentially dangerous drugs to children, most of whom will not need them?