'No evidence' curbs on puberty blockers have led to rise in suicide among trans children, report finds
19 July 2024, 22:59 | Updated: 20 July 2024, 00:01
An independent report has found no data to support activists' claims that restricting the use of puberty blockers has increased the risk of suicide among children with gender dysphoria.
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Public discussions of the issue online were labelled "insensitive, distressing and dangerous", by an adviser to the government.
New Health Secretary Wes Streeting asked Professor Louis Appleby to look into NHS England data on suicides by young patients of the now-closed Gender Identity Development Service (Gids) at the Tavistock and Portman NHS Foundation Trust.
It came after activist lawyers the Good Law Project, claimed the ban on puberty blockers had "put young trans people's lives at risk".
In March, NHS England said children would no longer be prescribed puberty blockers at gender identity clinics, except as part of clinical research trials which are not yet running.
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The health service said the decision to stop the routine use of puberty blockers was taken on the basis that "there is not enough evidence to support (their) safety or clinical effectiveness".
Prof Appleby referred to a claim by the Good Law Project director about "an explosion" of deaths after an earlier restriction of puberty blockers following a 2020 High Court ruling, as well as "multiple references to children dying in future because they are unable to access puberty-blocking drugs".
He said the claim is "said to be based on unpublished data provided by two members of staff at the Tavistock, described as whistleblowers".
But Prof Appleby concluded that the available data from NHS England - based on an internal audit by the Tavistock of deaths among current and former Gids patients from 2018 to 2024 - does not support the claim.
He said there were 12 suicides across the six years - half aged under 18 and half aged 18 or above.
In the three years leading up to 2020/21, there were five suicides, compared with seven in the three years after.
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Prof Appleby said: "The patients who died were in different points in the care system, including post-discharge, suggesting no consistent link to any one aspect of care. They had multiple social and clinical risk factors for suicide.
"However, it is likely that there has been a rise over a longer period as young people at risk have increasingly presented with gender dysphoria and referrals to Gids have risen."
Gids saw a sharp increase in referrals of young people to more than 5,000 in 2021/22 compared with just under 250 a decade earlier.
It closed at the end of March and was replaced by two regional hubs in London and the North West.
Prof Appleby was critical of how the issue of suicide among young people with gender dysphoria has been referred to online.
He said: "The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide.
"One risk is that young people and their families will be terrified by predictions of suicide as inevitable without puberty blockers - some of the responses on social media show this."
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He said the claims "do not meet basic standards for statistical evidence", adding that "to be reliable, evidence should be objective, unbiased and open to independent scrutiny".
He said "puberty-blocking drugs have come to be seen as the touchstone issue, the difference between acceptance and non-acceptance", something he described as "unfortunate" as he called for patients, staff and the public to move away from this perception.
He said: "In the end this is about a group of young people at risk of suicide and our collective responsibility to their safety.
"This means specialist health services with the capacity to respond to rising demand and appropriate skills in general services.
"It means a measured public discourse, making sure we do not stoke up prejudice or cause unnecessary alarm to the young people and their families."
A Department of Health and Social Care spokesperson said decisions on children's healthcare "must follow the evidence at all times" and insisted the Government is "committed to ensuring children questioning their gender receive the best possible multidisciplinary care, led by expert clinical guidance".
They added: "It is vital that the public discussion around this issue is handled sensitively and responsibly."
Good Law Project executive director Jo Maugham said: "I was not contacted in advance of the statement being released and will obviously need time to respond.
"I do have difficulties with the figures and analysis and will respond in due course."
