Study says puberty blocker restrictions have not led to increased suicides

Updated 1 hour ago

There is no evidence of a large increase in suicides among young patients attending a gender identity clinic in London, an independent review has found.

Health Secretary Wes Streeting has asked Professor Louis Appleby to examine the data following claims by campaigners of a rise in suicide rates since puberty-blocking drugs were restricted at the Tavistock and Portman NHS Trust in 2020.

Professor Appleby’s review concluded that “the data do not support the claim” and added that the way the issue had been discussed on social media was “insensitive, distressing and dangerous”.

Jo Maugham, founder of the Good Law Project which led the claims, said she had “deep difficulties” with the review and said its analysis also included patients on waiting lists.

The Department of Health and Social Care said it was vital that public debate on the issue was handled responsibly.

Professor Appleby, a professor of psychiatry and senior suicide researcher at the University of Manchester, said online discussions on the issue had gone against guidelines for safe reporting of suicide.

“One of the risks is that young people and their families will be terrified by predictions that suicide is inevitable without puberty blockers – some of the responses on social media demonstrate this,” she said.

There was also a risk that distressed teenagers hearing such a message might be induced to copy the behaviour being warned about.

He also said that public claims of an “explosion” of suicides “do not meet basic standards of statistical evidence.”

The Good Law Project is challenging the previous health secretary’s decision to end the prescription of puberty-blocking drugs by private clinics to children and young people with gender dysphoria.

That was the recommendation of the Cass Review, published in April, which found “remarkably weak” evidence on the use of the treatment.

In response to her claims, the new health secretary launched an independent review led by Professor Appleby, which analysed NHS England data on patient suicides at the Tavistock clinic, based on an audit of the trust.

Covering the period between 2018-19 and 2023-24, it found there were 12 suicides: five in the three years leading up to 2020-21 and seven in the three years after.

“There is essentially no difference,” Professor Appleby says in his report, “given the fluctuations expected in small numbers, and it would not reach statistical significance.”

And he adds: “Specifically, among those under 18 years of age, there were 3 suicides before and 3 after 2020-21.”

The patients who died were at different points in the care system, including after discharge, suggesting there was no consistent link to any aspect of care, Professor Appleby said.

However, he said it was likely there had been an increase over a longer period as more at-risk young people presented with gender identity issues.

The Good Law Project based its claims on information provided by whistleblowers at the now-closed Tavistock clinic.

The project’s chief executive, Mr Maugham, said in a lengthy response to the review on X, formerly Twitter, that this had been combined with public evidence from Tavistock’s own minutes.

He said freedom of information requests for official figures had been “rejected”, and that Tavistock and NHS England had declined to comment on their findings when contacted.

Mr. Maugham said in X: “We seem to be comparing apples and oranges.

“The DHSC adviser is talking about the small group of ‘current and former GIDS patients’, whereas my figures relate primarily to the larger group of ‘those on the waiting list’.”

A Department of Health and Social Care spokesman said decisions about children’s healthcare should follow evidence at all times.

“Dr Cass’s review found there was insufficient evidence to show puberty blockers were safe for under-18s, which is why the NHS has now stopped routinely prescribing them for children with gender dysphoria.

“We are committed to ensuring that children who question their gender receive the best possible multidisciplinary care, led by expert clinical guidance. That is why we are reforming gender identity services.

“It is vital that public debate on this issue is handled with sensitivity and responsibility.”