Wes Streeting MP: speeches 2025

Speeches

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I say respectfully to the hon. Gentleman, whom I like very much, and to his constituent, that it is because I have also had to look into the eyes of people in this community who have not received the right care and seen the deleterious impact it has had on their mental health and wellbeing. I have had to deal with parents who have suffered loss and bereavement. We have to make sure that we are doing the right thing by everyone. This should not be an either/or choice.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  The study includes a lot of research around wider therapeutic support and interventions, including mental health support. We are rolling out more clinics and services across the country to bring that care closer to home.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I first thank the right hon. Member for the way in which he puts his concerns. I know he is concerned about this trial and that he has stated publicly his opposition to it, and I enormously respect the way in which he has done that. These are finely balanced judgments, and I acknowledge that. The Cass review found that puberty blockers have been prescribed routinely without good evidence for their safety or effectiveness, and that is why a clinical trial was proposed. They are licensed and used safely in much younger children for precocious puberty or in older adults for certain cancers. For adolescents, the interaction with all the different processes of puberty may be very significant, which is why more evidence and a better understanding of their impact is needed in this patient group. Anyone on the trial can choose to stop taking puberty-suppressing hormones and leave the trial at any time; they do not need to give a reason. If a young person decides to stop taking puberty-suppressing hormones, their care in the NHS, including the gender service, will not change in any other way, and their doctors will explain to them and their parents or guardians what treatment options are available. I know that there are concerns about the longer-term impacts on fertility. Prospective participants will be given comprehensive information on the advantages and potential risks of the hormones, including details about preserving fertility. Doctors will explain the possible long-term consequences and available options. Young people will also be offered consultation with a fertility specialist. The young person and their parent or guardian must clearly demonstrate a full understanding of all these issues—only then, after that, would a clinician sign off on admission to the trial.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I will take the hon. Member’s question in three parts. First, the opinion polling that she mentions shows that people in this country are overwhelmingly kind, and they want to ensure that trans people, and LGBT people more broadly, are treated with kindness, compassion and inclusion. Secondly, I do not dismiss the opinion polling that shows that a majority are against this kind of trial. Thirdly, the reason I am doing this is that I have to think about this extremely small group of people. I do not know what it is like to walk in their shoes and I have to think very carefully about what is in their best interests. The best way to do that is to build the evidence base that we need to provide high-quality healthcare. I strongly, strongly do not agree with her characterisation of this study, which is in itself irresponsible.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  The right hon. Member is right that we need that data linkage study. That will happen, but it will not produce the same evidence base as a clinical trial, and that is the distinction between the two. It is frankly a disgrace that people have sought to withhold that kind of data and it is really important that we get this right. I appreciate the right hon. Member’s sympathy. I have wrestled with this issue probably more than any other ethical decision that I have had to make in this office. I do not seek any pity or sympathy for doing so—it is the job that I signed up to and a job that I love doing. I have taken great care and sensitivity in this area because of the particular vulnerability of this group of children and young people.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  They certainly can, and if they withdraw, they will still get the wider therapeutic support they deserve.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  The hon. Lady has offered a political opinion, not a clinical judgment. By that logic, we would not have any medicine for children and young people; we would never have undertaken clinical trials or studies, because we would have judged that children and young people could not take part in them. That is objectively not a sensible position. I understand the sensitivity surrounding this issue, and the hon. Lady is right to say that people in our country have received life-changing clinical interventions that they later regretted. As part of that regret, they have shared that they did not feel, at the time, that they were making or could have made an informed decision. That is why this trial is set up in such a way that it has such strong clinical oversight locally as well as nationally. It cannot happen without not just the assent of a young person but the consent of their parent or guardian. Those are important protections and safeguards. I do not share the hon. Lady’s characterisation of the trial.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  May I thank the hon. Member for the way in which he put his question? It is so important to emphasise that right across this House, there are many people who oppose this trial, but who do want to see trans people well supported and protected and to respect their identities. That is important for everyone to bear in mind. The hon. Member talks about placebo. For obvious reasons in this case, a placebo would not be appropriate, because it would be very obvious whether a young person was receiving the real medication or the placebo, but the trial design has included a control group. The way in which the trial is established will help us to distinguish between the benefits of receiving or not receiving this particular medication, and there will be really close oversight of the impact on development, but he is right that we need to judge these things on the question of risk. That is what led Dr Cass to make her recommendation, and that is why I support it.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I certainly do not need to be told what my responsibilities are on this. I always take responsibility for the decisions I take. I acknowledge the extent to which the hon. Gentleman and members of his party seek to weaponise this issue, and to personalise it. [ Interruption. ] We can simply refer back to his question and to the shadow Minister’s reference to the “Streeting trial”—if that is not personalising, I do not know what is. I’ll tell you what: I will take an evidence-based approach. I have done that on this issue from day one. Had the Conservatives done so, we would never have seen the Tavistock scandal. We would never have seen puberty blockers dished out willy-nilly to children and young people in this vulnerable patient group. I have sought at all times, including when I sat on the Opposition Benches, to treat this debate with the care, sensitivity and humility it deserves, and not to be tribal in my interactions. I only wish this Conservative Opposition would take the same approach.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  Let me reassure my hon. Friend and the House that I am absolutely open to receiving representations and evidence from clinicians involved in the care of children and young people, with insight, expertise and data, including those who might be critical of the approach that the trial team is setting out or, indeed, critical that the Cass review included this recommendation. That is important because the many things that have gone horribly wrong in this area have included the silencing of whistleblowers and the silencing of rigorous debate and discussion. We have to have this debate with due care and sensitivity for young people in this vulnerable group in particular and for the wider trans community, who feel extremely vulnerable in this country at the moment, including as a result of decisions I have taken as the Health and Social Care Secretary. We have to consider all of that in the round, but we must make sure that at all times we are following the evidence, that we are open to scrutiny and challenge, and that where we are making these finely balanced judgments, we are doing so with rigorous debate, testing the arguments, the evidence and the data. That is why I welcome the urgent question and this discussion.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  My hon. Friend is correct that the study is about building the right evidence so that we get high-quality, safe healthcare for this vulnerable group of children and young people.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  My hon. Friend is absolutely right. Given that I work for a former Crown prosecutor, I could not possibly disagree with her on evidence.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I wish I had certainty on this issue, and in some ways I envy my hon. Friend for his certainty. Having occasionally found myself to be a lonely voice in my party when sat on the Opposition Benches, I respect the fact that it is not easy to be a minority, dissenting voice, especially when one feels so strongly about an issue. I respect my hon. Friend’s position, even though I disagree with it—I do think this trial is the right thing to do. He is right that we need love, compassion and empathy for these young people; we also need to understand what health and care support will produce the best outcomes for them, which is what the trial is about.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I can certainly promise my hon. Friend that we will keep the House regularly updated. The risks he has described have weighed heavily on my conscience when putting in place a permanent ban on puberty blockers; I have understood the risk involved, and the vulnerability of this particular group of children and young people. I also meant to say, in response to my hon. Friend the Member for Pendle and Clitheroe (Jonathan Hinder), that the parents of trans young people love their children very much. That has been at the heart of so many of the representations I have received, from parents as well as from young people.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  My hon. Friend is absolutely right. Regardless of whether people are receiving this medication or not, we need to ensure that they receive the right therapeutic support to enable them to have healthy, happy childhoods and to understand themselves, the world they live in and how they relate to it in a way that does not cause them distress or harm. That is my objective in this process.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I thank the right hon. Gentleman for his question and for how he puts his criticism, too. As I said earlier, and for the avoidance of doubt, I know what my responsibilities are. I understand the decisions that I take in this office and that I am accountable for those decisions. I do not resile from that. I am following clinical advice; I think that is the right thing to do in this area. On the question of sex, the right hon. Gentleman is right: sex is immutable. Even if there has been treatment with hormones or surgery, underlying biology none the less means that trans women, for example, would still need to be screened and treated bearing in mind their biological sex, and the opposite is true for trans men. We have to draw that distinction between biological sex and gender identity. Whatever my discomfort and personal views about this particular trial or about the notion of young people using puberty blockers in this way, I cannot ignore, and should convey faithfully to the House, conversations that I have had with trans young people and adults. They have described in powerful and unforgettable terms not just the life changing, but the life enhancing experience that they have had. I am thinking particularly of the university student I met; if she walked into this Chamber now, we would assume that she was born female. She is living her best life and described in very powerful and unforgettable terms the impact that treatment has had for her and her quality of life. At the same time, I think of high-profile cases such as Keira Bell’s. That is why we have to tread extremely carefully in this area, to follow evidence and to build an evidence base. It is also why these are such finely balanced judgements and why I can be simultaneously uncomfortable with the permanent ban that I put in place and uncomfortable with the clinical trial. I hope that I have reassured people that I think very deeply about these issues before taking decisions.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I will try to do that, Madam Deputy Speaker. We will ensure that young people get good access to wider evidence-led support. I have had to wrestle with the fact that some trans people enter adulthood without ever receiving any sort of healthcare, and I have been heavily criticised by those people in particular for some of the decisions that I have taken. We are working to reduce waiting times, as I have described. My hon. Friend says that puberty blockers are reversible. We hear contrary views about that from Members across the House, some of whom say that puberty blockers are irreversible. The truth is that the evidence in this area is mixed, which is why we need to build a stronger evidence base.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I assure the hon. Member that as part of this study, and as part of the roll-out of services across the country, we are focusing on the therapeutic support that she describes. We are implementing the Cass review, which recommended this particular trial for this particular purpose, and we will follow the evidence. Of course we look at what other countries are doing, why they are doing it and what research emerges.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  As I reported when we put in place the permanent ban, there have been arrangements for people who were previously being prescribed puberty blockers. People who wanted to access them, but could not once the ban came in, have not been able to do so through authorised means. I recognised when I took the decision, and as a result of representations I have received, both directly and in writing, that it caused considerable pain and distress to a very vulnerable group of children and young people and to the people who care very much about them. I have not been indifferent to that; I have taken it very much into consideration. However, with respect to all the people I have met, no amount of political pressure should move a Health Secretary away from the clinical advice and expert opinion that should underpin these sorts of decisions.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  My hon. Friend is absolutely right that we must engage with due care and sensitivity on this issue. I can share with the House that these exchanges, Government policy, what is said by me and others, are followed extremely closely by this group of children and young people, who are extremely online, and by the wider LGBT+ community. My hon. Friend is right that trans people are often at the wrong end of the statistics as victims of hate crime, discrimination and mental ill health. We must always tread carefully when talking about suicide in this context, and bear in mind the warnings of the Government’s adviser on suicide prevention, Professor Louis Appleby, and the way in which that issue has been deployed irresponsibly by critics of the ban on puberty blockers that was put in place—we bear all those things in mind. I do think we have a high-quality trial set up. I do have confidence in the clinicians. We have had a cross-party briefing from the clinical team. I am happy to repeat that exercise, to keep coming back to the House and to arrange briefings for MPs and peers on a cross-party basis so that we can follow this closely, as we should.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  When it was published—I was in the Chamber at the time—there was an overwhelming consensus in the House. There were some people who criticised and challenged the Cass review at the time, including some outside the House in the LGBT community. I have always supported the Cass review, which was led by one of our country’s best paediatricians. Because of that, I am proceeding in the way that I am, which is the way that Dr Cass—now Baroness Cass—recommended. I will continue to follow the evidence and implement the Cass review comprehensively.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  The risk that my hon. Friend sets out was one of the considerations that I had to when weigh up—first when upholding the temporary ban, and then when making the ban permanent. I do worry that, outside of a trial, we may continue to see unsafe or unethical practice. I think we will be doing a service to medicine in this country as well as internationally if we have a high-quality trial with the highest standards of ethics, approvals, oversight and research from some of our country’s leading universities and healthcare providers to ensure that, for this particular vulnerable group of children and young people, we are taking an evidence-based approach to health and care.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I absolutely agree with my hon. Friend that we need a strong evidence base, that we need to conduct these conversations with great care, consideration and compassion, and that we need to recognise the vulnerability of this particular group of children and young people, and the fear that so many trans people in our country feel about whether this is a country that accepts and respects them. The political climate has changed since we made all the progress we have made on LGBT equality over the last 20 or 30 years, but do I think the character of this country has changed? Do I think we are less inclusive, less respectful, less loving or less caring? Absolutely not—those are the hallmarks of this country and of the British people. We might be having a debate about the efficacy of this trial, but I think the overwhelming majority of people in this House are doing so in the spirit of wanting trans people to live healthy, happy lives in which they feel safe, included and respected in our country.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  I can certainly give my hon. Friend that assurance.

• 17 Dec 2025 · Puberty Suppressants Trial · Hansard source

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  Let me just start by acknowledging the sensitivities around this issue and the strong beliefs held around this House. For all the division and divided opinion, I believe that there is a determination shared by everyone in this House to do the right thing by a vulnerable group of children and young people. It is for those reasons that I am taking the course of action that I am. Put simply, that is to follow expert clinical advice and take an evidence-led approach. The Cass review found shocking levels of unprofessionalism, a lack of clinical oversight and puberty blockers prescribed to children without sufficient evidence that doing so was safe or beneficial to those children and young people. What Dr Hilary Cass uncovered was a scandal. That is why, on coming to office, I made the temporary ban brought in by my predecessor, the right hon. Member for Louth and Horncastle (Victoria Atkins), a permanent one. Dr Cass also recommended a thorough study to establish how best to support children and young people who suffer gender incongruence. That is the pathways study. The study has four main parts, one of which is the clinical trial to study the effects of puberty-suppressing hormones on young people’s physical, social and emotional wellbeing. The other aspects of the pathways study will track the physical, social and emotional wellbeing of all young people attending UK NHS gender services. It will look at young people’s thinking and brain development, following both those who are and are not taking puberty-suppressing hormones, and it will gather evidence directly from young people, parents and staff about their experiences of living with gender incongruence. The bar for the trial to be approved was extremely high and oversight will be rigorous. Children cannot consent to being on the trial, so places will require parental consent, as well as the assent of young people. It is because protecting and promoting the health and wellbeing of affected young people is our primary concern that there are also strict eligibility criteria in place to join the pathways clinical trial. As such, the number of young people who would expect to qualify for the trial will also be low. Participants must undergo thorough mental and physical assessments and will be followed over a number of years with regular wellbeing checks. Puberty blockers have also been used to delay puberty in children and young people who start puberty much too early. Use in those cases has been extensively tested and has met strict safety requirements for that use. The study is led by King’s College London and the South London and Maudsley NHS foundation trust. It has been carefully checked by independent scientists who advise the National Institute for Health and Care Research and by the Medicines and Healthcare products Regulatory Agency, and received approval from a research ethics committee. I am treading cautiously in this area because the safety of children must come first.