Puberty blocker ban in Wales unlawful says former Plaid Cymru leader

A former Plaid Cymru leader has claimed that the Welsh government violated its own law in how it banned puberty blockers for under-18s questioning their gender identity, according to ‘BBC’. This decision came after a review found insufficient evidence of the long-term effects of these medications, prompting NHS GPs in Wales to stop issuing new prescriptions, in alignment with other UK nations. An expert group described the drugs as posing an “unacceptable safety risk.”

However, Adam Price and Rocio Cifuentes, the country’s children’s commissioner, asserted that the government should have evaluated the impact on affected children. The Welsh government has expressed commitment to developing gender services for young people.

Historically, puberty blockers have been used to treat early-onset puberty, but their demand has surged over the last decade among young people experiencing gender dysphoria. A review in 2024 by Dr. Hilary Cass highlighted a lack of evidence supporting the safe use of these drugs to “arrest puberty,” calling it unusual to administer such a potentially life-altering treatment to young people without understanding its effects in adulthood.

A young trans man, who began transitioning as an adult, shared with BBC Wales that he believed puberty blockers could have spared him “the trauma of living in a body that never felt like it was mine.” Despite the Welsh Conservatives supporting the government’s position, NHS England announced in March 2024 that the drugs would no longer be prescribed routinely, and a ban on private prescriptions was made permanent in December by UK government Health Secretary Wes Streeting. The Commission on Human Medicines (CHM) also recommended permanent restrictions due to unacceptable safety risks.

Currently, these drugs are only available if a patient participates in a clinical trial, as promised by the UK government, or if they were previously receiving them. Last year, similar restrictions were introduced in Wales by the Welsh NHS for GPs.

In December, Adam Price tried to have these regulations overturned, arguing that ministers had neglected a legal duty to consider the UN Nations Convention on the Rights of the Child, which was incorporated into Welsh law in 2011. Price noted in a Senedd debate that no impact assessment had been made, which contravenes government guidelines that ensure legal compliance.

Price told BBC Wales: “It's evident the government acted unlawfully. They need to urgently address this issue and meaningfully engage with the children and young people affected, whose rights deserve respect and whose voices need to be heard.” He suggested that children and young people could have highlighted the absence of clinical trials.

When asked if he opposed the ban, Price stated that it wasn’t his place “to give a view on a clinical question.” He emphasised the importance of whether the appropriate legal process was followed and whether the rights and voices of children and young people were respected.

Gwion Williams, 21, who began his medical transition as an adult, recounted difficulties in receiving assistance from the Welsh NHS when he was under 18. He was referred to child and adolescent mental health services, which he felt dismissed his dysphoric feelings. Despite his persistence and a subsequent application for funding to gain a referral to the former Tavistock clinic, he was deemed ineligible because he was 17 years and nine months old.

Williams stated that the Welsh government should have consulted both professionals and trans individuals and their families to understand the impact on them. Without a dedicated youth gender service, he argued that Wales lacks essential support for gender-diverse youth.

Williams added, “Assessing the situation is crucial because many GPs feel unqualified to prescribe puberty blockers or provide assessments, given the absence of a youth clinic in Wales.” In a letter to the Welsh children’s minister, Dawn Bowden, the children’s commissioner stressed that without an impact assessment, it is impossible for ministers to prove compliance with the 2011 duty. Ms. Cifuentes emphasised that although the matter involves a small group of children and young people, their rights should still be protected.

She also mentioned attempts to arrange meetings between ministers and young people affected by decisions about puberty blockers last year but said the meeting did not take place. Conservative shadow health secretary James Evans expressed agreement with the Welsh government’s position, stating, “Whether consulting young people was necessary is up to the Welsh government. If I were the health secretary, I would not endorse giving young people anything that could harm them in the future.” He acknowledged the importance of young people’s voices but stressed the necessity of safety and verification, citing the Cass review’s finding of insufficient evidence to deem the treatment safe.

In a recent Senedd session, the Welsh government's chief legal adviser, counsel general Julie James, noted that ministers had considered the convention since there was not an absolute ban. James said that in practice, few GPs in Wales actually prescribe puberty blockers for those under 18 due to concerns about the evidence base and the expertise needed to monitor use. She stated that the regulations aligned GP prescribing practices with the review’s recommendations.

She was criticised by Caerphilly Labour MS Hefin David for delivering her statement “without passion or enthusiasm.”

This issue arises a year after the government admitted failing to comply with its own children’s rights law in a similar case where no impact assessment was conducted on a decision to end holiday assistance for children receiving free school meals. Rachel Thomas, head of policy at the children’s commissioner’s office, noted that the situation felt like “history repeating itself” after the government again omitted to conduct an impact assessment regarding the decision to end support for school holidays.

She also commented on the government’s pledge in its LGBTQ+ action plan to explore a gender service for young people, which she observed had not progressed. As of now, under-18s must be referred to a clinic across the border in Bristol. Following a BBC Wales inquiry, the commissioner’s office stated its respect for the Cass review findings.

A Welsh government spokesperson commented, “Consistent with our commitments in the LGBTQ+ Action Plan, we aim to enhance gender identity services for young people and adults. We are considering the children's commissioner's suggestions and will respond accordingly.”