A new clinical trial in the United Kingdom is set to ask children as young as ten years old to consider whether they wish to freeze their sperm or eggs for potential future use, a direct response to the known risk of infertility posed by puberty-blocking drugs.
The Controversial NHS Trial Set for 2026
The two-year experiment, organized by the UK's National Health Service (NHS), is scheduled to begin in January 2026. It will involve 226 children who identify as transgender. All participants will receive puberty blockers, with some starting immediately and others after a one-year delay. Researchers plan to compare their outcomes with a control group of 300 "gender incongruent" children who do not take the medications.
This trial represents the only legal pathway for minors in the UK to access these drugs after they were effectively banned for routine use in March 2024. That ban followed the landmark Cass Review, an NHS-commissioned report that critically examined gender-affirming healthcare for youth.
Medical Risks and Ethical Concerns
Puberty blockers, intended to pause the physical development of children experiencing gender dysphoria, carry significant potential side effects beyond infertility. These concerns include bone density loss, vision loss, and brain swelling.
The Cass Review, led by retired pediatrician Dr. Hilary Cass, found the evidence supporting early puberty suppression to be weak. It stated the rationale for the treatment "remains unclear" and that its impact on gender dysphoria, mental health, and cognitive development is poorly understood. Despite these findings, the review ultimately recommended further study, paving the way for the upcoming trial.
UK Health Secretary Wes Streeting has acknowledged personal discomfort with the clinical study but has not halted it, drawing criticism from gender-critical advocates.
A Question of Maturity and Consent
The directive to discuss fertility preservation with pre-adolescent participants has sparked intense ethical debate. Helen Joyce, a journalist and director of advocacy for the Sex Matters charity, condemned the approach in comments to UK media.
"Some of the participants in this trial will be so young they still believe in Santa Claus," Joyce said. "Some may not even be clear on the facts of life. This guide envisages conversations they will not be mature enough for, and which are totally inappropriate for their age group."
Critics argue that asking children to make profound decisions about their future fertility, when they are potentially confused about their gender identity and unable to grasp long-term consequences, constitutes a profound ethical breach. They view the trial itself as a continuation of what they label a medical scandal, vowing to continue their opposition to the research.
