Adele Waters

Two controversial research studies assessing the risks and benefits of giving puberty blockers to young people with gender incongruence will go ahead.1The trials received all necessary regulatory and ethical approvals and will begin recruiting participants soon, with findings expected in four years. But some clinicians have argued that it is “unethical” to expose children to potentially damaging drugs without clear benefit.The first study, the Pathways trial, will measure the impact of puberty blockers on the quality of life and emotional wellbeing of young people with gender incongruence, as well as their cognitive, physical, and social development.Researchers aim to recruit 226 children over three years into one of two study arms. In the first group participants will get puberty blockers at the outset for 24 months, while participants in the second group will have to wait for 12 months before receiving them. Participants will be assessed at the outset, at 12 months, and at 24 months. Researchers will compare these assessments with 300 children with gender incongruence who will not take puberty blockers.The research teams, based at King’s College London and the South London and Maudsley NHS Foundation Trust, say that the study will be large enough …

At just nine years old, Jess Hoque has already experienced several episodes of a life-threatening reaction due to a dairy allergy he's had since birth.

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Domestic abuse in NHS workers is a “silent pandemic,” with some research finding that they are three times as likely to experience it. Adele Waters finds that the NHS needs to do more to end a “double layered stigma” affecting cliniciansCatherine,* a 40 year old psychiatrist from northwest England, recalls the moment she decided to end her 15 year marriage. “I was at work when I noticed a missed call from my 10 year old son,” she says. “That was unusual because he rarely used it for making calls, but I would soon find out why. His father—my ex-partner—had locked our younger child in a dog crate.”She tells The BMJ , “I couldn’t get my head around it. I managed to leave work and drive home as fast as I could, which took me about 20 minutes, to find our little boy—who was then just 3 years old and ill with chickenpox—locked in this tiny crate that was meant for our very small dog.“Even though my ex had agreed to look after our four children while I was at work, he had somehow decided that he shouldn’t have been, and it was his way of protesting. He’d sat the other children down opposite and made them watch their little brother trapped.”That was the point when Catherine made her decision to finally free herself from a long term abusive, controlling husband. “It was like a switch went on,” she says. “I finally gave myself that permission when I saw what he did to my little boy that day.”Catherine’s story is just one of many that have prompted the Doctors’ Association UK and the Medical Women’s Federation to launch a campaign to raise awareness about domestic abuse among healthcare professionals and urge NHS employers to ensure that …

Credit: Asadour GuzelianMedical students who are found to have sexually harassed fellow students could be barred from graduating at the University of Manchester.This is one option being considered in response to 31 alleged incidents of sexual harassment involving medical students by their peers in the faculty of medical sciences.The scandal was brought to light by a final year student, Charlotte Buttercase, after she received sexually explicit calls from a group of male students. It coincides with a police investigation into the harassment claims, as well as a parallel internal investigation by the university.Speaking to The BMJ , Buttercase (pictured) said that the profession needed a zero tolerance approach to this behaviour. “If [these men] did this when they were in their 20s, how bad will they be by their 40s?” she said. “The first patient they harm, it will be too late. The first colleague they harm, it will be too late.”Recalling the incident that sparked the campaign, Buttercase said that she had been sexually harassed just four days after celebrating her graduation ball. “It was 2 …

NHS England (NHSE) has failed to implement changes to ensure that a patient's sex, as well as gender, is recorded in all medical records.Last month the Professional Record Standards Body (PRSB), which advises health providers on what information should be recorded and shared by staff, revised its requirements on sex and gender. This change is designed to ensure that the sex of patients is clear in all records, including data held by GPs, hospital records such as eDischarge summaries, and social care documentation.1In an accompanying note the PRSB said that the previous system carried “major” risks for patients.2 It said that because some records may record only gender and may not record sex at birth - or may record it incorrectly - there was a risk that sex would be misinterpreted in clinical practice.While recognising the likelihood of this as low, it said that the risk carried the potential to cause “severe harm” if patients were sent or not sent for sex specific screening procedures.The PRSB's hazard log reads, “From a clinical perspective …

Lelia Duley was twice told to forget her ambitions in medicine. The first time was at her comprehensive school in Oxford, when a careers adviser suggested that because her “father wasn’t rich” she did not have the right background for medicine. The second time came years later when a senior colleague took her aside to inform her that obstetrics was, “of course, not a profession for women.”Duley was galvanised by both attempts to derail her ambition. She was driven by a quiet, fierce determination and went on to become one of the foremost obstetric trialists of the 20th century. Her work established a global gold standard for treating eclampsia, a condition that was said to kill a jumbo jet full of women and their babies each day.Before Duley’s pioneering studies there was no consensus on the best way to treat the condition. In the UK, doctors used diazepam; in the US, magnesium sulphate was favoured; and in other regions …

This time last year life had become a struggle for Ron Rigby, who was facing a growing number of health problems.

Thousands of former trans patients want to call a halt to their medical transition, but the NHS doesn’t offer them specialist care. Adele Waters asks what service the UK should offer this group of patients with complex needsMichael Kerr remembers the exact day he decided to detransition (discontinue his gender transition). The former nail technician from Glasgow stopped taking oestrogen, a medication he had first been prescribed more than four years previously.“It was 22 May 2025,” he recalls. “I’d been having doubts about continuing, and I was feeling overwhelmed, isolated, and unsupported. I phoned my sister and told her how I was feeling. She listened to me and then said, ‘What’s the harm with experimenting with being gay Michael again?’”The following month he informed his local gender clinic—Sandyford, run by NHS Greater Glasgow and Clyde.Kerr’s decision came after years of turmoil about his identity. Growing up, he says, he always felt uncomfortable with his body. But that feeling was magnified after he was raped in a toilet at a gay nightclub, aged 18. The violent assault triggered years of self-destructive behaviour, including cutting himself and using alcohol and illicit drugs, as he tried to cope with feelings of self-disgust.“I felt that being trans was a way out,” he reflects. “It offered an explanation as to why I hated my body. It felt like an answer, one that would allow me to rewrite my story.”Kerr, 33, says that in the five years of attending the Sandyford clinic he saw a succession of different doctors, so there was little continuity in his care. He was also disappointed by the lack of psychological support. When he told staff that he continued to have gender dysphoria despite taking hormones and developing breasts, he was told that …

Under 18s with gender incongruence or dysphoria should have NHS access to cross sex hormones, the BMA says.Currently, new NHS prescriptions for these drugs are not permitted for this age group, but they are available through private prescription.The BMA’s call to change this was made in a letter to NHS England regarding a consultation on stopping routine prescription of masculinising and feminising (MAF) hormones for children and adolescents with gender incongruence or dysphoria.1That consultation coincided with the publication of the NHS’s independent review in March, which found limited and weak evidence to support the use of the drugs in people under 18 years old.This review, in turn, was prompted by the landmark review for the NHS into gender identity services for children and young people by paediatrician Hilary Cass, published in April 2024.Signed by deputy chair of BMA Council, Emma …