Overview
- King’s College London received ethical and regulatory clearance for the Pathways Trial and Pathways Connect, with about 226–250 participants to be enrolled from early 2026.
- Participants under 16 who have started puberty and have a diagnosis of gender incongruence for more than two years will be randomized to immediate puberty suppression or a one-year delay, then followed for two years.
- The research will track potential risks and benefits including bone mineral density, fertility considerations, mental health, quality of life, and brain development using MRI and cognitive testing.
- Researchers say each participant’s care will be reviewed at the end of the trial and some may remain on puberty blockers if clinicians judge it clinically appropriate, during a period when routine NHS prescribing remains banned.
- Campaigners and some clinicians have raised ethical objections and threatened legal action, and initial results are not expected for around four years, with Scotland not participating on the same basis.