FOI 1557945 FC.pdf

Freedom of Information Team
Department of Health and Social Care
39 Victoria Street
London SW1H 0EU
www.gov.uk/dhsc

Finn Clark
By email to: xxxxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx
19 March 2025

Dear Finn,

Freedom of Information Request Reference FOI-1557945

Thank you for your request dated 17 December to the Department of Health and Social
Care (DHSC), a copy of which can be found in the accompanying annex.

Your request has been handled under the Freedom of Information Act 2000 (FOIA) and we
apologise for the long delay in replying.

We have separated elements of your request and wil  respond to them in turn.

Please note that, with regard to the wording in your request asking for all available
communications that show, we have interpreted this to mean ‘all available information that
shows’.

1) What the Health Secretary discussed with people with lived experience of gender
incongruence.

DHSC holds information relevant to your request.

The Secretary of State for Health and Social Care convened two meetings to discuss
LGBT+ issues, predominantly trans healthcare and the issue of puberty blockers for
children and young people experiencing gender incongruence.

2) How many families were consulted and what those families provided as evidence
for their lived experience
3) Who were the groups who represented families and service users and what
meeting minutes are available between these groups and the Health Secretary?

DHSC holds information relevant to your request.

The Secretary of State for Health and Social Care met with ten children and young people,
who were supported by six family members.

The following groups supported the children and young people, and their families, at those
meetings:
   •  Gendered Intelligence
•  LGBT Foundation
•  The Proud Trust

•  Transactual

Regarding your request for what those families provided as evidence for their lived
experience, family members at a meeting supplied the Secretary of State with a bundle of
documents. However, as some of this information is already in the public domain, we will,
under section 21 of the FOIA (information accessible to the applicant by other means),
refer you to the published source. These can be found at:

https://www.academia.edu/124722434/Children of Omelas Ef ects of the UK Puberty
Blocker Ban

https://www.nature.com/articles/s41562-024-01979-5

DHSC is withholding the remaining material from the above-referenced bundle of
documents, and the minutes from one of the meetings, under section 36 of FOIA.

Section 36 provides that information is exempt from disclosure if to do so would, or would
be likely to, prejudice the effective conduct of public affairs.

Section 36(2)(b)(i) and (ii) states that information is exempt if, in the opinion of a ‘qualified
person’ (in this case a Minister of the Crown), its disclosure would be likely to prejudice the
free and frank provision of advice or exchange of views for the purposes of deliberation.
We can confirm that in this case, the qualified person was the Minister for Patient Safety,
Women’s Health and Mental Health, Gil ian Merron.

Section 36 is a qualified exemption, and we are therefore required to consider whether the
public interest in disclosing the information outweighs the public interest in applying the
exemption.

DHSC recognises the general public interest in making this information available for the
sake of greater transparency and openness. It is essential, however, that ministers can
receive advice from third parties and ensure that third parties can be confident that they
wil  be able to share their views frankly and without fear of repercussions. Without that safe
space, which releasing these materials would be likely to undermine, a chil ing effect may
arise, negatively impacting ongoing policy development, as well as future policy
development. Therefore, we consider that these interests outweigh the public interest in
disclosure in this particular case.

Additionally, DHSC is withholding minutes relating to a different meeting under section 41
of the FOIA. Under section 41, a public authority is not obliged to disclose information that
was provided to the public authority in confidence.

4) What evidence was used to determine puberty blockers were safe for some
individuals, but not for others?

DHSC holds the information you have requested.

The decision to implement an indefinite order against the sale and supply of private
prescriptions of GnRH analogues (puberty blockers), for the purpose of gender dysphoria

and/or incongruence for those under the age of 18, whilst permitting use for other
indications (such as precocious puberty), was based on multiple strands of evidence:
  I.  The ‘Independent review of gender identity services for children and young people’
(the Cass Review), commissioned by NHS England (https://cass.independent-
review.uk/). Examples of evidence that informed this review include:
•  Systematic reviews by the University of York published in Archives of
Disease in Childhood: https://adc.bmj.com/pages/gender-identity-service-
series
•  Evidence reviews commissioned by NHS England by the National Institute
for Health and Care Excellence (NICE): https://cass.independent-
review.uk/nice-evidence-reviews/
•  Lived experience focus groups: https:/ cass.independent-
review.uk/contribute-to-the-review/lived-experience-focus-groups/

II.  Independent expert advice from the Commission on Human Medicines (CHM),
which be found at https://www.gov.uk/government/publications/chms-report-on-
proposed-changes-to-the-availability-of-puberty-
blockers#:~:text=On%2020%20August%202024%2C%20a,years%20for%20the%2
0purpose%20of.

III.  Responses to a targeted consultation to the ‘Proposed changes to the availability of
puberty blockers for under 18s’. Further information can be found at
https://www.gov.uk/government/consultations/proposed-changes-to-the-availability-
of-puberty-blockers-for-under-18s/outcome/governments-response-to-the-targeted-
consultation-on-proposed-changes-to-the-availability-of-puberty-blockers.

IV.  As outlined above, the Secretary of State also participated in in-person discussions
with children and young people, and their families, who had lived experience of
gender dysphoria and/or incongruence.

5) What percentage of those consulted disagreed with the ban of puberty blockers
for trans youth and who did Wes Streeting consult with about disregarding the
majority of consultation responses?

DHSC holds the information you have requested.

The Secretary of State consulted CHM
(https:/ www.gov.uk/government/organisations/commission-on-human-medicines) on the
changes to the availability of puberty blockers.

Information held by DHSC on the percentage of those consulted who opposed the
permanent order is in the public domain. We will, therefore, under section 21 of the FOIA
(information reasonably accessible to the applicant by other means), refer you to the
published source: https://www.gov.uk/government/consultations/proposed-changes-to-the-
availability-of-puberty-blockers-for-under-18s/outcome/governments-response-to-the-
targeted-consultation-on-proposed-changes-to-the-availability-of-puberty-blockers.

6) All communications Wes Streeting had with the trans groups or community
members.

DHSC holds information relevant to your request.

Please see the attached documents.

Please note that some of this information has been redacted under section 35(1)(d) and
section 40(2) of the FOIA.

Section 40(2) of the FOIA provides for the protection of personal information. Section 40
prohibits a public body from disclosing personally identifiable information, as doing so
would contravene data protection principles.

Section 35(1)(d) of the FOIA provides protection for information relating to the operation of
a ministerial private office.

Section 35 is a qualified exemption and requires consideration of the public interest test.

DHSC recognises that there is a public interest in understanding how an office of state
operates, and that disclosure leads to greater transparency in government. However, there
is also a public interest in ministers being able to rely on their support staff, and revealing
the methods and processes of private office might cause a distraction and disrupt its
operation. In order to be confident in the independence of the private office support staff,
they must be sure that they are not allowing external considerations, such as the possible
public perception of their processes, to affect their judgement in administering the private
office. Taking this into account, we consider that the balance of public interest favours
withholding this information.

If you are not satisfied with the handling of your request, you can request we undertake an
internal review. If doing so, it would be helpful for you to be explicit which areas of the
Freedom of Information response you consider dissatisfactory. Complaints to us should be
sent to xxxxxxxxxxxxxxxxxxxx@xxxx.xxx.xx or to the address at the top of this letter and be
submit ed within 40 working days of the date of this letter.

Please remember to quote the reference number above in any future communication.

If you are not content with the outcome of your internal review, you may complain directly
to the Information Commissioner’s Office (ICO). Generally, the ICO cannot make a
decision unless you have already complained to us about our original response and
received our response to your complaint and, if applicable, our internal review decision.
You should raise your concerns with the ICO within six weeks of your last substantive
contact with us.

Guidance on contacting the ICO can be found at https://ico.org.uk/global/contact-us and
information about making a complaint can be found at https:/ ico.org.uk/make-a-complaint.

Yours sincerely,

Freedom of Information Team
xxxxxxxxxxxxxxxxxxxx@xxxx.xxx.xx

Annex

From: Finn Clark <xxxxxxxxxxxxxxxxxxxxxxxx@xxxxxxxxxxxxxx.xxx>
Sent: Tuesday, December 17, 2024 5:34 PM
To: FreedomofInformation <xxxxxxxxxxxxxxxxxxxx@xxxx.xxx.xx>
Subject: Freedom of Information request - Puberty blocker ban evidence

Dear Department of Health and Social Care,

The Health Secretary, Wes Streeting, banned the use of puberty blockers following a
consultation which the government claims did the following:

"The consultation engaged widely, including groups that represent the LGBT+ community
and those representing patients and service users and their families, clinicians,
pharmacists, charities, regulators and experts.

The Health and Social Care Secretary, Wes Streeting, has also personally engaged with a
range of stakeholders on this issue, including with children and young people, and their
families, with lived experience of gender incongruence.

This government wil continue to engage with, and listen to, the trans community."

I would like all available communications that show:

1) What the Health Secretary discussed with people with lived experience of gender
incongruence.

2) How many families were consulted and what those families provided as evidence for
their lived experience.

3) Who were the groups who represented families and service users and what meeting
minutes are available between these groups and the Health Secretary?

4) What evidence was used to determine puberty blockers were safe for some individuals,
but not for others?

5) What percentage of those consulted disagreed with the ban of puberty blockers for
trans youth and who did Wes Streeting consult with about disregarding the majority of
consultation responses?

6) Al communications Wes Streeting had with the trans groups or community members.

Yours faithfully,

Finn Clark