Exclusive: Mike Nesbitt pauses Northern Ireland's involvement in controversial UK puberty blocker trial

The Ulster Unionist Party minister confirmed the major policy shift in a statement to this newspaper – just days after a review by Baroness Cass welcomed the work the Department of Health had undertaken so far to prepare for participation in the scheme.

New party leader Jon Burrows has previously publicly opposed medical or pharmaceutical interventions on children, but had also said Northern Ireland’s transgender services should be in line with the 2024 national Cass Review findings.

In a statement, Mr Nesbitt said: “Having taken account of the ongoing Judicial Review into the UK Government’s clinical trial of puberty blockers, I have decided to suspend Northern Ireland's agreement to participate in the UK wide trial until the legal process has concluded.

“Should the trial ultimately be given the green light to proceed, I shall take the views of Executive colleagues before any potential lifting of the pause.”

A review of Northern Ireland’s transgender service reported this week that the local health service is making “rigorous and demanding” changes to meet minister Nesbitt’s previous commitment to be part of the scheme.

It would have seen local children take part in tests to establish the effectiveness of the hormone-blockers on dealing with gender distress in children.

The drugs block normal physical development, and their use has been backed by Sinn Fein, Alliance and the SDLP in the past – and described as “gender affirming care”.

A UK-wide review into gender medicine resulted in a ban on their routine prescription amid safety concerns.

The local review by Dr Hilary Cass this week highlighted safeguarding concerns – including “parental motivations” – which may drive social transitions of children “inappropriately”, requiring “careful assessment”.

The Ulster Unionist Party had this week backed Mr Nesbitt on the issue – saying he faced a choice between “a very, very small number of local people participating in the UK trial” – and being unable to secure an indefinite ban on prescription of the drugs, which he introduced in 2024.

The local Cass Review found that the NI lifespan service introduced under Mike Nesbitt has “some distinct advantages” over English equivalents – such as an existing link with CAMHS services, which was described as “an important benefit of the NI service”.

Baroness Cass found that children in Northern Ireland benefit from these arrangements, which contrast with historical arrangements in England, where direct GP referrals “created an undifferentiated caseload of young people with complex presentations”.

Her report also also gave detail on the demographics of children presenting to the health service with gender issues.

Many of the children have a history of trauma and bullying and many are “known to ASD [Autism Spectrum Disorder] services”.

They are commonly presenting at 12-13 years old, are more commonly girls, who are often same sex attracted.

There were also “instances of children presenting from the same school and class”.

On his first day as an MLA, the party’s new leader Jon Burrows made clear that he did not support pharmaceutical or medical interventions in children.

Asked in August about a row over Mr Nesbitt funding a gender service with no lower age limit on referrals, Mr Burrows told the News Letter: “I think there needs to be real clarity as to what the service entails, what the boundaries are for it. We need to know more about the nuts and bolts of it, and ensure that everything we do is consistent with the Cass review findings.

“I think that’s critical, and we cannot relax the position that medical interventions for children are entirely inappropriate, certainly pharmaceutical ones,” he said.

In December, the party’s health spokesperson rowed back from comments in which he said he was “fully supportive” of a campaign against the trial.

Alan Chambers later said that while he is “uncomfortable with elements of the clinical trial” – it was a recommendation of the 2024 Cass Review of NHS gender identity services, which his party “fully supported”.

The policy change comes after growing unease within the party about the puberty blockers trial. Before Mr Nesbitt had made his decision, Upper Bann MLA Doug Beattie had told the News Letter that he remained “concerned about any interventions with pre-pubescent children who are questioning their gender identity”.

He said that “putting children onto a potentially harmful trial is not something I can personally support.

“I also accept there are more knowledgeable people on this issue than me, including clinicians, so in many ways my position is from a conscience standpoint.

“That said, why can any trial not use those who have already been subjected to puberty blockers before the ban being examined to see what physical and psychological effect they have had on them; therefore protecting our children?”